Doha+10: More people accessing HIV treatment

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Doha+10: More people accessing HIV treatment

22 November 2011

UNAIDS Executive Director Michel Sidibé speaking at the symposium.
Credit: Eric Roset

To mark the tenth anniversary of the Doha Declaration on TRIPS and Public Health adopted in November 2001, UNAIDS released a study evaluating how the use of the TRIPS flexibilities has helped improve access to antiretroviral therapy over the past decade.

Today, nearly half of people eligible for HIV treatment in low- and middle-income countries are now receiving it – 6.6 million out of the 14.2 million eligible - compared to 300,000 in 2002.  The most dramatic increases in antiretroviral therapy coverage have occurred in sub-Saharan Africa, with a 30% increase between 2009 and 2010 alone.

This effective scaling up of access to antiretroviral therapy has been largely due to a drastic fall in antiretroviral drug prices over the past decade. In 2000, three-drug antiretroviral therapy combinations cost US$ 10 000–15 000 per person, per year. Today the price for a similar regimen is less than US$ 120 per person, per year in many countries - a 99% reduction in cost.

UNAIDS recognizes the positive impact of the World Trade Organization’s Declaration on Trade-Related Aspects of Intellectual Property (TRIPS) and Public Health, otherwise known as the Doha Declaration. The Declaration clarified the scope of the TRIPS agreement and provided guidance for implementing TRIPS flexibilities to improve access to affordable medicines, including generic antiretroviral drugs and other essential drugs for AIDS-related illnesses.

“Although we have seen significant progress in the first decade since the Doha Declaration was adopted, much more needs to be done in the second decade if we are to achieve universal access to HIV prevention, treatment, care and support,” said Michel Sidibé, UNAIDS Executive Director. “Nearly half of people eligible for HIV treatment are now receiving it, but we have to redouble our efforts to ensure that children and adults everywhere have access to antiretroviral therapy.”

Although we have seen significant progress in the first decade since the Doha Declaration was adopted, much more needs to be done in the second decade if we are to achieve universal access to HIV prevention, treatment, care and support

UNAIDS Executive Director Michel Sidibé

The UNAIDS Executive Director was participating in a one-day symposium hosted by Geneva’s Graduate Institute of International and Development Studies, entitled “10 Years after the Doha Declaration: The future agenda at the interface of Public Health, Innovation and Trade”. Keynote speakers included Margaret Chan, Director-General of the World Health Organization, Pascal Lamy, Director-General of the World Trade Organization and Francis Gurry, Director-General of the World Intellectual Property Organization.

Over the past decade, the Doha Declaration has had a positive impact on increasing access to affordable medicines in low- and middle-income countries. Over 60 low- and middle-income countries have proactively used the TRIPS flexibilities to promote the production and purchase of generic antiretrovirals, according to the study findings. By using these flexibilities to introduce generic competition, countries, including Brazil, Malaysia, and Thailand, have been able to bring down the prices of originator medicines.

Furthermore, the United Nations Development Programme, the World Health Organization, the World Trade Organization, and the Global Fund to Fight AIDS, TB and Malaria have adopted clear policies supporting the use of TRIPS flexibilities. Civil society groups have used the Doha Declaration in their advocacy campaigns to support HIV treatment. Additionally, generic companies have increased investments in antiretroviral production. Today, close to 90% of the 6.6 million people in low- and middle-income countries accessing antiretrovirals use generics.

To expand access to HIV treatment in the future, including access to pediatric formulations of antiretrovirals, a greater number of countries will need to consider using the TRIPS flexibilities. Innovative mechanisms such as the Medicines Patent Pool*, and UNITAID will need to be leveraged. 

The UNAIDS study is based on an extensive review of policy documents on the Doha Declaration and the use of TRIPS flexibilities in low- and middle-income countries.

The Medicines Patent Pool was established in 2010 with the support of UNITAID. Multiple patents are ‘pooled’ and licensed out by one entity, in order to cut down on transaction costs for all parties involved. This allows more affordable and more adapted versions of patented drugs to be produced as generics, long before their 20-year patent terms run out.