Although the scale-up of antiretroviral therapy (ART) across Asia continues to progress, treatment of populations such as injection drug users (IDUs) and pregnant women remains insufficient, according to an April report from the World Health Organization, UNAIDS, and UNICEF. Of those who need ART in Asia, roughly 19 percent (280,000) are now receiving it, according to the new report, a fourfold increase over the 70,000 on treatment in 2003. But only 5 percent of HIV-infected pregnant women are receiving the medications that would prevent the transmission of HIV to their babies, and prevention services for IDUs are “very low in comparison with the size of the…IDU population,” according to the report.
Less than 10 percent of Asian IDUs have access to prevention services, according to UNAIDS, although new cases of HIV occur in high concentrations among the region’s six million IDUs. In a May speech, Prasada Rao, Asia Pacific regional director of UNAIDS, underlined the inadequacy of HIV prevention services for IDUs. If aggressive efforts are not made to stop the virus’s spread among IDUs, in Asia and around the world, he asserted, the number of new infections could rise rapidly. (Towards Universal Access, WHO/UNAIDS/UNICEF, 17/4/07; Reuters, 14/5/07)
Contradicting 2006 data from UNAIDS that found India to have surpassed South Africa in the number of people with HIV/AIDS, with 5.7 million cases, a new survey suggests that the true figure may be around half that—somewhere between 2 and 3 million. The lower estimate, generated by the National Family Health Survey under international supervision, can be attributed to a method of gathering and calculating data that involved sampling randomly chosen households. Standard methods used previously have entailed testing vulnerable groups and pregnant women. The results of this new survey suggest that India’s epidemic may be largely contained within groups such as commercial sex workers, men who have sex with men, and injection drug users. (New York Times, 11/6/07)
Maneuvering continues between the Thai government and two pharmaceutical companies over compulsory licenses, including three for second-line antiretroviral drugs. Negotiations between the Thai government and Merck over whether the Thais will break the patent on Merck’s efavirenz may be moving toward a resolution that will involve the drug company lowering its price to about US$23 a month, about half the original price of US$43. Merck would also provide a liquid version of efavirenz free to 2,500 HIV-positive Thai children, in return for which Bangkok would drop plans to issue a compulsory license for efavirenz. Negotiations between Abbott Laboratories and the Thai ministry of health with regard to the prices of anti-AIDS drugs Kaletra and Aluvia have been less productive, however, and plans to break these patents are moving forward. Discussions on both drugs continue, even as US trade officials in May put Thailand on a watch list of countries failing to protect the intellectual property rights of US companies. (Kaiser Daily HIV/AIDS Report, 5/7/07; Bangkok Post, 7/6/07)
Endorsing the actions of the Thai government, former US President Bill Clinton declared, “No company will live or die because of high price premiums for AIDS drugs in middle-income countries, but patients may.” In May, the Clinton Foundation also announced that it had negotiated deep price reductions for generic versions of several second-line AIDS drugs, including Kaletra and efavirenz. (New York Times, 9/5/07)