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PLOS BLOGS Speaking of Medicine and Health

UNAIDS' Outlook

Dr Rhona MacDonald, Freelance Editor rhonamacdonald@gmail.com

As the world the gears up for the XVIII International AIDS Conference in Vienna (a country in which apple strudels are more common than the number of people living with HIV/AIDS), UNAIDS has just launched a new report, Outlook, that “outlines a radically simplified HIV treatment platform called Treatment 2.0 that could decrease the number of AIDS-related deaths drastically and could also greatly reduce the number of new HIV infections.”

As the platform title—a blatant reference to web 2.0—suggests, the report focuses more on the high tech end of the HIV treatment and management spectrum. Its first recommendation is to “Create a better pill and diagnostics” something that MSF’s access to essential medicines campaign has been advocating for years. So why hasn’t it happened yet? Basically, because R & D into new treatments usually mean 20 year patents which make such medicines out of reach to most poor people in the world. Although drug companies do sometimes offer voluntary price reductions, the recently published 13th edition of untangling the web of antiretroviral price reductions shows the real costs of HIV medicines and how drug companies often fail to fulfill their promises. Without adequate muscle behind this recommendation, that holds strong against the obstacles acting against it (such as IP issues) and that swiftly moves the international community into collective action, I fear that progress in this area may be limited.

The UNAIDS report is accompanied by a poll that shows that AIDS still leads the public perception as the top health issue in the world, followed by safe drinking water. Although interesting, I wonder about the purpose of including the results of this survey of public perception in the report. As can be seen from WHO global burden of disease estimates, HIV/AIDs is not the top burden disease.  Much more neglected health areas, such as diarrhoeal illnesses, rank higher. Maybe in future, we can look forward to the international health community holding an appropriately “Roman numeralled” International safe drinking water conference every two years!

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