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Report Gives Mixed News in Fight Against AIDS in Africa - 2003-09-22

The medical aid agency Doctors Without Borders has released a report about the global fight against AIDS, on the first full day of an international AIDS conference in Nairobi.

Doctors Without Borders and the World Health Organization gave good news and bad news in a joint report about the procurement, distribution, and use of anti-retroviral medicines to control AIDS and HIV, the virus that causes AIDS.

The report's lead author, pharmacist Sophie-Marie Scouflaire, told journalists that anti-retroviral medicines, called ARVs, are available at low cost, despite complaints by pharmaceutical companies over patent issues.

"It is really possible to access treatment for less than $1 a day, good-quality treatment programs," said Ms. Scouflaire. "We have been able to use generics everywhere. We did not face any problems regarding patents."

There are success stories in Africa with respect to the distribution and use of anti-retroviral medicine. The head of Doctors Without Borders' mission in Malawi, Didakus Odhiambo, says Malawians living with HIV and AIDS have good access to anti-retroviral medicines, primarily because the government has registered several generic drugs in the country.

"What is significant in Malawi is that these companies compete with each other, and that is a very good climate for the price reduction," said Mr. Odhiambo.

Doctors Without Borders says anti-retroviral medicine prices in Malawi are among the lowest in the world. The organization's project there provides treatment to 1,400 victims.

But Ms. Scouflaire said that in Kenya the public sector is just beginning to purchase generic medicine, and the government recently placed anti-retroviral drugs on the list of essential drugs.

The organization provides anti-retroviral treatment to 800 Kenyans - a limited number because, it says, low-cost medicines are not available in the country's national procurement system.

The report says different countries can use their own methods to ensure drugs are available and distributed to those who need them. These methods may include developing local production, setting up a national procurement system, or constructing a framework for the private sector to supply drugs to treatment centers.

"There is no one ideal approach," admits Ms. Scouflaire. "It is just that we need the government to put in place the framework for treatment centers to be able to access" ARVs.

But sub-Saharan Africa as a whole is in great need of anti-AIDS drugs. The report says one-percent of the four-million people in need receives therapy.

Meanwhile, the UNAIDS agency says many countries have a long way to go before they meet basic AIDS prevention and care goals, established two years after a special session of the U.N. General Assembly on HIV/AIDS.

The situation is particularly difficult in sub-Saharan Africa. Only an estimated 50,000 victims out of 4.1 million had access to treatment by the end of 2002.