Dorlim Moiana Uetela

In this session issues related to the sustainability of HIV treatment and pre-exposure prophylaxis (PreP) were discussed, focusing on the challenges in low- and middle-income countries (LMIC) and the health and economic impact of broadly available and accessible antiretrovirals (ARVs) drugs.

Sébastien MORIN from Medicines Patent Pool (MPP), Switzerland, stated that access-oriented voluntary licensing through the MPP model has shown important success over its first ten years, which can credibly claim to have saved lives and reduced costs of HIV and HCV programs. According to Frances ILIKA from Palladium-USAID Health Policy Plus, the challenges to the feasibility of local production of HIV commodities in Nigeria include difficulty obtaining WHO prequalification and US Food and Drug Administration (FDA) approval, high cost of production inputs, insufficient government commitment and limited enabling environment to promote local manufacturing. Based on the study conducted in 2018 in the US, Robert BONACCI from CDC, US, stated that the estimated annual unmet financial needs for persons with PrEP indications was $106 million and that more than 90% of those with unmet needs qualified for medication assistance programs. The Ministry of Public Health of Thailand, Cheewanan LERTPIRIYASUWAT, stated that the number of PrEP users increased over the years, but sustainability is contingent on evidence-based policy advocacy, guidelines development, government commitment for financing it, capacity building, and robust monitoring and evaluation system. Erik LAMONTAGNE from UNAIDS, Switzerland underlined the economic returns of investing on the AIDS 2025 targets.

This was an insightful discussion about the progress and challenges associated with HIV prevention and treatment sustainability. The positive health and economic impact of licensing HIV medicines in low- and middle-income countries was highlighted. Local production of ARVs drugs for treatment and prevention as well as access to free HIV prevention and HIV treatment should be encouraged and supported in all countries to end this epidemic.