During the 2011 UN High Level Meeting on AIDS, I had the opportunity to attend two side events. This year, the Meeting focused on universal access to treatment. Although older persons attended both meetings, older people were not specifically mentioned. I had assumed that with the talk of universal access, all people infected by HIV/AIDS would be taken into account and that the topics and information would apply to older persons as well.
On June 7, I attended a meeting organized by Médecins Sans Frontières and the African Union. The topic of this event was “HIV Treatment: Reducing deaths, illness, and HIV infections while keeping costs down.” Some numbers came up frequently: 6.5 million people currently get antiretroviral therapy (ART); nevertheless, 9 million other people living with HIV/AIDS have not access to ART. The panelists underscored the need to provide treatment to these people. First, treatment saves lives. People with AIDS live longer and in better health than they would without treatment. Second - and this may be the most important means to stop or at least control the epidemic- is that having HIV positive people under treatment reduces transmission and can help stop the spread of the epidemic. But once you say that, another striking number is mentioned. Between 2011 and 2020, indeed, 12.2 million new people are expected to be infected. So the question comes up about how to treat all infected persons. Who will pay for the drugs? How can poor people afford drugs that are still expensive? Two panelists mentioned the role of government. For instance, the South African government recently decided to put all people living with HIV on treatment. Brazil, since its 1996 law has defined health as a right, now provides medication to everyone who needs it.
But the major challenge concerns the price of drugs. While pharmaceutical industries benefit from patents, the most effective way to decrease drugs’ prices is generic drugs competition. Unfortunately, this competition is challenged by developed countries that want to assure conformity with the TRIPS (agreement in the World Trade Organization on intellectual properties). So is there were we stand? Expensive drugs because of patent protections and actual funding cuts in AIDS programs since 2009? What should have precedence? Health or Profits?
I attended a second session on June 8 titled, “Faith-based Action to Achieve Universal Access.” Here the panelist described funding cutbacks, but the emphasis was more on mothers and children living with HIV. In some African countries faith based organizations provide support of up to 70% of the HIV positive population. For them, budget cuts mean more difficulty to access drugs, scarce nutritional support, and no access to ART for new patients. As traditional funding decreases, it is necessary to develop new ideas for revenue resources, such as the Air ticket tax implemented by UNITAID. Panelists also mentioned the need to develop better combinations of drugs, especially for children. But this idea can be extended to adults and older people as simpler and fixed-dose drug combinations help decrease the prices. In addition, a lower price will likely increase the demand as more countries and/or organizations can afford to purchase the drugs. Increased demand is likely to attract more pharmaceutical industries competing and eventually lowering prices.
To conclude, I would like to say that according to what I heard, universal access can be achieved. Dr. Bernhard Schwartlender, a UNAIDS worker said this was financially and technically possible. Of course, funding at the level of $22 billion annually by 2015 is needed too. I tend to agree with Dr. Bernhard Schwartlender: “[Fighting AIDS] is not a question of paying now or later; it’s a question of paying now or forever”. So what are we waiting for?
- Aude Feltz