[Ip-health] EB128: MSF intervention on the Draft WHO HIV/AIDS Strategy 2011-2015

thiru at keionline.org thiru at keionline.org
Thu Jan 20 02:11:46 PST 2011

18 January 2010

Draft WHO HIV/AIDS Strategy 2011-2015
WHO 128th Executive Board Agenda item 4.7
Intervention by Michelle Childs, Médecins Sans Frontières

Médecins Sans Frontières welcomes the ambitious goals and strategies in the
Draft WHO HIV/AIDS strategy 2011?2015.  WHO has shown strong leadership in
the past with its ?3 by 5? initiative and in issuing treatment guidelines
that embrace the latest evidence, recommending earlier treatment with
better drugs to increase survival and reduce new infections.

But the draft strategy falls short in key areas.  There is reluctance to
put numerical targets on the number of people to access ART by 2015, based
on WHO recommended eligibility criteria. The strategy needs to set
additional targets, including targets for countries to implement key
recommendations, like updating national treatment protocols and
decentralizing comprehensive HIV services.  An important part of WHO?s role
is to develop implementation targets and monitor progress achieved in
member states.

Future success depends on strong political and financial support, both by
affected countries and donors.  Yet donors recently failed to support the
most austere level of funding needed by the Global Fund to maintain
programs. The Fund does not have the resources to approve a new round of
proposals until mid-2012. 2011 will be the first year without a new round
of approvals since the Fund?s creation in 2002.

This will severely affect countries? ability to maintain the pace of
scale-up of improved treatment and prevention services. Some governments
have delayed or indefinitely postponed implementation of the new guidelines
due to financial constraints.

Member states should support innovative financing, such as financial
transaction taxes or proposals from the Leading Group on Innovative
Financing for Development, to raise additional, dedicated and regular funds
for HIV and other health issues, to help finance the MDGs.  If support for
universal access is not maintained, then we will, as Ban Ki Moon said, be
guilty of "snatching defeat from the jaws of victory."

WHO should monitor, at country level, the operational impact of limited
funding on the pace of scale-up of the recent recommendations.  WHO should
assess the risk to national ART programs in the near, medium, and
long-term, and report back to the World Health Assembly.

Continued scale up is under threat as increased patent protection in
developing countries leads to higher drug prices.  Generic competition has
been critical in reducing the price of medicines, and the strategy rightly
emphasizes the full use of TRIPS flexibilities like compulsory licences to
foster competition. It also recommends differential pricing as a way to
overcome patent barriers, despite this proving less effective in ensuring
sustainably low prices.  Instead, other mechanisms to reduce the price of
patented medicines should be supported, in particular the Medicines Patent

Finally, we welcome WHO?s voice in identifying clauses in free trade
agreements which threaten access to medicines, such as data exclusivity,
demanded by the EU in ongoing negotiations with India.

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