UNAIDS: The First 10 Years

Chapter 5123Still far too manypositive peoplein 2000 wereunable to affordantiretroviraltreatment.UNAIDS and itspartners workedclosely with someof the major drugcompanies to bringdown drug prices.UNAIDS/O.O’HanlonSans Frontières, generic manufacturers such as CIPLA and Chief Executive Officers fromthe seven largest pharmaceutical companies to sit down together with the leaders of WHOand UNAIDS and agree on a tiered price structure for the treatment of HIV, tuberculosis andmalaria 21 . In September 2000, the Chief Executive Officers expressed their willingness tolaunch such a scheme and CIPLA announced the availability of generic, first-line antiretroviralsat US$ 350 per patient per year.There is considerable disagreement between the activists and others over the effectivenessof the AAI in reducing drug prices. Médecins Sans Frontières claims nothing reallychanged until generic manufacturers began to reduce prices. After the AAI agreement wasannounced, Bernard Pécoul from Médecins Sans Frontières commented: “The elephant haslaboured mightily and brought forth a mouse”.As Cleves later commented, any efforts made by the UN were likely to be denounced as insome way inadequate.It was easy to underestimate the steps taken by the drug companies, given their culture andtrack record. According to Sturchio, the AAI helped to highlight the feasibility and urgencyof treatment delivery to key decision-makers within the pharmaceutical industry. “Whileeverybody on the outside was jeering that this was too little, too late and the prices werestill too high, the reality of the AAI was different. It wasn’t until some of the senior peopleat our companies could see that it was possible to work with UNAIDS and WHO and otheragencies, that the pharmaceutical industry could make progress on actually implementing21Ibid.