Abstract Book Vol. 2 [International Conference on AIDS (14th: 2002: Barcelona, Spain)]

XIV International AIDS Conference

Abstracts WePeF6671-WePeF6674 253

Presenting author: Fode Bangaly Magassouba, 1-Centre National de
Recherche et de Valorisationde Plantes Medicinales de Dubreka, Guinee, BP:
6411, Dubreka, Guinea, E-mail: [email protected]
WePeF6671 I Shared burdens, shared responsibilities: a
partnership framework for HIV treatment
accessibility
I.K. Nadchatram. Malaysian AIDS Foundation, Malaysian AIDS Foundation, No.
12, The Boulevard Shop Office, Jalan 13/48A, off Jalan Sentul, 51000 Kuala
Lumpur, Malaysia
Issue: Though "Highly Active Antiretroviral Therapy" (HAART) has many benefits, most People Living with HIV/AIDS (PLWHAs) in developing countries find the
costs of antiretroviral medications (ARVs) too high thereby depriving themselves
of treatment that will improve their quality of life.
Descriptions: The Drug Assistance Scheme, initiated in 1998 by the Malaysian
AIDS Foundation (MAF), makes HAART accessible to PLWHAs via a partnership framework with the Government, Private Sector and PLWHAs themselves.
Through the Government's policy of providing one ARV free, the MAF sponsors
selected PLWHAs on the most expensive ARV and viral load tests per year of
sponsorship should the PLWHA agree to source for the third ARV in the combination.
According to data collected, Scheme recipients are able to finance their third ARV
although all of them have access to incomes of below US$ 500 per month. Most
feel that the Scheme has helped make HAART affordable as 75% of the cost is
sponsored.
Lessons learned: Implementing this Scheme has given us more opportunities to
advocate on the issue of HIV treatments including those relating to its accessibility
and affordability.
The Scheme provides us a platform to initiate discussions with the pharmaceutical industry. Data collected from the Scheme assisted us in negotiations with
pharmaceutical and diagnostic companies, several of whom reduced the prices of
their ARVs and testing agents so that the Scheme could benefit more people. The
Scheme has enabled the MAF to create a network for doctors treating PLWHAs
in Malaysia so that they are kept abreast with developments in HIV treatment.
As a result of the successes of this Scheme, it was also suggested as a possible
model that businesses can use in making HAART accessible to their employees.
Since its initiation three years ago, the Scheme has increased its number of recipients by more than 100%.
Presenting author: Indra Kumari Nadchatram, Malaysian AIDS Foundation, No.
12, The Boulevard Shop Office, Jalan 13/48A, off Jalan Sentul, 51000 Kuala
Lumpur, Malaysia, Tel.: [phone], Fax: [phone], E-mail: indra
@mac.org.my
WePeF66721 Donor AIDS medicines to developing nations in
the absense of the global fund
J. Aquis1, H. Binswanger2, L. Francis3, M. Kattana4, A. Marty-Lavauzelle5,
J. Perez MD6, J. Landau7. 'Aid for AIDS, New York, United States; 2AIDSETI,
World Bank, Washington, D.C., United States; 3The Centre, Harare, Zimbabwe;
4Health Rights Action Group, Kampala, Uganda; 5AIDES, Paris, France;
6/nstituto Pedro Kouri, Havana, Cuba; 7Basic Sciences Planning Committee and
AIDS Treatment Access - Cuba, 119 del Rio, Santa Fe, New Mexico, 87501,
United States
Issues: In the absense of a fully implemented Global Fund, AIDS Donor Medical
Programs are often the most readily accessible means of providing treatment to
PLWA's in Developing Nations.
Description: Organizations in North America and Europe have made great
strides in recent years, in procuring and delivering sustained AIDS treatment to
PLWA's in Developing Nations.
Organizations in Africa, Asia, South America, and the Caribbean have also made
great strides in developing linkeages and accesses for AIDS-affected individuals
in their countries who might otherwise be denied acess to treatment, which in turn
deprives them of treatment choice and possibly life, itself.
Lessons learned: Partnerships must be developed between Donor and Recipient projects/nations in order to maximize the available of AIDS treatments among
persons in Developing Nations while an increased donor base must be identified
among clinics, funder, and pharmaceuticals in Europe and North America.
Recommendations: These programs recommend the continuation and expansion in developing nations of donor access treatment programs based in Europe
and North America until such time as the Global Fund fully addresses the disparities of cost of and access to AIDS treatments amidst the global pandemic.
Presenting author: Jeremy Landau, 119 del Rio, Santa Fe, New Mexico, 87501,
United States, Tel.: [phone]+1, E-mail: [email protected]

WePeF6673 Promoting prevention of mother to child
transmission of HIV through the
VIRAMUNE~Donation Programme: A model of
public-private partnership
M.H. Besson1, J. Wecker2, D. Ochola3, J. Ladner4, H. Coovadia5, J. Saba'.
1Axios, 7 Castlecourt Centre, Castleknock, Dublin 15, Ireland; 2 Boehringer
Ingelheim Gmbh, Ingelheim, Germany; 3Axios, Kampala, Uganda; 'University
Hospital, Rouen, France; 5Axios, Durban, South Africa
Background: In July 2000, Boehringer Ingelheim (BI) announced their commitment to donate VIRAMUNE~ free of charge to all developing countries for the
prevention of mother to child transmission of HIV (PMTCT). In order to provide
a significant and sustained benefit to a community, the drug donation must be
used in the context of a comprehensive PMTCT program. As a result, PMTCT
programs need to consider many programmatic and logistical issues in order to
effectively utilize the drug donation Axios is facilitating the dialog with PMTCT
programs.
Methods: A VDP administration center which includes an interactive website has
been established by Axios on behalf of Boehringer Ingelheim to provide relevant
information. Programmes interested in participating in the VDP have to provide
relevant information on the program and how the drug will be procured, stored
and used. When the form is completed and submitted to Axios, independent experts review it and comments are provided to the applicants in less than 4 weeks.
Once information is satisfactory, the program is recommended to BI for approval
then for processing the shipment of the drug.
Results: Until December 2001, a dialogue was established with 134 institutions
from 68 countries; 53 (40%) governments; 71 (53%) NGO and 10 (7%) private. 41
programs from 26 countries have completed the forms to participate in the VDP.
31 requests from 20 countries have been approved with a total quantity of drugs
to cover 66,200 mother-child pairs in the first year of the programs. 10 requests
are under review or required clarifications. Updated data will be presented.
Conclusions: The drug component represents only a small part of a comprehensive PMTCT programme. The VDP is helping to accelerate implementation
of such programmes. The coordination role of Axios is also improving access to
VIRAMUNE~ by facilitating the dialogue between BI and the programs, and by
fostering partnerships within the VDP.
Presenting author: Marie-Helene Besson, 7 Castlecourt Centre, Castleknock,
Dublin 15, Ireland, Tel.: [phone], Fax: [phone], E-mail: axios
@axiosint.com
WePeF6674 IDonated antiretrovirals in the management of HIV
disease in developing countries
M.C. Hosseinipour1, F Martinson2, J. Nyirenda2, S.E. Wilson', L. Bell1,
J.J. Eron', C.M. Van der Horst1, P. Kazembe3, I. Hoffman'. 'University of North
Carolina, Unc project, private bag a/104, Liongwe, United States; 2UNC Project,
Lilongwe, Malawi; 3 Lilongwe Central Hospital, Lillongwe, Malawi
Issues: The increasing demand for antiretroviral therapy in developing countries
has prompted innovative ways to deliver these potent medications to those in
need.
Description: Beginning in November of 1999, the UNC Project in Lilongwe
Malawi and the University of North Carolina Hospitals Infectious Disease Clinic
began a program whereby patient's unused antiretrovirals from the U.S. based
clinics were donated to the Malawi site. The program was directed to treat UNC
Project and Lilongwe Central Hospital employees or affiliates of these institutions.
Patients were eligible if their CD4 count was below 200 and a six month supply of
a 3 drug combination was available.
Lessons Learned: A total of nine patients were treated over this time period
representing 106 months of therapy. One patient had poor clinical response secondary to documented noncompliance and eventually expired secondary to pneumococcal meningitis. The remainder had marked immunologic and clinical improvement; Mean CD4 counts over 6 months increased by 122 cells and all patients are asymptomatic at present. The medication supply collected over this
time was adequate for substitutions secondary to toxicity, drug interactions and
virologic failure and 2 additional patients could have received 12 months of threedrug therapy if they sought treatment. A remaining 143 months worth of protease
inhibitors and NNRTI's were available but unused secondary to lack of the NRTI
backbone and patient demand.
Recommendations: Donated medications can effectively treat HIV infected individuals and can be sustained on a small scale. Collaborations between Western
clinics and developing world partners could serve to further such programs. If
patients, employers or government can sustain the NRTI backbone, the use of
donated medications for the third agent is a possibility to expand the number of
patients receiving HAART.
Presenting author: Mina Hosseinipour, Unc project, private bag a/104, Lilongwe,
Malawi, Tel.: [phone], Fax: [phone], E-mail: [email protected]