原创力文档intervening in global markets to improve access to hivaids treatment an analysis of international policies and the dynamics of global antiretroviral medicines markets在全球市场干预治疗改善条件的分析国际政策和全球抗逆转录病毒药物市场的动态.pdfVIP
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intervening in global markets to improve access to hivaids treatment an analysis of international policies and the dynamics of global antiretroviral medicines markets在全球市场干预治疗改善条件的分析国际政策和全球抗逆转录病毒药物市场的动态
Waning et al. Globalization and Health 2010, 6:9
/content/6/1/9
R E S E A R C H Open Access
Research
Intervening in global markets to improve access to
HIV/AIDS treatment: an analysis of international
policies and the dynamics of global antiretroviral
medicines markets
1,2 3,4,5 1 6 7 8,9
Brenda Waning* , Margaret Kyle , Ellen Diedrichsen , Lyne Soucy , Jenny Hochstadt , Till Bärnighausen and
Suerie Moon10
Abstract
Background: Universal access to antiretroviral therapy (ART) in low- and middle-income countries faces numerous
challenges: increasing numbers of people needing ART, new guidelines recommending more expensive antiretroviral
(ARV) medicines, limited financing, and few fixed-dose combination (FDC) products. Global initiatives aim to promote
efficient global ARV markets, yet little is known about market dynamics and the impact of global policy interventions.
Methods: We utilize several data sources, including 12,958 donor-funded, adult first-line ARV purchase transactions, to
describe the market from 2002-2008. We examine relationships between market trends and: World Health
Organization (WHO) HIV/AIDS treatment guidelines; WHO Prequalification Programme (WHO Prequal) and United
States (US) Food and Drug Administration (FDA) approvals; and procurement policies of the Global Fund to Fight AIDS,
Tuberculosis, and Malaria (GFATM), US Presidents Emergency Plan for AIDS Relief (PEPFAR) and UNITAID.
Results: WHO recommended 7, 4, 24, and 6 first-line regimens in 2002, 2003, 2006 and 2009 guidelines, respectively.
2009 guidelines replaced a stavudine-based regimen ($88/person/year) with more expensive zidovudine- ($154-260/
person/year) or tenofovir-based ($244-465/pe
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