PROVIDENCE, R.I. [Brown University] The President's Emergency Plan for AIDS Relief (PEPfAR) began in 2003 with good intentions, but it was not until the U.S. government's massive overseas public health campaign adopted generic drugs that it became a success, according to a new article by Brown University researchers in the July issue of the journal Health Affairs. Nearly a decade later, expanding the availability of generics remains urgent, especially as doctors in the field encounter resistance to first-line treatment regimens.
"By 2002 generic drugs had been shown to work, so there was not a question of whether they were efficacious," said Kartik Venkatesh, an M.D./Ph.D. graduate student and the paper's lead author. "So then it was a question of how do we expand access to treatment so that more than 5 to 10 percent of those in need of treatment were getting it. Now two out of three individuals who need treatment in the 15 PEPfAR countries are getting it."
That's because the program, which primarily bought proprietary medicines from major U.S. manufacturers in the early years, eventually made the transition to much cheaper generics, said Venkatesh who will speak about the paper as part of a Health Affairs briefing July 10 that features Nils Daulaire, director of global health affairs in the Department of Health and Human Services, and Eric Goosby, U.S. global AIDS coordinator.
Generics slashed the program's costs, allowing it to vastly expand care delivery. In their review article, Venkatesh and his co-authors cite data that PEPfAR has reduced its annual per person spending on antiretroviral medicines to $300 this year from $1,100 in 2005.
PEPfAR, launched by President George W. Bush and then reauthorized by President Obama, is a multibillion-dollar effort to deliver HIV treatment and other related health services to people in 15 developing nations, including 12 in sub-Saharan Africa.
Early on, the program d
|Contact: David Orenstein|