Inter Press Service - December 3, 2002
Lloyd Nicholas

Last year, the 16 members of the regional body negotiated substantial price reductions from drug makers but they say that without further cuts they will be unable to adequately care for the fast-growing number of people affected with HIV/AIDS.

"A meeting of health ministers was recently concluded on the matter and a new round of negotiations with the help of PAHO/WHO (regional and global health organisations) is being initiated," Jackie Joseph, director of human resources at the CARICOM Secretariat here, told IPS.

The discussions are expected to begin early next year. It is unknown if the multinational companies that supply the drugs will agree to further price reductions.

Working with the United Nations AIDS programme, the CARICOM nations negotiated price concessions for the anti-retroviral drugs, after assuring the firms that they had developed security mechanisms to ensure the drugs would not be sold elsewhere at market prices.

The new round of negotiations is intended to "broaden the sources of supply of not only retro-viral drugs but to include products from WHO approved generic drug manufacturers and suppliers of reagents (test chemicals)," said James St. Catherine, project manager for health in the CARICOM Secretariat.

"But our objective is to still achieve a lower price, although the current levels of reduction are in the region of 70 to 90 percent," he added.

Patient access to drugs is not the only challenge facing the region's countries in their fight against HIV/AIDS, said St. Catherine. Many have not fully developed the infrastructure and health systems needed to treat chronic patients, and putting that in place will drive up the cost of treating HIV/AIDS patients far beyond the cost of drugs.

He estimated the cost of the retroviral drugs alone to be in the range of 1,200 U.S. dollars to 1,800 dollars per patient while Guyana's Health Minister Leslie Ramsammy said recently the cost there is about 400 dollars per patient. The market price is about 10,000 dollars.

The Caribbean countries are second only to sub-Saharan Africa in the number of reported cases per capita of HIV/AIDS.

At their annual meeting in 2001, CARICOM leaders developed a five-year strategy to fight the AIDS pandemic. It was revised and expanded to include access to regional and global initiatives, including the Global Fund to Fight AIDS, Tuberculosis and Malaria, set up by U.N. Secretary-General Kofi Annan last year.

At the time, drug makers were sceptical that the region's countries had adequate health care systems to provide complete care, even if the drugs were available at cheaper prices.

"Trying to put that money into the system would like be pushing on a string. We couldn't spend that money if we had it," said Henry McKinnell, president & CEO of Pfizer and also chairman of the Pharmaceutical Research and Manufacturers of America.

Foreign donors have also anted up to assist in the region's fight against HIV/AIDS.

Canada offered 12.9 million U.S. dollars to support the battle, while the U.S. government, under the so-called Third Border Initiative, offered 20 million and Mexico offered technical assistance.

Even with the assistance, not all infected persons have access to the drugs, says St. Catherine. "Some individuals are too afraid to come forward and the infrastructure is not in place in some territories to deliver a comprehensive programme (of treatment)," he said.

And CARICOM says its flagging economies cannot meet the challenges without further price cuts.

For instance, a study conducted by the University of the West Indies (UWI) and the Caribbean Epidemiology Centre (CAREC) showed that Jamaica's gross domestic product (GDP) is likely to fall 6.4 percent from 2000 to 2005, while savings and investment would decline 23.5 and 17.4 percent respectively.

Spending on HIV/AIDS will skyrocket to 35.4 percent of national income in the same period, it showed.

But officials say price concessions are not the only route to reduce the hefty costs of the fight against HIV/AIDS.

For instance, processing drugs in the region reduces their cost, noted Guyana's Ramsammy. (END/IPS/CA/HE/HD/LN/ML/02) .

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