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MSF intervention on the Draft WHO HIV/AIDS
04 ¡ØÁÀҾѹ¸ì 2554
Date:
18 January 2010
Source: Knowledge Ecology International Online
Medecins Sans Frontieres 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
Pool.
Finally, we welcome WHO’svoice 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.