UNAIDS HIV Drug Access Initiative: Providing Wider Access to HIV-related Drugs in Developing Countries, Pilot Phase

As might be expected, the influence and effectiveness of the advisory board
has been related to the personal power and knowledge of the members and
the role of the advisory board in decision making was also proportional to the
number and frequency of meetings. While the start up phase (months 0-6) did
require a large number of meetings, the board will only need to meet every 3 -6 months in the subsequent period.
Negotiating with Pharmaceutical Companies
Pharmaceutical companies are large multinational bodies with differing
decision-making processes. These vary considerably and working effectively
with these companies requires time and knowledge of each company's
culture.
One element that contributed to the success of the negotiations was the fact
that the pharmaceutical companies were approached with a very concrete
proposal (reduced ARV prices in return for increased volumes of sales). This
is particularly important when working in the area of public-private
collaboration. The principles and scopes of the collaboration should be clearly
stated in the form of concrete projects if we expect the private sector to
actively participate.
Implementing the Initiative - Approach and Personnel
A high degree of flexibility is crucial for the success of a pilot endeavour such
as the Initiative. If-the Initiative's original design no longer reflects the local
reality, it must be changed to accommodate the new situation. In Uganda, for
instance, ARVs are now being sent to individuals from abroad. These clients
are encouraged to bring their drugs to treatment centres under the Initiative
for clinical monitoring and counselling.
A multidisciplinary approach including clinical, pharmacological, commercial,
logistical and social science perspectives is essential to designing a viable
and flexible approach not only for ARVs and expensive drugs, but also for
essential drugs including treatments for Ols. A diverse project team is
necessary for the implementation of the Initiative or any other project on
access to drugs, so that the coordinator can have up to date information on
drug prices, patient compliance and perception of quality of treatment, and
epidemiological trends.
Procurement and Supply of Drugs and the Non-Profit Organization
In the Initiative model, the NPC was designed to:
* Channel the companies' subsidies and donations which contribute to price

reduction. The sales prices from the NPC are therefore lower than the
open market prices.

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