‘Aids is only now beginning to be seen for what it is: a unique threat to human society, whose impact will be felt for generations to come’. – The World Health Organisation, The World Health Report 2004

The past two decades have seen rates of antiretroviral (ARV) medication access in developed words increase at unprecedented levels. While a year-long course of ARV treatment cost $ US 10,000 in 2000, the same course today has an average price between $US 123 and 493 per person¹. Indeed, ARV use in sub-Saharan Africa was at nearly zero percent in 2000 – it now sits at close to 39%². Yet almost 1.2 million people still die in sub-Saharan Africa from AIDS related diseases each year³. Clearly, renewed and greater efforts are needed to increase access to medications for HIV-positive patients in sub-Saharan Africa.

Australia’s international response to HIV/AIDS treatment

 Australia is widely recognised as a world leader in the response to HIV/AIDS pandemic. After an initial surge in domestic cases of the virus during the 1980s, cases of HIV/AIDS in Australia have decreased and remained controlled. In its goal to become a good ‘international citizen’⁴, Australia continues to donate money and public services to developing nations. Indeed, Australia has committed over $1 billion to international HIV efforts since 2004². Around one fifth of this has gone towards sub-Saharan African countries, with a significant portion going to the neighbouring Asian counties such as the Philippines⁵.

Why should Australia change the way it supports ARV access in Africa?

Despite Australia’s large financial humanitarian support of HIV/AIDS in developing nations, Australia has done little to reduce the cost of ART therapies in sub-Saharan Africa. Indeed, Australia is engaged in bilateral agreements with US pharmaceutical companies through the ‘TRIPS-plus’ provisions that place restrictions on compulsory licensing, patenting and patent lengthening within Africa⁶. Australia’s support of the TRIPS-plus provisions makes it difficult for African governments to import and produce generic-label ART drugs, so reducing the affordability and access of the medication for the average consumer⁶. Watch the explainer below for information on the TRIPS agreement from the perspective of both the pharmaceutical companies, as well as from a group lobbying to have the agreement amended – Oxfam.

What can Australia do differently that helps increase ARV access?

Renewed and different efforts are needed to address low ARV access in third world countries. One of the clearest ways that Australia could do this is by withdrawing its support of the TRIPS agreement. Whilst the patents on many first-line treatments have expired and generic-brand drugs are beginning to be produced, many second- and third-line drugs remain under patent and therefore expensive. If a patient develops resistance to a first-line drug, they are commonly unable to afford second- and third-line drugs and therefore mortality is high. By withdrawing support of the TRIPS agreement, Australia sends a message that it does not support profiteering by pharmaceutical companies, so applying international pressure to reduce the price and increase the access of ARV drugs in developing nations.

References 

1. (UNAIDS) UNPoHA. Global Report 2013 [cited 10/4/2016]. Available from: http://www.unaids.org/sites/default/files/media_asset/UNAIDS_Global_Report_2013_en_1.pdf
2. Haacker M. Financing HIV/AIDS programs in sub-Saharan Africa. Health affairs. 2009;28(6):1606-1616.
3. Avert. HIV and AIDS in Sub-Saharan Africa Regional Overview [Internet]. 2015 [updated 01/05/2015; cited 2016 28/3]. Available from: http://www.avert.org/professionals/hiv-around-world/sub-saharan-africa/overview
4. World Health Organisation. HIV/AIDS [Internet]. 2016 [cited 2016 28/3]. Available from: http://www.who.int/trade/glossary/story051/en/
5. Scanlon ML, Vreeman RC. Current strategies for improving access and adherence to antiretroviral therapies in resource-limited settings. HIV AIDS (Auckl). 2013;5(1).
6. Harrelson JA Widener L. Symp. J.: HeinOnline p. 175