United Press International - Wednesday, 12 July 2000
Michael Smith, UPI Science News

The organization also called for immediate programs to halt mother-to-child transmission of HIV, the virus that causes AIDS.

"Our target is $200 a year for antiretroviral therapy," said Daniel Berman, a spokesman for the Nobel Prize-winning relief organization. The savings would come through bulk buying and sharply expanded generic manufacturing.

A year's course of the top-line three-drug cocktails now being used in the developed world costs about $15,000, he said.

"There are generic drug manufacturers who think they can do that (cut the cost 75-fold)," Berman said, including those in India, Brazil and Colombia.

Berman said the few developing countries that have been able to afford the costly therapy -- such as Brazil and Thailand -- have done so by "aggressively pursuing generic strategies." In Brazil, he said, the cost has been brought down to $1,000 a year, and last year 80,000 people were treated in that country.

"But in Uganda," he said, "less than 1,000 people were treated" in a UN program using brand name drugs.

The difference in price is so great for some drugs that they are smuggled from Thailand to Africa, Nairobi physician Chris Ouma said. The drug fluconazole, which is considered essential to treat opportunistic infections in HIV patients, costs 70 cents a dose in Thailand, but the brand name version costs $18 a dose in Uganda.

Physician Eric Goemaere, head of the organization's mission to South Africa, said it's a myth that there's no access to antiretroviral drugs anywhere. In Khayelitsha, a poor suburb of Cape Town, local authorities last year started a program to interrupt mother to child transmission, using the drug AZT.

A year later, he said, 74 percent of the 6,000 pregnant women who came to the local hospital agreed to be tested for HIV and to have the drug if they were HIV-positive. In one year, Goemaere said the program has prevented more than 150 children from being born with HIV.

Another benefit of the program, he said, is that it gives women an incentive to get tested for HIV: "If prevention is not linked with some sort of benefit, it does not work," he said. "It is a total failure."

But when you "give a woman a chance to have an uninfected child," he said, she is more willing to be tested for the disease.

"Before this program," Goemaere said, "AIDS did not exist here...because no one was going for testing.
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