amfAR's HIV/AIDS Treatment Directory

Introduction

"Rigor is not the issue of the day, reality is." So spoke Oxford researcher Roy Anderson at a plenary session on "Living with HIV" at this summer's International AIDS Conference. More often than not, neither rigor nor reality won out at the Durban, South Africa gathering. Instead, the two exerted an opposed, almost magnetic pull on a parade of speakers struggling to find solutions to glaring global inequities in access to anti-HIV drugs. Hovering somewhere above the plane determined by these two poles was a third principle: reducing prices of anti-HIV drugs through any means necessary so that poor countries facing catastrophic losses from the epidemic could have access to effective antiretroviral therapy.

Parallel importing, compulsory licensing, generic production, tiered pricing, bulk buying were the most commonly mentioned means to reach goal. Yet another tantalizing, albeit elusive possibility is novel treatment strategies to simplify, improve and decrease the cost of the existing standard of care. Simplification is vitally needed in industrialized countries, too, as healthcare systems strain to support the cost of lifelong HAART (highly active antiretroviral therapy), and their HIV-positive inhabitants strain to support lifelong antiretroviral drug side effects.

At the end of the International Conference, researchers were still frustrated in their attempts to navigate between these conflicting poles of attraction. They could not chart a definitive course, but perhaps they had begun to trace out an emerging global effort to treat persons with HIV.

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