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APHA Scientific Session and Event Listing

Recorded presentation

Jim Yong Kim, MD, PhD, Harvard Medical School, Harvard University, 677 Huntington Avenue, Boston, MA 02115, +1-617-432-4750, kimj@hsph.harvard.edu

Issues: The United Nations and World Health Organization estimate that over 40 million people worldwide are living with HIV, and this number continues to grow. As availability of antiretroviral medicines have transformed HIV/AIDS into a chronic illness in high-income countries, they remain far out of reach in the developing world. In 2002, WHO estimated that approximately 6 million people would clinically qualify for highly active antiretroviral drug therapy. The recent massive global campaign to reach half of those people by the end of 2005 did not reach this goal but great progress was made and the number of Africans receiving treatment with ARV's increased eight-fold in two years. Access to good quality, affordable ARV's has been a key element of this scale-up and the WHO prequalification program was a key element in ensuring that access.

Description: This presentation will describe the ethnography of the struggle for AIDS treatment access at the World Health Organization, including the author's and others' efforts to defend the ARV pre-qualification program at WHO. He will discuss a proposed model for how access to ARV's and other medications might be secured for the long-term viability of HIV treatment programs in developing countries.

Lessons learned: 1. WHO has a critical role to play in the global response to the HIV pandemic. 2. WHO's prequalification program has made an important contribution to treatment scale-up by providing information on drug quality to countries that don't have the capacity to assess the quality of a wide range of ARV manufacturers. 3. Attacks against the WHO prequalification program and efforts to defend it reveal the interests of various stakeholders involved in the response to HIV/AIDS.

Recommendations: 1. WHO must continue to play its central role in supporting Ministries of Health and all HIV-related activities in the health sector in developing countries. 2. The WHO prequalification program must be supported and expanded in order to ensure that information on drug quality continues to be provided to WHO member states.

Learning Objectives:

• 1) List at least two attributes of the World Health Organization’s ARV pre-qualification program.
• 2) Describe the efforts to defend the ARV pre-qualification program at the WHO.
• 3) Identify at least two features of a proposed model for long-term viability of HIV treatment programs in developing countries.

Keywords: HIV/AIDS, Policy/Policy Development

Presenting author's disclosure statement:

Any relevant financial relationships? No

Recorded presentation