Report on the Global HIV/AIDS epidemic

Report on the global HIV/AIDS epidemic - June 2000

important older drugs were rarely on offer. Working with WHO and UNICEF, the
Secretariat identified manufacturers and prices for 44 essential drugs whose procurement was being hampered by insufficient information on cost and availability.
This information has been posted on the UNAIDS, UNICEF and WHO websites along
with an offer to assist countries in locating generic drug suppliers and organizing
drug procurement. Information of this kind is also used to help convince planners
that it is feasible to include HIV care and support in national strategic plans on
H IV/AIDS.
Strategies for cost and price reduction
One of the lessons learnt from the UNAIDS Drug Access Initiative in Cote d'lvoire
and Uganda (see Box 19, page 103) is that, with determination and good will, it is
possible to negotiate a significant reduction in drug prices and improve the delivery
of health care. End-user prices of antiretroviral drugs in both Cote d'lvoire and
Uganda decreased after negotiation with the pharmaceutical companies holding the
patents on those drugs. The companies that participated in the initiative either
donated a percentage of the drugs or agreed to sell them at a reduced price. Similar
decreases in drug prices were achieved through a national drug access initiative
conducted in Senegal.
Price reductions can be achieved through avenues other than negotiation with
patent holders. One strategy is to produce or import generic alternatives to proprietary drugs. UNAIDS' analysis of the patent situation of HIV-related drugs with WHO
and UNICEF has shown that most proprietary drugs used in the treatment of people
with HIV are not patent-protected in the majority of developing countries.
Table 2 shows the prices of proprietary antiretrovirals in the USA, Cote d'lvoire and
Uganda, and some generic equivalents in Brazil and Thailand. The lower price of
generic products is partly explained by the lack, or low level, of investment in
9research and development by the manufacturers.

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