Sixty-fifth General Assembly

High-Level Meeting on HIV/AIDS

Panel Discussion (AM)

Innovative HIV/AIDS Drugs, Treatments Must Be Urgently Developed, Made Readily

Available Worldwide to Those Who Need Them Most, Panel Told

 

Innovative drugs, diagnostics, vaccines and microbicides to treat HIV infection must be developed urgently and made readily available worldwide, particularly to sex workers, homosexual men, intravenous drug users and others who needed them most, participants said this morning during a panel discussion held in connection with this week’s United Nations high-level meeting on HIV/AIDS.

High-tech treatment breakthroughs, as well as low-tech prevention methods like male circumcision, had in a relatively short time turned HIV from a “death sentence” into a treatable, liveable illness, panel moderator and Financial Times journalist Andrew Jackson said at the outset of the discussion on “innovation and technology” to treat the disease.  The panel opened with a three-minute video that showed how such innovation could make a difference in people’s lives.

In opening remarks after the video’s conclusion, Ratu Epeli Nailatikau, President of Fiji and chair of the panel, said the trajectory of the global AIDS epidemic in the next 20 years would demand a major shift in investments, which if made properly, could avert some 12.2 million new infections and 7.4 million deaths between 2011 and 2020, according to data from the Joint United Nations Programme on HIV/AIDS (UNAIDS). 

The traditional market approach to treating HIV/AIDS since it was first discovered 30 years ago had been hugely successful for those living with the disease in the industrialized world, and notably for major pharmaceutical companies, but it had not worked for the world’s poorest nations, nor would it be adequate for the next phase of the AIDS response, he said.

While more than 6 million people living with HIV in low- and middle-income countries now had access to low-cost, life-saving antiretroviral therapy — a more than 20-fold increase over 2001 — another 9 million still could not obtain even older anti-retroviral medicines.

Now was the time to invest in innovation tailored to developing countries’ needs and health delivery systems and to create incentives that rewarded risks taken to develop low-cost, quality drugs, he said.  Strong partnerships among the public sector, non-profit organizations and generic drug manufacturers would be crucial in that endeavour. 

Dr. Margaret Chan, Director General of the World Health Organization (WHO), echoed those concerns.  “Innovation is important, but when innovation is not affordable and cannot reach the poor, we miss the point,” she said, lamenting that the international community still was not keeping pace with the devastating epidemic.  For each person who began antiretroviral treatment, another two became infected.

Creatively combining early diagnosis and treatment with innovative methods such as male circumcision, female condoms, prevention of mother-to-child transmission and education for high-risk groups, was crucial, she said, as was long-term investment in diagnostic research and creation of an HIV vaccine.  She lauded the Group of Eight’s (G-8) recent move to encourage patent holders to join the Medicines Patent Pool, which negotiated voluntary licenses from patent holders for use by product developers and generic drug manufacturers. 

But, more must be done to improve the medicine supply and delivery chain, eliminate procurement waste, make diagnostic testing less costly and onerous, and develop better, safer medicines that were effective against drug-resistant HIV, she said.  She called for greater public-private partnerships, similar to the International AIDS Vaccine Initiative and the International Partnership for Microbicides, to stimulate investment in research and development. 

Dr. Jose Angel Cordova Villalobos, Mexico’s Minister of Health, cited the merits of “Treatment 2.0”, a UNAIDS initiative aimed at simplifying HIV treatment to an easy-to-use pill and at-home monitoring, that would serve also as a prevention tool.  The initiative called for the development of better combination treatment regimes, cheaper and simplified diagnostic tools, and low-cost community-led healthcare delivery systems that would reduce the need for highly qualified doctors and expensive laboratories. 

“People taking medicines every day need a lot of motivation to continue,” he said, stressing the need to expand initiatives for low-cost daily care such as Treatment 2.0.  Mexico was doing its part through a federally funded nationwide health insurance scheme that would guarantee universal access to HIV treatment by 2021.  His Government already had set up mobile medical units in remote, rural areas to expand access to marginalized areas, as well as installed a system for purchasing medicines in bulk at low-cost. 

In addition to ensuring access to treatment, it was important to continue to promote the systematic use of condoms, which remained the most effective way to prevent HIV transmission, as well as to promote comprehensive sex education, he said.  It was not enough to eliminate new HIV infections and HIV-related deaths; HIV-related stigma, discrimination, homophobia, transphobia, gender-based violence, and violations of sexual and reproductive rights must also be erased.

Christoforos Mallouris, Programmes Director of the Cyprus-based Global Network of People Living with HIV, agreed.  “I should have access to treatment, irrespective of where I live, what sexual orientation I have, whether I’m taking drugs or engaged in sex work,” he said.  Mr. Mallouris said he and others living with the disease, particularly sex workers, homosexual men and intravenous drug users, must be involved in the search for and design and distribution of new treatment and prevention techniques, including microbicide gels and female condoms, so that their concerns were taken into account.

He worried about the ability of those groups to access new treatment when it became available in the face of laws that criminalized prostitution, homosexuality and drug use.  He also expressed concern over fragmented health care delivery systems that made treatment too costly and inaccessible for those groups, and over barriers to access caused by rigid protectionist policies set by the Trade-Related Aspects of Intellectual Property Rights (TRIPs) system of the World Trade Organization.

When the floor was opened to audience participation, a member of India’s parliament said while his Government did not oppose to the “TRIPS plus” obligations, more flexibility in TRIPS was needed to make medicines more readily available and affordable to those in need.  Indian pharmaceutical companies were doing their part, providing affordable, high quality drugs to 200 countries.

A speaker from Thailand noted his country’s technical cooperation with India’s pharmaceutical industry to produce less expensive and more readily available drugs for Thailand, and soon for neighbouring Lao People’s Democratic Republic, Cambodia and Myanmar to meet emergency needs.  He was optimistic that more patent holders in the region would negotiate voluntary licenses for product developers and generic drug manufacturers. 

A representative from the Bahamas echoed the concerns of other speakers that innovation was not enough.  An attitudinal change among older, rich men was necessary to ensure they respected and adhered to treatment and prevention methods. 

Representatives of Brazil, Malawi, Mozambique, Portugal, Indonesia, Swaziland, Nigeria, South Africa, Rwanda, Canada and Kenya also participated in the discussion.

Representatives of civil society organizations, including Knowledge Ecology International, the International AIDS Vaccine, and the Prevention and Justice Alliance, also spoke.

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For information media • not an official record