JP/4/AIDS

JP/4/AIDS

Road map to improved access to HIV/AIDS therapy in
poor countries

Debbie A. Lubis
Contributor
Yogyakarta

Life seems quite unfair for Yanti (quoted with her permission).
After surrendering her husband to AIDS last year, the mother of
two children has to go on with her battle to fight HIV in her own
and her second son's bodies.

Worst still, she lost her job because her colleagues were
terrified of being infected by the deadly virus. The company
actually was willing to cover her ARV treatment costs.
Unfortunately, she is no longer able to afford antiretroviral
(ARV) therapy for her and her 2.5 years old son.

ARV treatment has been proven effective in reducing the viral
load until undetectable so that people living with HIV/AIDS
(PLWHA) can lead a more productive life and mortality and
morbidity caused by opportunistic infectious diseases among them
can be reduced.

At present, a monthly package of imported, generic version ARV
cocktails in Indonesia is worth Rp 650,000 (US$76) while patented
ARV drugs cost ten times higher.

"My physical condition is deteriorating. My weight has dropped
drastically to 37 kg from 55 kg previously. Actually, ARV helps
us so much. I went up to 50 kg within five months of taking the
miracle cocktails while my son went up to 13 kg from eight kilos
before. He returned to being a cheerful boy
again," Yanti said.

Rinaldy (not his real name) is also in a dire need of
affordable ARV cocktails. His father abandoned the family as soon
as he found out that his son was infected by the virus. Rinaldy
was confined to bed for one year due to heart and lung disorders

"Maybe it's because of the drugs I abused," he said,
disclosing that he used to share needles with other injecting
drug users (IDUs) for five years.

"My salary is just enough for our daily needs but I must
support and take care of my son. He is still young," he said. His
mother collects money from her extended family to purchase the
ARV drugs.

Yanti and Rinaldy feel lucky because they can get free or
subsidized ARV treatment from a number of NGOs in Jakarta. But,
out of 130,000 PLWHA who are in a dire of need of ARV treatment
in the country, only 1,000 have access to the drugs they need.

The problem of access to ARV treatment is not unique to
Indonesia. It is experienced by many developing countries in the
world. Therefore, representatives from around 16 countries are
scheduled to attend the Yogyakarta round-table meeting (JRM) from
Sept. 1 through Sept. 4, to renew the spirit of a similar meeting
in Canberra last year. The last meeting formulated a strategic
framework for improving access to HIV/AIDS therapy in poor
resources settings. The meeting will have delegates from the
ASEAN countries, America, Cuba, Japan, Australia, France and
India.

"The World Health Organization expects that by 2005, an
estimated 600,000 PLWHA in the Asia Pacific region will have
improved access to HIV/AIDS treatment. After one year from the
first meeting, there must be many accomplishments and obstacles
in achieving the targets that the participants can share," said
Dr Samsuridjal Djauzi, coordinator of Access to Therapy and
Diagnosis at the Working Group on AIDS at the University of
Indonesia in Jakarta.

In Indonesia alone, the National Movement on Improved Access
to HIV/AIDS Therapy (GN-MATHA) has targeted around 2,000 people
with HIV/AIDS this year.

PLWHA, academicians, experts, government officials,
representatives of international agencies, NGO activists, and
journalists will actively take part in thematic lectures under
main theme of From International Collaboration towards National
Self-Reliance and the Role of Media in Combating HIV/AIDS.

Samsuridjal, who is also the initiator of JRM, said that the
issue of self-reliance was included in a bid to reduce the
reliance of poor countries on foreign aid and the developed
countries in accessing ARV therapy. The press's role would also
be significant in disseminating information on the therapy.

"We will also build up networks among the participants here
because it is high time for developing countries to fight for
their citizens's rights to health given the fact that there are
many barriers imposed by the WTO and TRIPs," he said.