AIDS drugs can dramatically increase survival for patients in poor countries but further drug price cuts are needed for patients who develop a resistance to the initial therapy, Medecins Sans Frontieres said on Monday.
The independent humanitarian relief organization treats 13,000 patients in 25 countries. It says patients receiving antiretroviral (ARV) drugs have an 85 percent chance of being alive two years later.
The majority of patients use first-line drugs and pharmaceutical companies have cut the prices of these by more than 90 percent because of political pressure. The cost of a fixed-dose combination treatment, consisting of one pill twice a day, is about $200 a year, MSF said.
But that cost jumps to $5,000 a year if a patient needs a new combination of ARV drugs, called second-line therapy, if they developed resistance, a growing problem in wealthy countries.
“Unless this situation changes, per patient costs will skyrocket and people will die needlessly,” Dr Alexandra Calmy, an HIV/AIDS advisor, told an international AIDS conference in the Thai capital, Bangkok.
Daniel Berman, of MSF Campaign for Access to Essential Medicines, echoed Calmy’s remarks, calling growing drug resistance and the high cost of second-line treatment a crisis.
Drug-resistance, when the treatment is no longer effective, has been a problem in wealthy countries where antiretrovirals have been available for several years.
Calmy said it was inevitable that sooner or later patients in poor countries would also become resistant to first-line ARVs. About two to five percent of patients receiving treatment from MSF need second-line therapy.
Little choice
But unlike developing countries there are few affordable, therapeutic choices.
There is also a need to develop second-line fixed-dose drug formulations that do not need to be refrigerated and can easily be administered in developing countries.
“We want to dramatically decrease the price of second-line therapy as we have done with first-line,” Calmy added.
Only about seven percent, or 440,000 people, of the six million who need treatment receive the life-saving drugs. The World Health Organization has launched an ambitious program to provide three million people with ARVs by the end of 2005.
Calmy said MSF had demonstrated that it was possible to treat large numbers of patients with the drugs in remote areas of poor countries.
About 55 percent of the MSF patients are women. All patients receive the treatment for free and get continuous support to ensure they adhere to the treatment. Most patients were in an advanced stage of AIDS when treatment began.
Women account for nearly 50 percent of people living with HIV/AIDS worldwide and 57 percent in sub-Sahara Africa. Young people, aged 15-29, are another vulnerable group.
In addition to price cuts for second-line drugs, MSF said better efforts were needed to prevent mother-to-child transmission of the virus. About 700,000 babies are infected by their mother each year through birth or breast feeding.
In developing countries there are also no fixed dose drug combinations or simple guidelines to treat children.
