July 21, 2014
Written by Rajiv Malik, President, Mylan
As the president of a company whose antiretroviral (ARV) products are helping approximately 40% of people living with HIV/AIDS in the developing world, I truly am inspired by the theme for this year’s meeting – Stepping up the Pace!
My company, Mylan, is one of the world’s leading pharmaceutical companies. We are committed to setting new standards in health care and providing 7 billion people access to high quality medicine. Since 2007, for instance, we have lowered ARV costs for tenofovir-based treatment by more than 50% in developing countries, helping to increase the number of people on treatment to 12 million by the end of 2012. Further, we are investing $250 million USD to increase our ARV-manufacturing capacity – for the millions more who still need access.
Our efforts, combined with those of many other caring and dedicated organizations, have helped reduce the overall cost of providing HIV/AIDS treatment to approximately $250 per person per year in low- and lower-middle income countries. In fact, of the $18.9 billion spent on HIV programs there in 2012, only 8%, or $1.5 billion, was spent on ARVs. Put another way, the cost of ARV drugs no longer represents the barrier to access it once did.
Studies have shown that ARV medications can not only render HIV/AIDS a chronic, manageable condition, they also can prevent its transmission. So, practically speaking, putting an end to AIDS means getting appropriate medication to everyone who needs it, and keeping them on it for life – bridging the treatment gap.
Doing so, however, will require all international stakeholders – scientists, medical practitioners, activists, policymakers and people living with HIV – to step up the pace. According to the World Health Organization (WHO), 28 million people are eligible to receive ARV treatment. As concerning, more than 2 million additional people contract the virus each year. By working together, we can bridge the gap and reach another goal, that of achieving an AIDS-free generation.
However, low drug costs alone won’t bridge the treatment gap. Treatment programs need more than affordable drugs to expand access and provide sustainable services to all 28 million treatment-eligible patients. We need to scale up, which requires investment in physical and human-resource infrastructure and systems to improve patient linkage, retention in care and adherence support. It also requires a joint effort among all manufacturers to add ARV production capacity to ensure adequate supply of safe, high-quality medicine. To that end, it is important that we balance the historic focus on ever lower ARV prices with the investments needed for continued innovation, capacity and quality.
In addition to scaling up, we believe to reach the end of AIDS, HIV program policies need to be adjusted to reflect the latest scientific evidence. For instance, we know that early treatment benefits HIV patients and largely prevents transmission. Yet guidelines in many countries reflect older policies that recommend later treatment initiation. Similarly, studies have shown that certain lower-dose regimens reduce side effects without compromising efficacy. Yet the timeline for global adoption of these newer and more cost-effective treatments is unclear. If the world aims to treat three times as many people without a tripling in treatment funds, the HIV community cannot afford to delay introduction of dose-reduced regimens.
By working together, we can overcome these challenges and find solutions. This year’s meeting presents a perfect opportunity to do so.