AIDS treatment: quality over quantity

The WHO, the Global Fund and the Clinton Foundation therefore sanctioned a drug that was not only unapproved and potentially sub-standard but also more expensive. This is perverse in the extreme.

The consequences of such AIDS politics are starting to appear. In July, the director of infectious diseases at Belgium’s Saint Pierre University Hospital told the Financial Times of his shock after examining 100 AIDS patients in the Democratic Republic of Congo: 30 of them had virus strains that resisted the standard medicines. “We are creating a virological time bomb,” he said.

Brazil is often held up as the model for universal AIDS treatment. It too has based this largely on cheap, untested copy drugs. In July, the government acknowledged that one third of the 190,000 AIDS patients under treatment were in what it called “a more advanced stage”—but medical studies had already shown even higher levels of drug-resistance.

In Asia, Thailand’s government-made GPO-vir has generated 12.5% resistance, the government admitted in April this year, up from 10.5% in 2006—although medical studies put it closer to 50%. Even the Global Fund has withdrawn support for GPO-vir but the drug-resistance has started and it is still distributed by Medecins Sans Frontieres.

These alarming figures show what will happen under current policies. If donors reach the U.N. target of putting 9.7 million on AIDS treatment by 2010, then 3.2 million would reach an “advanced stage of this disease,” needing drugs that are two or three times more expensive to buy and far more expensive to administer.

Creaking African health systems will be put under intolerable pressure by millions of drug-resistant patients requiring expensive in-patient care. This growing mass of patients would soon need not only all the money currently spent on AIDS but the total of present foreign aid too.

The WHO and its partners have focused on the politically-correct quick-win without regard to the consequences. The Global Fund’s donors and WHO member states must demand a stop to practices that threaten entire health programs and patients’ lives.

Jeremiah Norris is director of the Center for Science in Public Policy, Hudson Institute, Washington D.C.

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