SOUTH AFRICA: Second helping of ARVs no longer an issue
Photo: IRIN  |
| New initiative brings cheaper second-line ARVs within reach of HIV-positive people |
JOHANNESBURG, 9 May 2007 (PlusNews) - Access to second-line antiretroviral (ARV) therapy in developing countries could become more widely available after former US president Bill Clinton unveiled a new venture earlier this week.
Clinton told a press conference in New York on Tuesday that deals to provide low-cost ARVs to 66 countries in Africa, Asia, Latin America and the Caribbean had been clinched with two Indian generic drug companies.
The move, which could help HIV-positive people who naturally develop resistance to first-line drugs, or experience complications when taking them, has been widely welcomed in South Africa, where growing numbers of patients need to switch to newer and more advanced anti-AIDS drugs.
Medicins Sans Frontieres (MSF), the international medical relief agency, estimated that at least 20 percent of all patients accessing ARVs needed to switch to second-line drugs around five years after starting first-line treatment, as the HI virus mutates and becomes resistant to the first-line medication.
MSF has been pivotal in providing ARVs since it began rolling out the medication free of charge in 2001, in Khayelitsha, a township near Cape Town.
Marta Darder, who coordinates access to essential medicines at MSF, told IRIN/PlusNews that the Clinton Foundation initiative was also "a timely intervention" when considering the cost of second-line ARVs available from the government programme.
"Take Kaletra, for instance. It is an important component of South Africa's second-line regimen but costs the government up to R525 (US$77) per patient per month, whereas first-line [drugs] only cost R100 ($16) per patient per month," she pointed out.
Apart from its exorbitant cost, Kaletra was also unstable when exposed to heat and needed constant refrigeration, an unrealistic request in resource-limited settings, where erratic electricity supply was often an everyday occurrence.
After negotiations with Matrix Laboratories and Cipla, the Indian generic drug manufacturers, the Clinton Foundation would also introduce two more drugs with the same benefits as Kaletra, to create the necessary competition to bring prices down. The sole manufacturer of Kaletra, international drug giant Abott Laboratories, has enjoyed a monopoly until now.
"We welcome Clinton's move, especially at a time when the nation's drug rollout programme is set to kick into overdrive," said Dr David Kalombo, national manager of the Comprehensive Plan on HIV and AIDS Care, Management and Treatment, the South African government's anti-AIDS programme.
By the end of 2007 some 120,000 people are expected to be added to the more than 300,000 people already obtaining ARVs from the private and public sectors.
Doctor Francois Venter, an HIV specialist with the University of Witwatersrand's Reproductive Health and HIV Research Unit, stressed the urgency of reasonably priced and readily available second-line regimens.
"In addition to the concerns around natural resistance for those patients who have been taking first-line drugs over prolonged periods, there is also the concern about those patients whose bodies might reject first-line treatment due to toxicity, or sometimes even develop lactic acidosis," he said.
Lactic acidosis is a rare and serious illness, caused when lactic acid is not eliminated from the body and instead builds up in the blood and cells, causing abdominal pains, nausea, vomiting and muscle weakness.
The illness is linked to nucleoside analogues, a class of drugs that prevent healthy cells from becoming infected with HIV, although the condition may occur more commonly with Stavudine, a medicine also used in first-line regimens.
"More people on first-line drugs ultimately might mean more people needing to switch to second-line therapies," Venter added.
During his drug deal announcement Clinton said nearly 500,000 HIV-positive people worldwide would need second-line drugs by 2010.
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Theme(s): (IRIN) Care/Treatment - PlusNews, (IRIN) HIV/AIDS (PlusNews), (IRIN) Prevention - PlusNews, (IRIN) PWAs/ASOs - PlusNews, (IRIN) Research - PlusNews
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[This report does not necessarily reflect the views of the United Nations] |
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