ARVs: Two pills same as good as six

Jul 26, 2005

An AIDS patient can take two Anti-Retroviral (ARV) pills a day and still get the same value as the one who takes six.

By Timothy Makokha
An AIDS patient can take two Anti-Retroviral (ARV) pills a day and still get the same value as the one who takes six.
Those who are on six pills are taking the brand name drugs, which are produced by companies that have a patent on the medicines. They are expensive but original.
Some other companies have been allowed to manufacture the same drugs under certain arrangements.
These are known as generic drugs made mainly in India, Brazil and South Africa. Some of these generic ARVs combine three brand name medicines into one pill to sum up a day’s dose in two instead of six pills.
Rachel Cohen, Medecins Sans Frontiers (MSF), US director on campaign for access to essential medicines, said two pills a day greatly facilitate patient adherence and reduce the risk of developing resistance to specific molecules. She was recently in the country on a working visit. Cohen said for rural people, any regimen whose prescription allows taking drugs less frequently is better. MSF is running an HIV project in Arua district.
The outgoing MSF head of mission, Isabelle Voiret, said besides being convenient, generic ARVs are affordable. Originator drugs cost as much as sh1.4m per patient per year, about three times more expensive than generic drugs. Yet patients taking six drugs a day are not necessarily better than those who take two generic pills per day. MSF provided free generic ARVs.
According to the US State Department, Uganda has the largest number of people receiving ARV treatment through the US President’s Emergency Plan for AIDS Relief (PEPFAR) fund.
Out of about 235,000 people living with HIV/AIDS on PEPFAR-funded treatment in the world, Uganda has 50,900. South Africa, which has the highest number of people living with HIV/AIDS in the world, has 44,600 people; Kenya has 28,300 and Tanzania 4,300.
However, to be treated under PEPFAR, patients must use brand name medicines manufactured in the US.
Voiret says this denies millions access to cheap ARV treatment, which only requires about sh447,000 a year.
“In sub-Saharan Africa, which is home to 4.1 million people living with HIV/AIDS, PEPFAR would be covering threefold more people if it allowed generic drugs,” she says.
Cohen said the future of African countries depended on continued supply of generic ARV drugs.
Voiret says out of about 10,000 people living with HIV/AIDS in Arua, 2,200 are under treatment. Another 5,500 registered, whose CD4 count is still high, are being treated for sexually transmitted diseases and opportunistic infections. MSF gives ARVs to anybody from Arua district, whose CD4 count is low after screening.
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