Three Out of 27 Asian Antiretroviral Drug Manufacturers Meet WHO Quality Standards, Study Says

Only three of the estimated 27 pharmaceutical companies in Asia producing generic antiretroviral drugs meet World Health Organization quality standards, leading to concerns that widespread use of possibly substandard drugs could result in drug resistant strains of HIV, according to a report to be released by the Therapeutics Research, Education and AIDS Training program -- which is supported by the American Foundation for AIDS Research -- the New York Times reports (Altman, New York Times, 7/8). The report is set to be released on Sunday during the first day of the XV International AIDS Conference in Bangkok, Thailand, Agence France-Presse reports (Agence France-Presse, 7/7). Researchers from TREAT Asia conducted interviews with health officials in 15 Asian countries and interviews with government officials, drug makers and HIV/AIDS organizations in the region, Kevin Frost, a TREAT Asia public health worker and report co-author, said, according to the Times (New York Times, 7/8). The researchers found that there are 27 companies in Asia that manufacture generic antiretrovirals, compared with four companies in Latin America and one generic drug maker in Africa. Only three companies -- Cipla, Ranbaxy Laboratories and Hetero Drugs/Genix Pharma, all of which are Indian -- are certified by WHO, according to the report. The other Asian companies have not been reviewed or failed to meet WHO standards, the report says. The findings demonstrate a significant risk that sub-standard antiretroviral treatment could be sold to the region's general population, Agence France-Presse reports (Agence France-Presse, 7/7). Frost said, "[M]any questions linger about the relative safety and consistency of these drugs." The report calls for the creation of a regional database of generic drug manufacturers to help determine the drugs that are available in each country, according to the Times (New York Times, 7/8).

Doctors
The report also includes a table that compares the number of trained doctors to HIV-positive people in 13 Asian countries, Agence France-Presse reports. Researchers found that Japan had the best ratio with one doctor for every 24 HIV-positive people, followed by Taiwan, Hong Kong, Singapore and the Philippines. Vietnam had the worst ratio with one doctor for every 11,250 HIV-positive people, followed by Thailand with one doctor for every 6,700 HIV-positive people, Indonesia with one doctor for every 4,630 HIV-positive people and China with one for every 4,200 HIV-positive people, the report says, according to Agence France-Presse (Agence France-Presse, 7/7). There are fewer than 200 doctors in China who are trained to administer antiretroviral treatment, the report says. In other countries, "unqualified" health workers have issued prescriptions to HIV-positive patients with "little or no instruction on the safe and proper use" of antiretrovirals, according to the report. In addition, "widespread" self-medication among some people living with HIV/AIDS in the region could have "catastrophic" consequences, the report says. Frost said, "The availability of drugs is far outstripping the capacity to deliver them." International AIDS Society President Dr. Joep Lange, who read the report last week, said, "We need to scale up training efforts quickly and develop a better mechanism for quality control of drugs" (New York Times, 7/8).

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