Sustaining treatment costs: who will pay?

• Published in: AIDS (London) Vol. 21 Suppl 4; no. Suppl 4; pp. S1 - S4
• Main Authors: Zewdie, Debrework, De Cock, Kevin, Piot, Peter
• Format: Journal Article
• Language: English
• Published: England 01.07.2007
• Subjects: AIDS/HIV; Anti-HIV Agents - economics; Anti-HIV Agents - therapeutic use; Antiretroviral Therapy, Highly Active - economics; Developing Countries; Drug Costs; Health Care Costs; HIV Infections - drug therapy; HIV Infections - economics; Humans
• ISSN: 0269-9370
• DOI: 10.1097/01.aids.0000279700.86309.f6

At the end of 2006, more than 2 million people across the world were receiving life-saving combination antiretroviral therapy (ART). Years of committed work and advocacy, and the unprecedented mobilization of financial resources from the international community have contributed to this humanitarian achievement - and have made the goal of universal access to prevention, treatment, and care seem possible. However, in the midst of this success we must recognize the many challenges that large-scale treatment with combination ART brings. The overwhelming majority of patients are receiving first-line regimens that have significant issues of toxicity. Access to adequate pediatric formulations remains disproportionately low. Availability of the expensive and technically demanding laboratory assays required to monitor treatment has not kept pace with the expansion in treatment. Delivery of health services remains critically limited by the shortage of trained health-care workers. Furthermore, in the context of treatment regimens of finite longevity, second- and third-line antiretroviral agents remain significantly more expensive than first-line drugs.