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Q&A : the pharmaceutical industry and access to ARVs in Africa

HEALTH ACTION INTERNATIONAL AFRICA
December 2005

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To mark World AIDS Day 2005, HAI Africa has prepared a simple, concise fact sheet on the pharmaceutical industry's role in access to HIV/AIDS treatment. The document, written in a question-and-answer format, addresses the impact of generic competition, compulsory licences and what the industry can do to increase access. It asks questions such as 'Are pharmaceutical companies involved in initiatives to increase access to ARVs?' and 'Do patents on medicines have an impact on access to ARVs?'

A briefing paper for DFID : update on China and India and access to medicines

GRACE, Cheri
November 2005

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This paper looks at the major developments in the Indian and Chinese pharmaceutical industries and the major opportunities. It considers how the agreement on Trade-related Aspects of Intellectual Property Rights (TRIPS) has been translated into domestic law in both countries; and the role India and China might play for either finished product or active pharmaceutical ingredient supply for domestic use or export, with regards to first-line recommendations for diseases like malaria and HIV

Delivering antiretroviral therapy in resource-constrained settings : lessons from Ghana, Kenya and Rwanda

RITZENTHALER, Robert
July 2005

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This publication is aimed at governments, development partners, and public and private health facilities seeking to provide ART as part of comprehensive care and support for people living with HIV and AIDS. It describes valuable lessons learned from several ART learning sites throughout Ghana, Kenya and Rwanda. By the end of April 2005, more than 5,800 new patients had initiated ART through this treatment and care initiative. Strategies, challenges and key recommendations are presented and comments by national and community leaders, providers and patients appear throughout the text to give readers a sense of the programs as they progressed. The lessons may not have direct relevance to all health facilities providing or planning to provide ART; it should be used or adapted depending on the epidemiological, political, social, cultural and economic context of each setting

Expanding access to HIV treatment through community-based organisations

SIDACTION
JOINT UNITED NATIONS PROGRAMME ON HIV/AIDS (UNAIDS)
WORLD HEALTH ORGANIZATION (WHO)
July 2005

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This UNAIDS Best Practice Collection document aims to highlight and advocate for the work of civil society, community based organisations in particular, in responding to the AIDS epidemic in Africa. The paper describes a ground breaking survey by Sidaction, a Paris based treatment rights group, which supports community responses to AIDS in low and middle income countries. In 2004, Sidaction, in cooperation with the UNAIDS secretariat and WHO mapped treatment and care efforts by community based organisations in Africa. Many community based organisations are already dispensing ARVs on a significant scale. The survey confirmed that community efforts to provide treatment represent an important opportunity to enrol more people in antiretroviral therapy. To seize this opportunity, national governments and the international community need to quickly provide support to expand the coverage and impact of community based treatment. The aim is for CBOs to work closely with the public sector so that each reinforces the efforts of the other

Engaging local non-governmental organisations (NGOs) in the response to HIV/AIDS : Community REACH Programme

PRIVATE AGENCIES COLLABORATING TOGETHER (PACT)
CORNMAN, Helen
et al
July 2005

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This paper draws on an extensive literature review of local NGO engagement, the direct experience of Pact's rapid response HIV/AIDS grants programme known as Community REACH and formal and informal interviews with the grantees highlighted in the paper. It considers the lessons learned from the programme and the authors hope that these will assist other organisations to successfully engage local partners and provide guidance to donors and national decision-making bodies. The paper is divided into four sections: the first outlines some successful strategies of local NGO engagement; the second examines local NGO strengths and weaknesses; the third provides advice to donors on effective and sustainable partnerships; and the fourth describes four funding models that harness the strengths of local NGOs to effectively respond to HIV/AIDS

Progress on global access to HIV antiretroviral therapy : an update on "3 x 5"

WORLD HEALTH ORGANIZATION (WHO)
JOINT UNITED NATIONS PROGRAMME ON HIV/AIDS (UNAIDS)
June 2005

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WHO and UNAIDS launched a strategy for ensuring treatment for 3 million people living with HIV and AIDS in low and middle income countries by the end of 2005 - the "3 x 5" target. Since late 2003, coverage of antiretroviral therapy (ART) has more than doubled from 400,000 to approximately 1 million receiving treatment by the end of June 2005. 14 of these countries are providing ART to at least 50% of those who need it, consistent with the 3 x 5 target. This interim report highlights progress made to date and the major obstacles that remain to the rapid scale up of HIV treatment. It looks primarily at the reasons for the successes and failures of scaling up HIV/AIDS interventions in different settings. The report also makes recommendations concerning the approaches needed to overcome bottlenecks as well as the need for sustainable financing mechanisms and greater harmonisation of effort by technical and financing partners at country level

Paediatric HIV/AIDS : MSF fact sheet

MEDICINS SANS FRONTIERES, CAMPAIGN FOR ACCESS TO ESSENTIAL MEDICINES
June 2005

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A useful fact sheet, providing a brief but comprehensive overview of problems associated with children with HIV/AIDS. The majority of children with HIV/AIDS live in developing countries, and often have no access to health care, while diagnostic and treatment services for children are more expensive than for adults. The document shows how disparities between North and South are particularly visible in transmission prevention, diagnosis and treatment. Médecins Sans Frontières calls for: 1) WHO to develop a clear strategy to ensure that greater numbers of children receive antiretrovirals, 2) UNICEF to raise awareness about the fact that children are being excluded from AIDS treatment, and 3) pharmaceutical companies to facilitate access for children to antiretroviral therapy

Eldis OnDisc : Feasibility study for document caching and CD-ROM creation and distribution project

INSTITUTE OF DEVELOPMENT STUDIES
June 2005

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This report documents the Institute of Development Studies' investigation into the feasibility of creating Eldis OnDisc, a CD-ROM derived from their extensive website of development information. This report provides: background to the proposal, description of how the feasibility study was conducted, findings from the user survey, publisher survey, and other interviews, recommended next steps, and suggested budget. Annexes include user and publisher surveys, potential copyright agreements, and user and publisher responses to their proposal. The report concludes that there is a substantial market for offline distribution of Eldis-identified documents, and that publishers and distributors seem very interested in participating in this. Key findings from the survey are that: users still have problems accessing full text on the internet and have a need for offline access to such content, for both their own work and that of their colleagues; publishers are generally willing to release copyright, but there is a major logistical task in collecting the agreements although there is a growing interest in open-source content provision; users see value in a range of disc formats, including both single subject and multiple subject discs; and finally, small scale, high-impact distribution is possible. The business case for Eldis' involvement in such distribution is leverage of the IDS network of information service consumers

Containing antimicrobial resistance

WORLD HEALTH ORGANIZATION (WHO)
April 2005

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The emergence of antimicrobial resistance is a natural phenomenon that follows use of antimicrobial drugs but it is being accelerated by inappropriate antimicrobial use. This leaflet considers various methods that can be used to help contain antimicrobial resistance

The influence of the pharmaceutical industry

HOUSE OF COMMONS SELECT COMMITTEE ON HEALTH
April 2005

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This is the fourth report of session 2004-2005 and includes both the report and formal minutes. The committee considered increasing sale in the UK of patent and proprietary remedies and appliances and medicated wines, noting that while some were genuine scientific preparations, other were "unobjectionable remedies for simple ailments" and others still were "secret remedies making grossly exaggerated claims of efficacy"

The global threat of counterfeit drugs : why industry and governments must communicate the dangers

COCKBURN, Robert
NEWTON, Paul N
KYEREMATENG AGYARKO, E.
AKUNYILI, Dora
WHITE, Nicholas J
March 2005

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This article suggests that many pharmaceutical companies and governments are reluctant to publicise the problem of counterfeit medicines to health staff and the public. It recommends mandatory reporting to governmental authorities, which should have a legal duty to investigate, issue appropriate public warnings, and share information across borders

Paediatric ARV roll-out in South Africa

HORIZONS PROGRAM
CAPE TOWN UNIVERSITY
2005

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The Horizons Program of the Population Council and the University of Cape Town are conducting a study to identify successful programme strategies in paediatric HIV treatment in South Africa and to determine priority knowledge gaps to be addressed by operations research. This report summarises key findings from the initial consultative workshop of expert practitioners and stake-holders, focusing on the status of providing antiretroviral therapy to children in South Africa and strategies to expand and improve services. It includes providing services to under six year olds

Ensuring equitable access to antiretroviral treatment for women : WHO/UNAIDS policy statement

WORLD HEALTH ORGANIZATION (WHO)
2005

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This policy brief identifies actions needed to address the gender dimensions of equity in access to ART. It identifies four key areas: development of a supportive policy environment; strengthening health systems to make them more responsive to the specific needs of women and men; promotion of programmes that overcome obstacles to equitable access; development of benchmarks and indicators to measure progress. This brief addresses each area in turn

Health Canada unveils new health threat alert system

January 2005

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This brief article reports on a new global system to detect public health and bioterrorism threats, developed in Canada. The system will be used to track high-profile threats, as well as lesser problems such as contamination to food and water sources, natural disasters, and unsafe medical products, drugs and medical devices. WHO is a key recipient of the alerts, and is using the information to develop plans of action to control outbreaks

Anti-retroviral therapy (ART) information kit

AIDS RESOURCE CENTRE
2005

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This infopack includes five inserts, which provide background information on antiretroviral therapy (what it is, challenges to implementing safe and effective antiretroviral programmes); antiretroviral therapy (ART) in Ethiopia, including details of where ART is available and eligibility for treatment; general health indicators for Ethiopia, including demography and health service statistics; a statement on the impact of HIV and AIDS in Ethiopia, from societal to community and individual level; and a glossary of words related to HIV and AIDS treatment

Global health watch 2005-2006 : an alternative world health report

LEMA, Claudia
et al
2005

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This report is the result of a collaboration of leading popular movements, NGOs, activists, academics and health workers. It provides an evidence-based analysis of the political economy of health and health care and challenges policies and initiatives of global organisations including the World Bank, the World Health Organization and UNICEF. Many key issues relevant to health are covered, including health care services and systems, health of vulnerable groups, climate change, food and water, education, armed conflicts. Part E also provides and assessment of the impact global institutions, transnational corporations and rich countries. This report is a call for action, directed to health workers and activists and national and international policy-makers

Adherence to HIV antiretroviral therapy

MACHTINGER, Edward L
BANGSBERG, David R
2005

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This "chapter" of the HIV InSite website provides a technical overview of key issues concerning adherence to ARV treatment including global rates of ARV adherence, implications of adherence, predictors and measuring adherence and interventions to promote adherence. While the emphasis is not on developing countries, one section on adherence in resource poor countries is of interest. It says that recent data suggests that even without dedicated adherence programmes, patients in resource poor settings have levels of adherence and virological suppression that are equivalent to, or possibly better than those seen in resource-rich settings. According to their data, financial barriers have been the only consistent predictor of incomplete adherence in resource limited settings

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