Community-based Antiretroviral Therapy Delivery. UNAIDS and Medecins sans Frontieres. (2015)

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This document presents experiences of how community-based antiretroviral therapy (ART) delivery can improve both the level of access to treatment and the quality of health outcomes for people living with HIV. These experiences illustrate that community-based ART delivery is efficient, effective and high quality.


Keywords: HIV, patient, clinical, treatment, testing, medication

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Annual Report 2013. UNITAID. (2014)

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UNITAID’s Strategy 2013-2016 guides the organization’s response to HIV/AIDS, malaria and TB. In total, these global epidemics kill almost 4 million people every year. Forward looking and flexible, UNITAID collects intelligence on product markets for these diseases in order to inform its investments, which are implemented by the world’s top development organizations.

 

Keywords: HIV/AIDS, TB, malaria, medicines, diagnostics, prevention

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The Trans-Pacific Partnership Agreement: Implications for Access to Medicines and Public Health. Bhardwaj K and Oh C. (2014)

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The objective of this report is to provide an analysis of the provisions in the proposed TPPA in order to obtain a clearer understanding of their implications. It is hoped that the report will also be a useful resource for other stakeholders in the public health field.

The report analyses the key negotiating issues in the USA’s proposals (widely considered to be the basic negotiation text for the TPPA) which are likely to have an impact on access to medicines and public health.


Keywords: HIV, health, access, medicines, financing, 

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Challenges and Potential Barriers to the Uptake of Antiretroviral-based Prevention in Asia and the Pacific Region. Lo YR, Kato M, Phanuphak N, et al (2014)

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Evidence has emerged over the past few years on the effectiveness of antiretroviral-based prevention technologies to prevent (i) HIV transmission while decreasing morbidity and mortality in HIV-infected persons, and (ii) HIV acquisition in HIV-uninfected individuals through pre-exposure prophylaxis (PrEP). Only few of the planned studies on treatment as prevention (TasP) are conducted in Asia. TasP might be more feasible and effective in concentrated rather than in generalised epidemics, as resources for HIV testing and antiretroviral treatment could focus on confined and much smaller populations than in the generalised epidemics observed in sub-Saharan Africa. Several countries such as Cambodia, China, Thailand and Vietnam, are now paving the way to success. Similar challenges arise for both TasP and PrEP. However, the operational issues for PrEP are amplified by the need for frequent retesting and ensuring adherence. This paper describes challenges for the implementation of antiretroviral-based prevention and makes the case that TasP and PrEP implementation research in Asia is much needed to provide insights into the feasibility of these interventions in populations where firm evidence of 'real world' effectiveness is still lacking. 

 

Keywords: Cambodia, China, pre-exposure prophylaxis, Thailand, treatment as prevention, Vietnam

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UNITAID Strategy 2013-2016. UNITAID. (2013)

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The purpose of UNITAID is to contribute to the achievement of global long-term goals for HIV, tuberculosis and malaria through its interventions in product markets. These goals have determined the Strategic Objectives described in this Strategy for the coming four years and are shared by the international community at large.

 

Keywords: HIV/AIDS, TB, malaria, medicines, funding, diagnostics, prevention

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HIV Medicines Technology and Market Landscape - 1st Edition. UNITAID. (2014)

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Access to appropriate antiretroviral therapy (ART) is vital to prevent HIV morbidity and mortality, and high ART coverage also promotes HIV prevention by lowering the amount of virus circulating in people within a particular setting or population. The World Health Organization (WHO) released new treatment recommendations in June 2013 that raise the CD4 cell count threshold for ART initiation for most people (from 350 to 500 cells/mL) and expand the number of populations that should receive treatment irrespective of their immune status. These changes have substantially increased the number of people eligible for ART. At the end of 2012, almost 10 million people were receiving ART in low- and middle-income countries, or about 34% of the total eligible population under the 2013 WHO treatment guidelines (28.6 million). The access level in children was falling behind at an estimated 20% of the total paediatric population in need of ART; while 647 000 children were receiving ART as of December 2012, an additional 2.6 million children were eligible for ART under current WHO treatment guidelines, but not receiving it.


Keywords: HIV, ARV, treatment, infant, children, medicines

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Joint WHO/UNAIDS Annual Consultation with Pharmaceutical Companies and Stakeholders on Forecasting Global Demand of Antiretroviral Drugs for 2013-2016. WHO. (2014)

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The World Health Organization (WHO) and the Joint United Nations Programme on HIV/AIDS (UNAIDS) Secretariat jointly organized an annual two-day consultation with pharmaceutical companies and stakeholders to present them with the draft forecasts for the demand of antiretroviral (ARV) drugs in 2013–2016.

 

Keywords: Anti-Retroviral agents, supply and distribution, HIV infections, therapy, drug industry

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Antiretroviral Medicines in Low- and Middle-income Countries: Forecasts of Global and Regional Demand for 2013-2016. WHO. (2014)

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The global effort to scale-up HIV treatment in low- and middle-income countries continues to move closer towards achieving the goal of 15 million people receiving treatment by 2015. By the end of 2012, 9.7 million people in low- and middle-income countries were receiving antiretroviral therapy (ART), which represents an increase of 1.7 million from the previous year.

The goal of this report is to provide countries and suppliers with a sense of how the global market for antiretroviral (ARV) medicines in low- and middle-income countries is likely to evolve from 2013 to 2016. The report also aims to provide suppliers with a global forecast of the estimated demand for active pharmaceutical ingredients (APIs) so that they can manage their manufacturing capacity accordingly.


Keywords: HIV, ARV, infections, therapy, drug, adults, children

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March 2014 Supplement to the 2013 Consolidated Guidelines on the Use of Antiretroviral Drugs for Treating and Preventing HIV Infection. WHO. (2014)

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WHO guidelines on the use of antiretroviral (ARV) drugs for treating and preventing HIV infection provide a public health approach for scaling up HIV care and treatment programmes and focus on simplified, harmonized and effective antiretroviral therapy (ART) regimens for use in resource-limited settings. In 2013, for the first time, WHO revised and combined guidelines for adults and adolescents, infants and children and pregnant women as well as other ARV-related guidance documents into one set of consolidated guidelines that addressed the use of ARV drugs for HIV treatment and prevention across all age groups and populations, based on the broad continuum of HIV care.

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Assessing the Impact of Alternative Patent Systems on the Cost of Health Care: The TPPA and HIV Treatment in Vietnam. Moir H V J, Tenni B, Gleeson D and Lopert R. (2014)

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In the Trans Pacific partnership Agreement (TPPA) negotiations, the United States has proposed expanded patent protections that will likely impact the affordability of medicines in TPPA partners. This includes antiretroviral (ARV) medicines used in the treatment of HIV/AIDS. Vietnam has the lowest GDP per capita of the 12 countries participating in the TPPA negotiations. Using the current Vietnamese patent regime as our base case, we analyse the potential impact of alternative patent regimes on access to ARVs in Vietnam. The two other scenarios investigated are a patent regime making full use of TRIPS flexibilities, and a regime based on the US proposals in the 2014 leaked draft of the TPPA intellectual property chapter. Using World Health Organization (WHO) treatment guidelines, we identified the most commonly used chemical entities and combinations used in the treatment of HIV. We examined patent data sets to discover patents that had been registered for these medicines and used information from examination of these patents to identify which might be granted under alternative patent regimes. We then drew on the empirical literature to estimate prices under the three patent scenarios. The current ARV budget was used as a constraint, with the consequence that the results focus on the impact of alternative patent regimes on access to treatment. Our results indicate 82% of the HIV population eligible for treatment would receive ARVs under a full TRIPS flexibility scenario, while only 30% of Vietnam's eligible HIV patients would have access to ARVs under the US 2014 TPPA proposals – more than halving the proportion treated compared to the current 68% receiving treatment. Similar price impacts can be expected for other countries participating in the TPPA, though these are less economically vulnerable than Vietnam.

 


Keywords: TPPA, patent policy, trade policy, access to medicines, Vietnam

 

 

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