A Desperate Global Scavenger Hunt to Keep AIDS Patients Alive

People in poor countries are desperately scavenging for the drugs that can suppress HIV. The World Health Organization reports that only 5 percent of persons in developing nations who need AIDS drugs can get them.

Though precise numbers are unavailable, thousands of people now get AIDS drugs from programs that recycle them, from networks of doctors who donate them, by crossing borders to buy relatively low-cost generic copies, and on the black market.

Manhattan-based Aid for AIDS, a nonprofit with branches in Italy, Spain and Switzerland, collects the drugs of HIV patients who change medications, take a break from treatment, or die. The group passes these to more than 500 HIV patients throughout Africa, the Caribbean and Latin America.

Some people cross borders to take advantage of price discrepancies. While a year's supply of antiretrovirals costs $2,000-$2,200 in South Africa, the same regimen is available for $300 in neighboring Lesotho and Namibia, where the sale of generic copies is allowed.

While Doctors Without Borders has the South African government's authorization to use generics bought elsewhere, other groups distribute lower-cost medicine illegally and without oversight. A thriving black market is the result. Health care workers report illegal sales of antiretrovirals left over from clinical trials in the United States, for instance.

But while drugs from these sources can keep hopes alive, health experts are concerned that substandard drug quality and inadequate oversight and patient education will create serious public health problems. Inappropriate drug combinations or inadequate doses can result in side effects, drug resistance and drug interactions. Though taking two antiretrovirals can breed drug resistance and is less effective than a three-drug regimen, some doctors prescribe this if a patient cannot afford a third drug.

The World Health Organization has recently set up a coalition to make antiretrovirals affordable and available, and to track resistance.

Back to other news for July 24, 2003