HIV Treatment Bulletin - December 2003 / January 2004
Polly Clayden, HIV i-Base

• On 23 October, in an agreement with generic antiretroviral manufacturers Aspen, Cipla, Ranbaxy and Matrix, the Clinton Foundation HIV/AIDS Initiative announced a price of just 36 to 38 cents a day (less than $140 per year) for triple combination therapy in South Africa, Mozambique, Rwanda, Tanzania and the Caribbean - around half the current price for antiretrovirals in the developing world.
• On 19 November, the South African cabinet approved the long awaited Operational Plan for Comprehensive Treatment and Care for HIV/AIDS. Unsurprisingly the Treatment Action Campaign (TAC) welcomed the cabinet’s decision stating: “This is a wonderful day for all in South Africa” but remind us “…the hardest work is ahead of us.”
• Brazil negotiated a 76.4% discount on the US price of $13.80 for the protease inhibitor atazanavir making it a still rather costly but infinitely more affordable $3.25 per capsule.
• The draft 2003 revision of the WHO treatment guidelines for resource-limited settings – final version due to be published on 1 December – recommends NNRTI-containing triple regimens for first line therapy - either efavirenz or nevirapine plus 3TC plus either d4T or AZT, and stresses the advantages (besides price) of generic manufacturers’ fixed dose combinations (FDCs). Notably WHO discuss the question of whether single dose nevirapine prophylaxis compromises subsequent NNRTI containing HAART, which it describes as one of “…the most pressing operational research questions facing the field.”

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