keynote address at Retroviruses Conference - San Francisco

[Guest guest]

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What clearly makes the best sense, if 3 by 5 is to succeed, is the WHO

pre-qualified triple fixed-dose combination; one pill taken twice a day,

available only from generic manufacturers. It’s noteworthy that Medecins

Sans Frontieres uses this drug with several thousand clients, in twenty

countries, with excellent therapeutic results and excellent adherence

rates. In order for us to find the money to put huge numbers of people into

treatment, and scale up dramatically, this is the drug regimen of

first-line choice. It is surely of significance that the Clinton Foundation

has negotiated, in India, a reduction in the price of this fixed dose

combination to $132 per person per year. No one would have thought that

possible, even six months ago.

The international community, through the World Health Assembly, has

bestowed upon WHO the responsibility for approving, and providing guidance

in safety and efficacy for a vast array of medications. They do so with

consummate science, fidelity and integrity. Fundamentally, evaluations

carried out by the WHO pre-qualification team provide assurance that

international quality standards obtain. One of the great strengths of

multilateralism is that we have the World Health Organization to do this

work. There may be individual countries who wish to pursue a different

tack. But when WHO has identified and pre-qualified generic drugs, at low

cost, to prolong millions of lives, that’s the route the international

community, without caveats, should follow.

As a Canadian, I’m particularly sensitive to this reality. The Government

of Canada --- deserving of both recognition and plaudits --- is about to

amend patent legislation, in relation to AIDS and other diseases, to permit

the manufacture and export of generic drugs, consistent with the WTO

agreement reached August 30th, last. The Government of Canada will

undoubtedly accept the purview of the World Health Organization.

If there’s one thing we’ve learned about testing and treatment, it’s that

the involvement of the community is decisive. If 3 by 5 is to make the

intended impact, it must call on the community for help, and jettison the

lip-service to which so many are addicted. And the key element of the

community are the People Living With HIV/AIDS, who are the real experts,

and must be acknowledged as such. They should be consulted on every aspect

of the treatment process, and they should be seen as helping to mobilize

the community to work, in an equal partnership, with the medical facility

dispensing the treatment.

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(See attached file: SL Feb. 8.doc)