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The Alliance works with communities in developing countries to prevent the spread of HIV,support and care for those infected and ease the impact of HIV on families and communities. Access to treatment for HIV is an essential component of such work.

Since its establishment in 1993, the Alliance has provided both financial and technical support to over 1,500 HIV/AIDS projects and has worked with NGOs and CBOs from over 40 countries. This experience reveals that:

• Barriers such as lack of food, clean water, adequately trained health workers and infrastructure,and the stigma and discrimination which surrounds HIV/AIDS, all hinder poor people’s access to care and treatment. While working towards solving these problems, the priority must be to prolong life and improve its quality by whatever means are immediately available, accessible, affordable and safe. Primary health care systems and home care need to be strengthened as a basis for

improving access. Existing tuberculosis (TB) services using Directly Observed Treatments, Short course (DOTS) can be an entry point for the provision of care to people with HIV/AIDS.

• Policies and processes to make effective drugs available to people in developing countries at an affordable price must be developed urgently. This effort needs unique commitment from governments, multilateral agencies and the pharmaceutical industry, and the participation of communities and civil society.

• Reduced prices are an essential element of increasing access to drugs, but this alone will not ensure access to the best treatments for the poorest people. Improved and properly financed delivery systems are essential and can only be achieved through partnerships between communities, civil society organisations, the private sector, and governmental and intergovernmental organisations.

• Antiretroviral drugs (ARVs) are currently the most effective long-term treatment for HIV infection. But other drugs including antibiotics, antifungals and treatment for TB improve both quality and length of life of people with HIV. Work to increase the accessibility and affordability of drugs such as these should not be compromised by efforts to provide ARVs.

The Alliance believes that the United Nations and its Member States should:

• Primarily direct their treatment resources towards improving the quality and length of life of the poorest.

• Support increasing access to ARVs for the poor, but only alongside a major effort to increase access to and appropriate use of drugs for opportunistic infections and palliative care.

• Ensure that every country has at least one care and support unit as a reference centre and for nationwide training in diagnostics, treatment (including ARVs), standards of care and monitoring of HIV and HIV-related diseases.

• Establish an international HIV/AIDS drug and commodity procurement fund under the UN system that could leverage the buying power of developing countries and donors. Resources demarcated for the procurement of HIV/AIDS drugs, related commodities and the development of new products such as vaccines must include a strategy to strengthen related health systems infrastructure including necessary personnel training.

• Continue to work with both the research-based and generic pharmaceutical industries to dramatically lower the prices of all relevant drugs and diagnostics, while maintaining incentives for investment in research and development.

The Alliance’s contribution is and will continue to be:
To advocate:

• for better access for the poorest to effective drugs that can be immediately and safely delivered.

• for resources, transfer of expertise and development of infrastructures to facilitate equal access to treatment for whoever needs it.

• against discriminatory practice by medical insurance companies.

To build our own and our partners’ capacity to work towards:

• ensuring that our programmes reach poor people with an effective and good quality basic level of care and support.

• continually improving the quality of care and support provided by Alliance-supported programmes as technologies and resources become available, to as high a level as is consistent with their local technical and financial capacity.

To act directly by:

• improving access to HIV related treatment for Alliance staff in developing countries and staff of our partner organisations.

• developing tools and information and supporting more community organisations to become involved in providing care and support through the development of a toolkit on access to treatment.

• continuing to support NGOs/CBOs to develop an integrated approach to care and support, which includes psycho-social support, nutritional information and traditional remedies, and recognises the role that treatment plays in both prevention, impact mitigation and in reducing stigma and discrimination.

• expanding our work in consumer education on health in general and HIV/AIDS in particular both directly to the people we reach through programmes and through our partnership with NAM (National AIDS Manual).

YRG Care, an Alliance partner located in Chennai, India, is demonstrating that community groups can make a real difference in treatment access. YRG serves over 3000 PLHA and their families by offering home care, a 24-bed inpatient care facility, outpatient care, nutritional counselling and a subsidised pharmacy. YRG also
undertake capacity building and advocacy with healthcare workers. In the words of Dr. Tokugha Yepthomi of the Indian Network of Positive People Research & Education, "TB should be a treatment priority. Taking care of TB can provide major relief for PLHA."

The YRG experience shows that it is important to develop links with other reatment centres in order toimprove treatment access. For example, YRG Care collaborates closely with TB research and treatment centres in order to improve access to TB treatment. In addition to making sure that affordable and appropriate drugs are available, YRG has learned that it is important to train doctors so that they do not prescribe inappropriately and waste resources, as well as to educate PLHA as consumers.

The International HIV/AIDS Alliance mail@aidsalliance.org www.aidsalliance.org www.aidsmap.com

May 2001

 

Alliance Policy Statements

For the UN General Assembly, 2001

• Access to treatment for people with HIV must be dramatically improved
• Additional funding needed
• Building partnerships
• Children affected by HIV/AIDS
• Linking prevention and care
• People living with HIV/AIDS
• The importance of prevention