HIV Treatment Bulletin - October 2003

This issue of HTB leads with a treatment alert circulated to doctors in the US. The reasons for its inclusion are made clear in the comments section on page 4. It is still the general rule that European patients have to wait at least six months more than people in the US for drugs to be fully licensed.

However, the simplest safety measure is to monitor drug levels. Patients using new drugs particularly need therapeutic drug monitoring because of multiple drug interactions or pre-existing hepatic or renal damage.

Providing necessary pure compound for independent laboratories to develop and validate drug level monitoring assays prior to widespread use in expanded access programmes is a key patient safety issue. It would save the guesswork involved as unforeseen interactions are discovered even post registration.

UK treatment guidelines are published this month and are available on the BHIVA website (www.bhiva.org), in html and pdf format.

The World Trade Organisation has attracted much publicity for – and many people have welcomed – its agreement on allowing generic drugs in developing countries but many activists and NGOs see the agreement as a disaster for positive people in poor countries. A statement issued by 14 NGOs describes the deal as “a ‘gift’ bound tightly in red tape”. This month we analyse the issues surrounding this controversy.

The day we went to press (24 September, 2003) WHO decided to declare the failure to deliver AIDS medicines to those who need them a global health emergency... really?

The good news on access to treatments is that the South African cabinet has announced a complete change of policy and will distribute antiretrovirals in public hospitals. However, India, which has the second biggest epidemic after South Africa, focuses all its attention on prevention. We report on a Supreme Court challenge to the Indian government that hopes to force the government to provide treatment as well.

This issue of HTB also includes reports from the 1st South African AIDS Conference, which was held in Durban in August and was a useful meeting, but has received little coverage elsewhere.

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