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Aids Monday, 8 November, 1999, 09:03 GMT
Experts fight back against HIV threat
anti-HIV drugs
Drug firms have lowered the price of anti-HIV drugs in poor countries
Developing countries are setting up good practice guidelines for preventing the spread of new treatment-resistant strains of HIV.

Their governments and Unaids, the United Nations Aids programme, have been working for the past three years on models for regulating the use of anti-HIV drugs.

Aids Special Report
Most of the treatments, which have been credited with dramatically reducing Aids deaths in the West, are too expensive for widespread distribution in developing countries, although efforts have been made to bring the cost down.

But some people have been able to get hold of them through aid agencies, the black market or relatives living in the West.

People taking anti-HIV drugs often have to follow a complicated regime.

They may have to take a number of different drugs every day and some of the drugs must be taken at specific times of the day and on an empty stomach.

Already, health experts have noticed a rise in the number of people in the West who do not respond to any anti-HIV drugs. They think this is mainly linked to failure to follow drug regimes correctly.

Pilot models

Unaids has helped set up pilots in four developing countries - Ivory Coast, Chile, Vietnam and Uganda - which are looking at ways of reducing the cost of anti-HIV drugs and setting up structures to ensure they are delivered properly.

Although the pilots have a year or so left to run, there is great demand for information on their success from other developing countries.

For this reason, a first model will be available from early next year.

The pilots involve the setting up of advisory boards on drug procurement with the health ministries of each country involved.

Anti-HIV drugs are only made available in certain centres in the main cities, allowing doctors to monitor their use.

People taking the drugs - mainly those selected by health officials - can only take them at the centres and are given support to keep taking them correctly.

Aids education in Africa
Aids is the number one fatal infectious disease in Africa
Unaids has also devised a stock management system which links drug batches to individual patients to ensure that people take their full dose.

Joseph Saba, the former coordinator of the scheme and now a health consultant with Axios International Consultants, says that in Uganda efforts have been made to reach people who are getting their drugs through unofficial sources.

"The advisory board there was worried about misuse. For example, people may be being sent the drugs by relatives and one month they may not have the money to send them so they miss a dose which can be dangerous.

"The worst thing would be to ban the drugs as, because they are life-saving, that would only mean they would go underground."

He said most of these people were in touch with the health service and were being directed to the special centres.

Some advertisements had also been placed in the media to encourage them to go to the centres.


However, Mr Saba said the government had to ensure publicity over drug availability did not suggest the drugs were widely available and so raise expectations falsely.

According to official statistics, some 850 people out of Uganda's one million HIV positive population are taking anti-HIV drugs.

Mr Saba said non-compliance rates were about 30% - more or less the same as in the West.

"People have a vested interest in complying with the drugs because they know they are life-saving," said Mr Saba.

The draft model will be refined over the next year and the pilot scheme will also be extended to areas outside the main cities.

See also:

08 Jul 99 | Aids
08 Jul 99 | Aids
04 Nov 99 | Aids
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