The Global Fund to Fight AIDS, Tuberculosis and Malaria, the World Bank, UNICEF and the Clinton Foundation have announced agreements that will make it possible for developing countries to purchase high-quality AIDS medicines and diagnostics at the lowest available prices, in many cases for more than fifty percent less than is currently available. Countries will be required to provide guarantees of payment, to conduct long term tenders and to ensure the security of drug distribution.

The Global Fund and the World Bank are among the world’s largest sources of funding commitments to AIDS treatment. The Global Fund focuses more than 60 percent of the $US 2.1 billion committed for two years to 122 countries to the fight against AIDS. The World Bank has currently committed $US 1.6 billion to fight AIDS through the Multi-country HIV/AIDS Programs (MAP) and other AIDS operations, including grants for the poorest countries. UNICEF spent $US 111 million during 2003 in the fight against AIDS and is rapidly accelerating the procurement of antiretroviral medicines (ARVs) and AIDS diagnostic equipment and tests for developing countries.

The drugs in these agreements include individual formulations and two- and three-drug fixed dose combinations which have been prequalified by WHO to assure quality and efficacy. These medicines are critical components of the four regimens recommended by WHO as “first line” treatment for AIDS in its 3 by 5 initiative. In developing countries outside of Brazil, such life-sustaining therapy is available to fewer than 200 000 people living with HIV, although almost six million require it.

The pharmaceutical manufacturers included in these agreements are from South Africa and India. The price for the most common first line formulation under these agreements is as low as $US 140 per person per year, one-third to one-half of the lowest price otherwise available in most settings. The diagnostic tests included in these agreements are offered by five leading medical technology companies and include CD4 tests and viral load tests. The prices available for these tests under the agreement include machines, training, reagents and maintenance and are up to 80% cheaper than otherwise available in the market.

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