© Brendan Bannon
Looking back upon the first decade of AIDS treatment in developing countries shows key successes. Four million people on treatment are alive today, many of whom would have died without ARVs long ago. The case has thus been proven that AIDS treatment is entirely feasible in resource-limited settings. However, with six out of ten people in need of treatment still not receiving it and with projections of up to 50 million people in need of treatment in roughly 20 years, it is clear that treatment scale up must occur at a faster pace.
At the same time, steps must be undertaken to ensure that people in developing countries are receiving the optimal monitoring and treatment that supports their long-term survival, comparable to their counterparts living with HIV/AIDS in wealthy countries. This means securing access to needed monitoring tools, while providing patients both with a robust first-line regimen that has few side effects, as well as ensuring there are treatment options for when patients show signs of drug resistance and need to switch to a second- or third-line combination.
Although prices for certain key newer medicines have come down significantly because of competition among generic manufacturers and increased demand, overall prices for newer drugs remain unaffordable for developing countries and out of reach of national treatment programmes.
Countries must be supported in their use of flexibilities in international trade rules to help bring prices of newer drugs down more systematically and speedily, so that the growing number of people in need of newer and more potent drugs has immediate access once they require them. Pharmaceutical companies must be urged to participate in the patent pool being designed by UNITAID, so that needed formulations can be made available to developing countries more swiftly and at much more affordable prices.
HIV/AIDS must continue to be treated as the emergency it is. Funding levels must be increased to take on the massive task of providing sustained AIDS treatment in developing countries. New financing mechanisms, such as financial transaction taxes including currency transaction levies, should be introduced to help raise much needed additional sustainable and predictable resources, part of which must be dedicated to global health. The worrying trend of treatment providers needing to scale back ART at a time when they should be scaling up must be countered with sustained and reaffirmed commitment by leaders and donors to universal access to HIV/AIDS treatment.