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Economic Crisis Hits People Living with HIV, Treatment and Health Care Systems Endangered
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Kiev, Ukraine, October 2009 - Access to medicine for people living with HIV is one of the latest casualties of the global economic crisis. At a time of shrinking national health budgets, declining grant funding and high prices for medicine, the number of individuals in the region in need of treatment remains large. The issue has both a human and long-term development dimension. In response, representatives from the United Nations Development Programme and the Open Society Institute organized a two-day meeting in Kiev on September 21-22 bringing together government and non-governmental representatives from six countries – including Armenia, Georgia, Kazakhstan, Russia, Tajikistan and Ukraine and international experts. The meeting centered on how countries in Eastern Europe and Central Asia can apply the flexibilities contained in multilateral trade agreements to reduce the prices of essential medicines for people living with HIV. Antiretroviral therapy is typically a combination of drugs used in the treatment of HIV to interfere with the virus’ ability to replicate itself and therefore slow down the progression of the disease. The costs of medicines, however, can be prohibitive, particularly when production is restricted by international patents. In Russia for instance, six months of treatment can cost as much as $12,500. On the other hand, it is important to ensure access to antiretroviral therapy since it provides people living with HIV with the option of longer and healthier lives. ARV therapy is considered a lifetime commitment whereby each failure to provide that treatment and care is a matter of life and death. As of 2008, only 17 percent of the 320,000 in need of ARV therapy in Eastern Europe and Central Asia received treatment. The coverage is half the global rate. At the same time, the number of people living with HIV in the region has doubled in seven years. Eastern Europe and Central Asia are home to approximately 1.5 million people living with HIV and 90 percent of all new cases are from Russia and Ukraine. Globally, for every three people who receive treatment five become infected, joining the 33 million people living with HIV worldwide. In addition to human and health concerns related to HIV, countries with larger numbers of people living with HIV also face economic concerns. Higher need for health services can further strain health care systems. The envisaged impact of the crisis leading to budget cuts for HIV could result in the collapse of health care systems and availability of antiretroviral treatment. Cuts in treatment can prove also prove dangerous since those who stop treatment became far more infectious and disrupted treatment diminishes drug effectiveness, requiring use of costly second-line drugs and placing additional demands on health systems. Finally, a main outcome of the meeting was the development of a resolution by participants highlighting issues to be considered during the negotiation and implementation of trade agreements, especially those involving intellectual property rights.
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