• Significant steps have been taken in the past 15 years to control the HIV/AIDS epidemic by preventing transmission and providing access to treatment. Government policy success factors include national plans, implemented through appropriate healthcare infrastructures. But women and children continue to face significant challenges in access to treatment.
• Both the generic and the bio-pharmaceutical industries have contributed to the affordability of antiretroviral drugs (ARVs); supported by an increasing trend in the use of voluntary licensing. Maintaining innovation will be crucial to meet United Nations (UN) targets.
• Data collection on the clinical and economic impact will be imperative in providing a continued rationale to tackle HIV/AIDS.

GENEVA--(BUSINESS WIRE)--A report by Charles River Associates (CRA) provides an analysis of the factors that impact access to HIV/AIDS treatments and the role of bio-pharmaceutical innovation in Low-and Middle-Income Countries (LICs and MICs) over the past 15 years. In the report, CRA looks at the implications in helping meet the UN’s goals to end the AIDS epidemic by 2030. The report focuses on six countries that have made progress in providing access to ARVs - Botswana, Brazil, China, India, Rwanda and South Africa - and identifies a number of success factors. These include dedicating resources and sustaining national disease awareness programmes, as well as having an appropriate healthcare infrastructure to ensure diagnosis, testing, access to medicines and keeping patients on a course of treatment. In reviewing an extensive body of literature and official documents, the report could not determine that intellectual property rights impacted access to HIV treatment and identifies an increasing trend in the use of voluntary licensing.

While significant steps have been taken since HIV/AIDS was recognised as a global health crisis, there is relatively little evidence on the value of innovation in emerging markets. This report, commissioned by the International Federation of Pharmaceutical Manufacturers and Associations (IFPMA), is intended to complement the body of knowledge on innovation and access as governments, the global health community and the private sector are engaged in efforts to meet the UN’s aim to ensure at least 90% of all people with HIV have access to ARVs by 2020 and end the AIDS epidemic by 2030.

The report highlights the role the generic and bio-pharmaceutical industries have and continue to play to address the epidemic by delivering value to patients in LICs and MICs. Access to ARVs has rapidly increased in LICs and MICs from 400,000 in 2003 to 13.6 million people by the end of 2014. To meet the 2020 and 2030 targets, it will be critical to pursue national strategies targeting population groups that still face significant challenges in access to treatment. For example, paediatric access to ARVs is particularly challenging in Brazil, China and India due to the lack of paediatric specialists and the lack of paediatric formulations.

There is also recognition of challenges in accessing ARVs in rural areas such as the Amazon. But while such variation in access to ARVs remain, improvements in access have been registered. For example, in India, the average travel distance for a patient in rural settings to access ARV reduced from 70km to 30km since 2007.

Generic manufacturers, often through voluntary licensing, have been able to supply a large proportion of first line ARVs with generic alternatives in countries such as Rwanda and South Africa. Access to ARVs has also improved as innovative biopharmaceutical companies have increased access to their new medicines by introducing voluntary licensing and differential pricing, and working with partners on the ground. All countries in the report show that a reduction of the burden of HIV/AIDS is aligned with an improvement in access to ARVs. For example in India, the National Institute of Medical Statistics and the National AIDS Control Organization found that wider access to ARVs through the scale-up of free ARVs since 2004 has saved 150,000 lives by 2012. Over the next five years, around 50,000 to 60,000 deaths will be averted annually.

Looking ahead, the report recommends both the generic and bio-pharmaceutical companies continue with their roles to improve access to HIV medicines, and ensure continued investment for the development of new HIV therapies. Data collection on the clinical and economic impact of HIV/AIDS treatment are imperative to provide a continued rationale for investments to tackle this burden. According to Mr. Wilsdon, “ensuring access to innovative antiretrovirals will continue to be important in the future. In addition to clinical and therapeutic benefits, their introduction brings socio-economic benefits by reducing healthcare costs such as hospitalisations, adding to economic productivity and improving the patient’s quality of life”. However, he adds that “substantial progress is still needed to achieve the UNAIDS target to treat 90% of all people diagnosed with HIV by 2020”.

The report outlines how the actions of many stakeholders increased access to HIV/AIDS treatment. Non-governmental organizations have encouraged policymakers to prioritise action, international organisations provided funding, expertise and facilitated collaboration between companies, national policymakers recognised the problem and prioritised the building of healthcare infrastructure, and the bio-pharmaceutical and generic industries played a vital role in researching, developing, manufacturing and distributing medicines.

“In addition to addressing HIV, these efforts have contributed to combatting other diseases and provided important policy lessons regarding the development of Universal Health Coverage by taking a holistic approach to innovation and access that acknowledge the conditions that encourage further R&D” explains Eduardo Pisani, Director General of the IFPMA. He adds: “to this end, the policy implications in this report have relevance beyond access to HIV/AIDS treatment”.

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IFPMA represents the research-based pharmaceutical companies and associations across the globe. Based in Geneva, IFPMA has official relations with the United Nations and contributes industry expertise to help the global health community find solutions that improve global health.

Contacts

IFPMA
Mario Ottiglio
Tel: +41-22-338-32-11, +41-79-538-86-24
Director, Public Affairs, Communications & Global Health Policy
Email: m.ottiglio@ifpma.org