Encouraging Increase in Number of Patients Treated in Africa Continues

London, January 25, 2005 � The estimated number of HIV patients in developing countries receiving antiretroviral (ARV) treatments supplied by the seven research-based pharmaceutical companies in the Accelerating Access Initiative (AAI) reached more than 333,000 patients by the end of September 2004.  This is the first time that the AAI companies have presented data from all developing countries; previous figures have only covered Africa.  These new data were released today by the AAI companies � Abbott, Boehringer-Ingelheim, Bristol-Myers Squibb, Gilead Sciences, GlaxoSmithKline, F. Hoffmann - La Roche and Merck & Co., Inc.

The data show that the estimated number of patients treated in Africa with ARVs supplied by the AAI companies increased by more than 50% in the 12 months from September 2003 to September 2004, reaching 157,500. During the same period, the number of patients treated with medicines from the AAI companies reached 127,000 in Central and South America; more than 37,000 in the Middle East and Asia, and more than 11,000 in Eastern Europe. (In terms of percentages, the regional distribution of the total number of patients treated by AAI medicines in the developing world is about 47% in Africa, 38% in Central and South America, 11% in Middle East and Asia and 3% in Eastern Europe).

"These data are encouraging and more people are gaining access to therapy but much more needs to be done," said Peter Bains, Senior Vice President, GlaxoSmithKline, and Chairman of the AAI. "We must all work together to accelerate these trends and bring the benefits of HIV care and treatment to those in need. The AAI companies are determined to continue their efforts to work closely with affected communities, non-governmental organizations, the medical community, governments and multilateral organizations (including our partners in the AAI), to improve their initiatives and look for opportunities to do more. "

With more than 333,000 patients receiving ARVs provided by the AAI companies, the data show that the R&D-based companies are key suppliers of ARVs to developing countries.

"These new data demonstrate real momentum to expand access to antiretroviral treatment in developing countries," said Dr. Peter Piot, Executive Director, UNAIDS.  "The pharmaceutical industry has an important role to play in making progress towards the goal of "3 by 5".  However, it is also clear that much more needs to be done, and the industry, like all other partners, needs to continue to intensify its efforts."

"We are very encouraged by these data, because they provide independent confirmation of the data provided to us by our member states.  Their data say that access to treatment for people with HIV and AIDS is really taking off.  According to our estimates of treatment access, it would appear that the R&D industry is currently providing about 50% of all antiretroviral treatment in the developing world," said Jack Chow, Assistant Director General of the World Health Organization.  "We are confident that, with the commitment of our member states and the donor community, the number of people on treatment will increase dramatically this year.  This would be excellent news, not just for the people who need treatment, but also for the fight against AIDS.  Data from developing countries show that treatment and prevention do strengthen each other."

Notes to editors

1.      The Accelerating Access Initiative (AAI) was launched in May 2000 and is based upon the principles set out in the attached Joint Statement of Intent. The AAI is a partnership of five United Nations organizations (UNAIDS Secretariat, WHO, UNICEF, UN Population Fund, and the World Bank) and seven research-based pharmaceutical companies (Abbott, Boehringer-Ingelheim, Bristol-Myers Squibb, Gilead Sciences, GlaxoSmithKline, F. Hoffmann - La Roche, and Merck & Co., Inc.), designed to improve access to more affordable HIV-related medicines and diagnostics for developing countries and those hardest hit by the epidemic, in the context of a broader framework of care, treatment and support.   All of the members of AAI subscribe to the principles in the Joint Statement of Intent. The AAI has been a country-led process, responding to the priorities and needs identified at the national level.  

2.      The figures announced today are an estimate of the number of patients who have been treated with antiretrovirals supplied by the seven companies in the countries of the regions mentioned. Coverage includes countries that are most affected by the HIV/AIDS epidemic and the regions in which efforts by the AAI have been concentrated.[1]  The summary data are attached, together with a graph of the growth in estimated number of patients treated since the AAI began.  (This figure shows both the actual numbers as reported (dotted lines) and 4-quarter moving averages (solid lines).  The moving averages provide a clearer view of the long-term trends in patient numbers, since they smooth the quarter-by-quarter variations that can occur due to tenders or other unusual buying patterns.)

3.      The estimated number of people on treatment was based on actual quarterly drug supply data from the seven companies, provided on a confidential basis, for independent analysis, by each individual company to Axios International, a third party with experience in the area of HIV/AIDS care in the developing world. The drug unit data were converted into patient-equivalent numbers by quarter, based on dosage and indications. The estimated patient numbers are a conservative estimate of the number of people actually treated with antiretrovirals in developing countries, since they do not take into account such factors as patient adherence to therapy, the number of children treated, use of other drugs, and drug wastage.

4.      The fact that this analysis was based on drug units supplied and converted into estimated patient numbers offers a number of advantages and limitations compared to formal country surveys.   The data are collected precisely and consistently as they represent units supplied and actual sales. The analysis is therefore underpinned by reliable data.  The calculated number of patients represents only an estimate of the number of patients treated by antiretrovirals supplied by the seven companies in the Accelerating Access Initiative. The figures announced today do not represent an estimate of the total number of patients treated in these countries, as they do not take into account the patients treated with antiretrovirals supplied by other companies.  Thus, due to the factors noted above, the actual number of patients treated is likely to be higher than the reported figure of 333,074. [2]

Accelerating access to HIV/AIDS care and treatment

in developing countries

A Joint Statement of Intent

Building on the work undertaken by the Joint United Nations Programme on HIV/AIDS (UNAIDS), its Cosponsors and other partners worldwide in responding to the growing demand for care and treatment of HIV/AIDS-related illnesses in developing countries, a new effort is being undertaken to enhance progressively the capacity of countries to increase access to, and use of, sustainable, comprehensive and quality HIV/AIDS interventions across the entire spectrum of prevention, treatment, patient care and support (including prevention of perinatal transmission).

Five pharmaceutical companies--Boehringer Ingelheim, Bristol-Myers Squibb, Glaxo Wellcome, Merck & Co., Inc., and F. Hoffmann - La Roche �  are responding  to calls from UN Secretary-General Kofi Annan (in launching the International Partnership against AIDS in Africa, in December 1999);  Dr Gro Harlem Brundtland, Director-General of the World Health Organization (in her address to the WHO Executive Board in January 2000), where she invited the pharmaceutical companies to �take a fresh and constructive look at how we can increase access to relevant drugs�, and to the invitations of Dr Peter Piot, Executive Director of UNAIDS, James D. Wolfensohn of the World Bank, Carol Bellamy, Executive Director of the United Nations Children�s Fund, and Nafis Sadik, Executive Director, United Nations Population Fund, to the private sector to engage in partnerships for expanding the global response to HIV/AIDS.

The five companies have begun constructive discussions with UNAIDS, WHO, the World Bank, the United Nations Children's Fund (UNICEF), and the United Nations Population Fund (UNFPA), to explore practical and specific ways of working together more closely to accelerate access to HIV/AIDS-related care and treatment in developing countries. This endeavour is expected to expand to include other partners from all sectors.

Participants acknowledge that affordability of HIV/AIDS-related care and treatment is an issue in developing countries -- though only one among many obstacles to access including social/political/structural and economic issues, healthcare financing, physical barriers, and information gaps --  and are willing to work with committed governments, international organizations and other stakeholders to find ways to broaden access while ensuring rational, affordable, safe and effective use of drugs for HIV/AIDS-related illnesses.  The companies, individually, are offering to improve significantly access to and availability of a range of medicines.

Intended to benefit people in developing countries, this public/private cooperation

q       is designed to accelerate their sustained access to, and increase their use of, appropriate, good quality interventions for the prevention, treatment and care of HIV/AIDS-related illnesses, and the prevention of perinatal transmission of HIV;

q       strives to ensure that care and treatment reach significantly greater numbers of people in need, through new alliances involving committed governments, private industry, the UN system, development assistance agencies, non-governmental organizations and people living with HIV/AIDS;

q       will be implemented in ways that respond to the specific needs and requests of individual countries, with respect for human rights, equity, transparency and accountability.

The following principles reflect a common vision of how the HIV/AIDS epidemic can more effectively be tackled in developing countries:

(i)                 Unequivocal and ongoing political commitment by national governments is essential for successful efforts to reduce the impact of HIV/AIDS in line with poverty reduction and broader development strategies.

(ii)               Strengthened national capacity, including well-designed HIV/AIDS prevention and care strategies and a strengthened health-care infrastructure, is crucial for delivering care and treatment to people with HIV/AIDS on an equitable basis.

(iii)              Engagement of all sectors of national society and the global community -- including governments of developing and industrialized donor countries, international NGOs, industry, other segments of civil society (particularly people living with HIV) and multilateral organizations � is essential in facilitating access to treatment of HIV/AIDS-related illnesses.

(iv)             Efficient, reliable and secure distribution systems are necessary to ensure that medical supplies and other consumables procured by the public sector or NGOs are made available to people who need them at the appropriate contact points within health systems.

(v)              Significant additional funding from new national and international sources, commensurate with the health challenges posed by the HIV epidemic, is necessary for long-term success, so that current health and social sector priorities can be maintained. 

(vi)             Continued investment in research and development by the pharmaceutical industry on innovative new treatments for HIV/AIDS and other diseases affecting the developing world  -- the best hope for new and better future medicines and vaccines -- is critical to expanding the global response to HIV/AIDS and to advancing world health. Therefore intellectual property rights should be protected, in compliance with international agreements,  since society depends on them to stimulate innovation.

This public/private cooperation is intended to increase the proportion of people living with HIV/AIDS in the developing world who have safe, equitable, sustained and affordable access to care and treatment.  As a practical response to the call for multisectoral action in the face of this global health challenge, it is an important step in a longer-term process of increasing the access to care of women, men and children in developing countries.   It aims to contribute to the International Partnership against AIDS in Africa, as well as efforts to curb the spread of HIV and mitigate its impact in other continents and, more broadly, to support the international development agenda.