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CDC HIV/AIDS/Viral Hepatitis/STD/TB Prevention News Update
AIDS Plan Would Cut Drug Costs for Poor
Shankar Vedantam
October 27, 2003
Washington Post (10.25.03) - Monday, October 27, 2003

The World Health Organization will soon disclose the first details of a global AIDS strategy to bring low-cost drugs to 3 million people in poor countries by the end of 2005. The plan, according to top officials, will eventually include endorsement of pills that combine three HIV drugs - lamivudine (3TC), stavudine (d4T) and nevirapine - into a single tablet.

Fixed-dose single-pill HIV medicines, health experts say, offer huge benefits by providing medication, effective for about 80 percent of patients, in an easy-to-use, low-cost form. Drawbacks include limited flexibility to adjust medications for side effects, complicated patent infringement issues, and that generic fixed-dose drugs have not been thoroughly tested and would make it easier to introduce counterfeit drugs onto the market.

If the combination pills prove popular and effective, the Bush administration could face a politically difficult choice between costly patented drugs and low-cost combination generics as it implements its five-year program to fight AIDS. Unlike current generic AIDS drugs that copy a single drug's formula, each of the new combination pills could infringe on several patents at once, taking the conflict of life-saving medicine vs. intellectual property rights to new levels.

The WHO strategy will also call for treating patients at the first sign of HIV symptoms, rather than waiting for test results, and for radically expanding access to the medicines.

"We will say, you don't need to get care only from doctors; let's train nurses, community organizations, and families. We're changing the paradigm of AIDS treatment," said Paulo Teixeira, director of WHO's HIV/AIDS Department.

The WHO strategy targets 2 million patients in Africa, with the rest scattered throughout Asia and Latin America. Despite its potential complications, Ellen 't Hoen, spokesperson for the Campaign for Access to Essential Medicines of Doctors Without Borders, said combination pills are essential to fight AIDS in poor countries. "WHO would have to say that this is the way to go," she remarked. "That implicitly says that patents shouldn't stand in the way."