WHO Provides HIV Drug Advice to Developing World -- HIV/AIDS INFO AND UPDATES

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Date Posted: 12:35:49 05/16/02 Thu
Author: Anonymous
Subject: WHO Provides HIV Drug Advice to Developing World

http://www.medscape.com/viewarticle/432311_print

WHO Provides HIV Drug Advice to Developing World

Reuters Health Information 2002. � 2002 Reuters Ltd
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Introduction
LONDON (Reuters Health) Apr 22 - The World Health Organization for the first time on Monday issued guidelines designed to encourage developing countries to provide effective drug treatments for HIV infection.

Until recently, the high cost of antiretroviral drugs has put them beyond the reach of African countries.

But the life-extending medicines are coming within reach of more nations thanks to treatment access campaigns, cut-price generic competition and international funding, such as the UN's Global Fund, which announced its first round of spending on Monday, WHO officials told Reuters Health.

"This is the first time we have issued treatment guidelines on the use of antiretroviral drugs for the treatment of HIV infection in developing countries," Dr. Bernard Schwartzlande, director of WHO's HIV/AIDS programme, told Reuters Health.

"This is actually quite timely. The fact that we now have prices that are increasingly reachable by many health systems has made it a burning issue for us to set out guidelines."

Although just 5% of about 6 million people living with HIV/AIDS who need access to antiretroviral treatment are currently receiving these medicines, WHO says that by 2005 at least 3 million should be able to get medicines.

The agency guidelines propose a standardized and simplified combination of antiretrovirals.

"I think it is very important to identify what is rational [in terms of treatment]," Dr. Joseph Perriens, Director for Care in WHO's HIV/AIDS department, told Reuters Health.

"In developing countries it is not always possible to sift through all the combinations available. If you're in a country and looking at all these drugs and wondering 'What am I going to recommend as a first-line treatment,' it helps to have this list available."

The recommendations offer several choices of regimens that governments and others running HIV treatment campaigns can choose, depending on the cost and availability of drugs in their particular country.

They include several medicines with multiple drugs in a single pill.

"There is a strong case for more use of single-pill combinations," said Dr. Jonathan Quick from WHO's essential medicine programme. These pills make HIV medications less complicated to take, and reduce the risk of drug interactions, he said.

WHO has also for the first time added antiretroviral drugs to its Essential Medicines List, which provides countries with an example of the drugs that they ought to make available.

The Essential Medicines List now includes abacavir, didanosine, efavirenz, indinavir, lamivudine, lopinavir, nelfinavir, ritonavir (low-dose), saquinavir, and stavudine.

It also recommends nevirapine and zidovudine, previously listed for prevention of mother-to-child transmission, for treatment of HIV in adults and children.

"The goal is to provide clear and scientific advice to government policy advisors that these drugs work," Dr. Quick said.

"The experience since the first list was drawn up in 1977 is [also] that they tend to force prices down and improve quality assurance. When you have a set of promoted medicines, it tends to focus demand."

"The antiretroviral treatment guidelines developed by WHO will greatly assist governments and national AIDS programmes in providing people living with HIV/AIDS with greater access to these life-saving medicines," Dr. Peter Piot, UNAIDS Executive Director, said.

"The long-sought inclusion of antiretrovirals in WHO's Essential Medicines List will encourage governments in hard-hit countries to further expand the distribution of these vital drugs to those who need them."

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