Is the new "combination therapy" for countries heavily burdened by HIV/AIDS going to be the potent mix of one former US President + funding from a French-led airline levy + the high volume-low margin business model of Indian drug manufacturers? This morning's announcement by President Bill Clinton and French Foreign Minister Philippe Douste-Blazy in New Delhi of a new pricing deal for pediatric fixed-dose combinations of antiretroviral treatment, funded by UNITAID and supplied by Cipla and Ranbaxy, is certainly a welcome one. Through the agreement, the price of 19 drug formulations appropriate for children will fall by 45 percent, to less than $60 per year for 62 of the lowest-income countries. This important achievement will surely increase access to life-extending drugs for many children, hopefully reducing the approximately 400,000 child deaths from AIDS each year. It also reinforces the merits of the Clinton Foundation model, which pairs deep discounts with good demand forecasting , multi-year procurement arrangements, and a recognition that pharmaceutical companies will only continue to supply products if it is a profitable business model and not just charity. (For more details, see the CHAI press release and Q&A.)
The only thing not to like about the new deal is the painful reminder of all the missed opportunities to raise awareness, mobilize money and achieve results in the fight against other causes of infant and child illness and death. There are few celebrity galas for acute respiratory infection, which kills about 2 million children in the developing world each year; no dedicated funds providing an indefinite flow of hundreds of millions of dollars to combat malnutrition, a risk factor a large share of the 10 million child deaths annually; no summits of world leaders wringing their hands about the fact that the high child death rates have remained virtually unchanged in many sub-Saharan African countries for more than 10 years (see the Lancet Child Survival series for more details). The correspondence between the magnitude of health problems and the allocation of donor resources is weak indeed, as highlighted in a recent article by my colleague Jeremy Shiffman (.pdf). Donors and politicians seem to be busy overcorrecting for their shamefully slow action to prevent AIDS in the early days of the pandemic, but in the process they may be setting themselves up for even harsher judgment by future generations. So, while we take a moment to applaud the truly impressive achievements of CHAI in responding to the lack of good AIDS medicines for children, let's not fool ourselves into thinking that the hard work is done.
Update: Jeremy's editorial on how AIDS is crowding-out priority for other health causes came out in today's Bulletin of the World Health Organization
CGD blog posts reflect the views of the authors, drawing on prior research and experience in their areas of expertise.
CGD is a nonpartisan, independent organization and does not take institutional positions.
