[Ip-health] MSF Statement at the AIDS Summit

Judit Rius juditrius at yahoo.com
Fri Jun 10 11:17:36 PDT 2011


Delivered by Dr. Tido von Schoen-Angerer, Executive Director, MSF Campaign for 
Access to Essential Medicines 


10 June 2011 

UN High-level Meeting on HIV/AIDS 
+++++++++++++++++++++++++ 

Thank you Chair, 

Ten years ago, I was working as a doctor in Thailand where we had just opened 
Médecins Sans Frontières’ first AIDS treatment programme. Starting from that 
first project, we have witnessed time and time again how treatment saves lives 
and keeps people healthy. 

Committing to a target of 15 million people on treatment by 2015 is a critical 
step and the clock starts ticking now. This target recognizes the evidence that 
treatment not only saves lives but prevents transmission of the virus. The 
latest data from the HPTN052 trial that earlier treatment has a dramatic effect 
on preventing TB disease, and preventing HIV transmission by 96%, has very real 
policy implications, also in terms of how to approach the integration of care. 

With treatment as one of the most important tools in the prevention toolbox, we 
can get ahead of the wave of new infections -- but we need treatment to be 
integrated into every clinic in endemic settings. This will also reduce the toll 
that tuberculosis continues to take as the main killer of people living with 
HIV. 

There are ways to reach more people with care and yet reduce the strain on the 
health system, reduce the burden on patients and reduce costs: Providing 
integrated treatment of HIV and other diseases as a one-stop-shop at primary 
health care clinics and rural health posts. Empowering nurses to start people on 
treatment and post exposure prophylaxis – not just doctors. Allowing people who 
are doing well to only come to checkups twice a year, like we do with the 
Ministry of Health in Malawi. Having neighbours take turns getting medicine 
refills for each other like we do in Mozambique. Providing HIV and TB care by 
the same health care worker as in Swaziland, and providing outpatient treatment 
of drug-resistant TB like we do with the Ministry of Health in South Africa. 

But integration and getting ARVs into every clinic means that drugs must be 
affordable.   

Even though the price of drugs has fallen by 99% over the past decade thanks to 
generic competition, another price crisis is looming at the doorstep. We need 
access to newer medicines that are better-tolerated and newer medicines to treat 
those that have grown resistant to the virus.  But with patents blocking the 
affordable production of these drugs, we won’t see prices come down the way they 
did with the first generation of AIDS medicines - unless governments act 
decisively. 

Action has to be taken to ensure price-busting competition can continue. TRIPS 
flexibilities must be used to overcome patent barriers. But the only flexibility 
specifically mentioned in today’s declaration, for countries that don’t make 
their own medicines, doesn’t work and needs to be fixed, not affirmed. 
Governments that choose to increase access to medicines through compulsory 
licensing should not face retaliation. Ten years ago, countries affirmed the 
primacy of health over commercial interests in the Doha Declaration, which was 
created for the world we face today. But we must confront the reality of what is 
happening outside this building:  Countries should stop pushing free trade 
agreements that demand stricter patent rules than what the TRIPS Agreement 
requires.  New, innovative mechanisms should be supported to increase access to 
drugs in all developing countries, like the Medicines Patent Pool. 

We are at a unique point in time. The lessons learned from treating HIV/AIDS 
over the last decade, combined with the latest science that treatment is 
prevention could help us break the back of the epidemic. As has been said: ‘pay 
now, or pay forever.’ 

We now have a commitment for 15 million people to be on treatment by 2015, which 
will help save lives and stop the virus.   

Let’s do it. These are the lives that hang in the balance. 




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