For countries with little resources to fight AIDS, Thailand has become a beacon of hope on how to deliver drug treatments on a mass scale to those with the deadly disease, according to a report published by the World Bank on Wednesday.
The country has built a program that provides antiretroviral drugs for free or for a minimal amount.
Antiretroviral drugs work by inhibiting the replication of HIV. When antiretroviral drugs are given in combination, HIV replication and immune deterioration can be slowed and survival time boosted.
But the costs associated with the drugs have been a major barrier to access for those in the developing countries where a majority of those who have AIDS live. About 40 million people worldwide are believed to be infected with HIV.
At present, the cost of these drugs in developed countries ranges from $300 to $1,200 per year, according to the World Health Organization. Despite barriers to access, Thailand has managed to provide antiretroviral drugs to about 78,000 AIDS patients, which is more than 90 percent of those in need of the treatment.
About 6.8 million people living in low- and middle-income countries currently require antiretroviral therapy, according to the WHO. Yet the organization says only about 1.6 million of them are receiving the drugs.
Triple-Drug Combo
Thailand was able to deliver better treatment access due in part to an affordable domestically produced triple-drug combination, which costs about $30 per month.
The low price allowed the country's public health ministry to roll out a large-scale campaign to provide the drug combo as standard care.
The World Bank report also credited Thailand's success of widespread treatment to the country's vast network of district level hospitals and rural health clinics. The country also worked with NGOs to get the job done. Despite Thailand's success, it's still not enough to solve access problems to HIV therapies.
"In many ways we are still at the beginning of this effort," said WHO HIV/AIDS Director Kevin De Cock.
Dr. De Cock made the comment at the 16th International AIDS Conference, taking place this week in Toronto, where he announced the number of people receiving HIV antiretroviral therapy in sub-Saharan Africa had surpassed 1 million, a tenfold increase in treatment access in the region since December 2003.
Among the challenges to access will be funding the growing need in developing countries for second-line drug regimens, which are much higher in price in comparison to first-line treatments.
Health care and policy advocates have been taking the fight for improved access directly to the pharma industry.
