Voice of America - February 22, 2004
Joe De Capua
Washington

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A humanitarian group says if efforts to increase AIDS treatment for developing countries are to succeed, a simple, standardized drug regimen is needed. Doctors Without Borders is urging the widespread use of F-D-C’s, or fixed dose combinations, which it uses in its treatment programs.

According to Doctors Without Borders, fixed dose combinations allow access to treatment “even in areas where there are few hospitals, doctors and laboratories.”

Rachel Cohen is the US director of the group’s Campaign for Access to Essential Medicines.

"Fixed dose combinations are when you combine two or three compounds into one pill. It’s a way of co-formulating medicines that makes it much, much easier for patients to take the drugs because there are fewer pills, and therefore easier to adhere to over the long term."

She says similar treatments are also available for such illnesses as malaria and hypertension. F-D-C’s, she says, are not only easier to use, they are also cheaper to buy.

"We source from many, many different suppliers. In principle, we use the lowest price quality drugs. So, in this case, we’re paying between $200 and $300 dollars per person per year for these fixed dose combinations. And they even could be available for as little as $140 dollars per person per year in the near future."

Ms. Cohen says if these same drugs had to be taken separately – in brand name form instead of generic – it could cost as much as $600 per day. She says use of F-D-C’s have proven very successful.

"We see in all of our programs dramatic weight gain, steady increases in CD-4 count (immune system cells), all of the indicators that tell us that people are doing very well. On average, almost 90 percent of the people that started on treatment in our programs remain on treatment and only about eight percent have died over the past several years."

Doctors Without Borders says it currently provides treatment to “more than 11,000 people living with HIV/AIDS in over 20 countries.” It hopes to increase that number to 25,000 by the end of this year.

Doctors Without Borders says fixed dose combinations are a major component of the World Health Organization’s 3 X 5 plan. The plan calls for three million people to be on anti-retroviral drugs by the end of 2005. The group also wants F-D-C’s to play a major role in President Bush’s $15 billion Emergency Plan for AIDS Relief.

Only a limited number of the 20 available anti-retroviral drugs are currently used in fixed dose combinations. Analysts say increasing the number would most likely involve negotiations or legal battles between governments and drug companies over patents and prices.

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