·        The growing AIDS crisis in Africa is one of many health challenges facing not only the developing world but the entire global community – and it requires a broad and comprehensive solution. This human tragedy demands a response from everyone:  governments, international organizations, non-governmental organizations, the business community, and individual citizens.  We collectively share the responsibility for responding, and must mobilize all parties and all available resources. 

·        Medicines are one part of the solution to the AIDS crisis, but are by no means a silver bullet.  Pharmaceutical companies are committed to our primary mission of discovery and development of new medicines. And we are painfully aware that as yet, there is no cure for AIDS.  But we also recognize that sustainable progress in improving access to health care, including innovative medicines, can only be made through an integrated approach to addressing the complex environmental, economic and social factors contributing to current health problems.

·        Many developing countries have been unable to adequately deliver health care services, including medicines, to their populations. 

-        To successfully get health care services and medicines to the sick, countries need well-functioning public health systems.

-        Unfortunately, in many countries in sub-Saharan Africa, there are fewer than three doctors per 10,000 people.

-        Storage and distribution systems are poorly managed, resulting in significant losses of available medicines (the World Bank estimates that for every $100 spent by African governments on drugs, only $12 of medicines reach patients).

-        Existing networks of health facilities often are physically inaccessible to large proportions of the population.

-        Countries need adequate infrastructure (roads, transportation, electricity, water supplies) so that the health system can operate.

-        Countries also need their governments to devote adequate resources to health care systems.

·        Underlying the health challenges in many developing countries are some fundamental economic, social, and political issues, that impede patients’ access to health care services and medicines.

-        Lack of passable roads and transportation networks mean patients cannot reach health facilities to seek treatment.

-        Lack of clean water and sewage treatment, and overcrowded housing, mean that disease is easily spread.

-        Concentration of health facilities in urban areas mean rural populations have nowhere to seek care.

-        Social stigmas attached to some health problems, resulting from ignorance and lack of information, mean that many will not turn to the public health system.

·        Governments have often failed to make health care a spending priority, and have lacked the political will to acknowledge health problems, make difficult but critical choices, and face up to daunting challenges.

-        Few developing country governments have historically assigned high priority to health, and the level of resources devoted to health care has been disappointingly low, even in the face of the HIV/AIDS problem.

-        Health care services have often taken a back seat to defense spending; even worse, there have been instances of available health funds being left unspent due to bureaucratic mix-ups and mismanagement.

-        Until recently, many governments refused to acknowledge to existence or the extent of the HIV/AIDS problems in their countries.

·        To adequately address the health care problems facing developing countries, we must recognize and respond to the broader challenges to our collective ability to provide access to health care and medicines.

-        Pharmaceutical companies have collaborated in solving health problems in the past, and remain committed to playing that role in the future.

-        We play an important role in public health by donating badly needed medicines, sponsoring and supporting public health programs around the world, in partnership with governments, international agencies, and NGOs.

-        We recognize our responsibility but we cannot do it alone.

·        Although some have advocated the use of compulsory licensing or parallel trade as a solution to the AIDS crisis in the developing world, these mechanisms would do little to improve access to health care services or HIV medicines.

-        The success of antiretroviral therapy requires an effective health care infrastructure to support drug delivery, monitor the response, manage side effects, and ensure patient adherence to complex regimens. 

-        The absence of this infrastructure remains the major obstacle to access to treatment, and in fact, threatens to worsen the crisis by mutating the disease and developing resistance to existing drugs.

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