Report on the Global HIV/AIDS epidemic

Report on the global HIV/AIDS epidemic - June 2000
Government subsidizes the cost of antiretroviral drugs for patients enrolled in clinical trials in a few centres of excellence, but this currently ensures access for only
around 2000 of the approximately 70 000 new AIDS cases occurring annually.
A few projects in sub-Saharan Africa aim to promote the rational use of treatment for
people with HIV, including antiretrovirals (see Box 19, page 103). Even within the
projects it has repeatedly been problematic for patients with opportunistic infections
to have access to the essential drugs they need. Outside these projects, antiretrovi1 rals can only be purchased from a poorly regulated private sector where concerns
about inefficiency and the potential for counterfeit loom large.
- There are some Latin American and Caribbean countries where even treatment for
opportunistic infections is problematic. However, other countries in the region have
responded to demands from groups of patients, doctors and human rights organizations and now lead the developing world in providing access to antiretrovirals.
Argentina, Brazil, Colombia, Costa Rica and Uruguay provide a legal right to some
form of antiretroviral therapy, though the application of the law is somewhat patchy.
S Coverage of eligible patients has been reported to be 100% in Brazil, 70% in
Argentina, 65% in Chile and Uruguay, 40% in Panama and 20% in Ecuador. Some
S countries operate with a lottery system or limit antiretroviral drug access to those
with social security or private health insurance. Experience in Brazil shows that the
costs of such therapy, although high, are offset to some extent by savings on treatment for opportunistic infections and on hospital stays (see Box 18, page 101).
Nevertheless, some concern has been voiced over the risk that HIV prevention activities may suffer if too much effort and money is devoted to providing treatment.
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