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re:Better treatments put to the back of cupboard?
Sep 23, 2005

I'm responding to Ben's answer to the question about whether there is a real risk of drug companies/gov't holding back on research or taking to market advanced medications/even cures for HIV due to motivations for profit reasons. You either sidestepped the question or went off point talking about the problems of access to drugs in the third world. The developing world/developed world issue is a real one but putting that aside, what is the panel's opinion (trusting you are independent enough to be truthful) about this risk. What should the HIV community do to ensure this does not happen? Thanks for your time!

Response from Dr. Young

Thanks for your comments. I'd like to think that I'm an independent thinker, but will admit (and challenge others) my own potential bias.

I didn't intend to sidestep the issue in any way, but perhaps was diverted by my own personal interest in developing world (having worked in India and Ukraine this year).

The process of drug discovery is far from perfect, and yes in our capitalist world, the people that ultimately fund development of new drugs actually expect (and probably are entitled to) some return on investment (ROI). How this calculus is calculated varies from country- and company- specific situations. On the basis of my 10+ years of observation of the pharmaceutical industry and drug discovery for HIV, I don't see any evidence of a masterminded strategy to hold back on cures, though the size of the potential market and ROI is calculated and reflected in which compounds are brought forward.

What I do know is this: Collaborative efforts between governmental agencies in the developed world, drug companies and community groups have seen the most rapid paced development of new pharmaceuticals in the modern era. These drugs have revolutionized the prognosis for a killer disease and have done so in less than 20 years after the disease was first discovered. I actually believe that such investment deserves a dividend, thought the size of that dividend can be hotly debated. Will there be continued pressure (financial and advocacy) to continue with this discovery? Therein lies the challenge. Community advocacy has fallen in recent years- witness the challenges of even maintaining flat funding for Ryan White or ADAP or the lack of community-based uproar over Abbott Laboratories 400% increase in the price of Norvir. Specific to your question, I'd follow the procedings of international meetings, monitor what the FDA does (or doesn't), contact your local and national congressional delegations-- let them all know your views about HIV medications, access to care, or anything else that's on your mind. (The US Congress' phone number is 202 224 3121, ask to speak to your congressperson' office and their legislative aid for healthcare.) Effective advocacy requires continuous pressure on those who make decisions. In our democratic society, we the people get what we vote and advocate for.

As I said in my previous post, be vocal-- loudly and frequently. Elsewise other forces will prevail. BY



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