UNAIDS: The First 10 Years

UNAIDS The First 10 Years124programmes that would help people who needed the medicines. From the inside, AAI wasmuch more significant than it was represented to be in the media”.In April 2001, Annan met with the leaders of six research-based pharmaceutical companies(Abbott Laboratories, Boehringer Ingelheim, Bristol-Myers Squibb, GlaxoSmithKline,Hoffman-La Roche and Pfizer) in Amsterdam, together with the Director-General of WHOand the Executive Director of UNAIDS, to discuss “what further steps can be taken by thesecompanies to make care and treatment more accessible for people living with HIV/AIDS indeveloping countries”.Annan explained he had called for the meeting because encouraging the active participationof all partners in the fight “has become my personal priority … The pharmaceuticalindustry is playing a crucial role”. He also applauded the contributions from nongovernmentalorganizations “who are our vital partners in this fight”.At the Amsterdam meeting, the drug companies agreed to continue to accelerate reducingprices substantially, with a special emphasis on the least developed countries 22 , particularlythose in Africa; to continue to offer affordable medicines to other developing countries,on a country by country basis, and to recognize the need to consider increased access toHIV/AIDS medicines to qualified nongovernmental organizations and appropriate privatecompanies offering health care to employees and local communities in these nations.Marta Mauras, then Director of the Office of the Deputy Secretary-General of the UN, wasinvolved in arranging the Amsterdam meeting and a subsequent one in New York. Shebelieves these meetings with Annan were probably very instrumental in putting pressure,“very important political pressure”, on the drug companies to start lowering prices. It wasalso clear that despite the research and development companies’ objections to generics,their existence and value was at least acknowledged as a political and economic fact.Looking back at that period, Schwartländer, former Chief of the UNAIDS epidemiology unitand now Director for Performance Evaluation and Policy at the Global Fund, commented: ‘Aunique combination of generic competition and strong political, activist and media pressurewere crucial factors leading to the rapid reduction in prices. The question remains, however,whether reductions could have been achieved earlier’ 23 .Whatever the answer to that question, the two UNAIDS drug initiatives were importantbecause they would, in the not too distant future, lead to far more ambitious schemes.The work on drug pricing was also an example of effective collaboration between theUNAIDS Secretariat and WHO, one of the Cosponsors. Both were essential to this work, andthis partnership would continue later as access to treatment became a major focus of theirwork from 2002 onwards.22A category used by the UN to describe poor, commodity-exporting developing countries with little industrywhere the gross national income per capita is less than US$ 750.23Schwartländer, Grubb, Perriëns (2007).