Onus on governments to organise ARV procurement - MSF

Governments must urgently develop procurement strategies to supply people living with HIV/AIDS with low-cost antiretroviral medicines (ARVs), Medecins Sans Frontieres (MSF) said on Monday. "The need to get effective medical treatment to people living with HIV/AIDS in developing countries has never been more urgent and will only grow in the coming years," MSF said in a joint report with the World Health Organisation, titled "Surmounting Challenges: Procurement of Antiretroviral Medicines in Low-and Middle-Income Countries". As the price of ARVs continues to fall and governments have the legal right to import or make affordable generic drugs, they must put in place systems and infrastructure - detailing procurement, supply chains, transport, training for health professionals and essential monitoring of people taking ARVs - to accelerate their distribution, MSF delegates told reporters in Nairobi at the launch of the draft report. The price of ARVs - necessary to decrease levels of the HIV virus in the body - has fallen dramatically from between US $10,000 and US $15,000 per year in 2000 to about US $300 per year in 2003. Yet in Sub-Saharan Africa only one percent of the 4 million people in need of the drugs can access them. Supplying ARVs to people was often more challenging than other essential medicines, MSF/WHO reported, as the drugs were expensive, stock management was essential to avoid disruption of treatment, and systems had to respond quickly to evolving treatment regimes. The easiest, most effective procurement strategies were either having a strong public procurement agency in place (as in Cameroon), local manufacturers producing the drugs (in Thailand) or dynamic private sector distributors (in Malawi), the report found. The price of ARVs in Malawi ranked among the lowest in the world, at US $288 per person per year, because the government had registered generic ARVs, developed a national treatment plan that included ARV treatment, and allowed intense competition among several procurers of the drugs, MSF/WHO reported. Kenya, on the other hand, had no national plan in place governing public sector procurement, despite the fact that at least 250,000 people were in urgent need of ARVs. WHO has confirmed a target of providing three million people with ARV therapy by the end of 2005, but without the necessary structures in place in many countries where they are needed, activists wonder how it will be achieved. Compounding this, levels of ignorance about ARVS and their health benefits remain high in some countries, keeping the numbers trying to access them relatively low.