Break down barriers to treatment – UN secretary-general

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Reaching universal health coverage by 2030 in the fight against the HIV/Aids pandemic demanded breaking down barriers to treatment and developing treatments for TB, neglected tropical diseases and other unmet needs, UN Secretary-General Ban Ki-moon told the 21st International Aids Conference in Durban.

Last November Ki-moon convened the UN Secretary-General’s High Level Panel on Access to Medicines following the adoption of the 2030 Sustainable Development Goals to address policy incoherence between the justifiable rights of inventors, international human rights law, trade rules and public health in the context of health technologies.

The panel comprises 16 well-respected individuals with a deep knowledge and understanding of the legal, trade, public health and human rights issues associated with innovation and access to medicines and health technologies. In December it issued a call for contributions and received 182 submissions from the private sector, governments, civil society groups, multilateral organisations and academia.

In March 2016 the panel held two global dialogues in London and Johannesburg where participants proposed solutions to the challenges of promoting innovation and access to medicines, vaccines and diagnostics. The panel is currently finalising its report before presenting it to the UN secretary-general.

UN Development Programme director of health and HIV Mandeep Dhaliwal said the panel hoped the report would develop new pathways to innovation and access to health technology. The panel had a key mandate and the members were grateful to everyone who had contributed ideas and proposals to move the issue forward.

Ki-moon said when Durban hosted the 13th International Aids Conference in 2000, less than 1% of those living with HIV in poorer countries had access to treatment and millions of people died waiting for medicines. Today, more than 17 million people receive treatment, but more was still required.

Panel member Ruth Dreifuss said the world struggled to effectively respond to challenges like anti-microbial resistance, TB, diseases of the poor and rare diseases, as there was no clear immediate return on investment. Consequently, the panel was seeking to ensure innovation was sufficiently rewarded, while also progressing towards universal health coverage by boosting access to health technologies.

South African deputy president Cyril Ramaphosa said since the country last hosted the International Aids Conference, the world had “turned the tide on HIV/Aids” with strides made particularly in regions most affected like eastern and southern Africa. Currently 10.3 million of the 17 million people globally on anti-retroviral (ARV) treatment live in this region.

Ramaphosa said UN Aids figures reflected the number of people in eastern and southern Africa receiving treatment had more than doubled since 2010; Aids-related deaths had dropped by more than a third and mother-to-child transmissions had been significantly reduced.

However, he believed the infection rate remained “stubbornly high” as too many people living the disease did not know their status and others did not have access to treatment.

Adolescent girls and young women between 15 and 24 years old accounted for 20% of new infections globally in 2015 – and in sub-Saharan Africa they accounted for 25%.

“This means as we work harder to provide testing and counselling services, as well as massively expand treatment, we need to significantly improve our prevention efforts,” he said.

This meant ensuring young adults – men and women – received information and advice; had access to condoms and, where necessary, access to pre-exposure prophylaxis. Governments also needed to recognise the social and economic drivers of the epidemic and implement programmes to address them.

“Millions of people died unnecessarily because HIV/Aids drugs were not available to those that needed them. In Durban 16 years ago, treatment activists told the world everyone with HIV/Aids had a right to treatment,” panel member Lorena Di Giano concluded.

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