WHO plans global ARV purchasing system by end of 2003

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The World Health Organization plans to unveil a bulk purchasing and procurement system for antiretrovirals by December 1, according to a report this week in the Boston Globe. The new model will be based on the Global TB Drug

Facility, which has purchased and distributed drugs for nearly two million TB

patients over the past two years.

Glossary

generic

In relation to medicines, a drug manufactured and sold without a brand name, in situations where the original manufacturer’s patent has expired or is not enforced. Generic drugs contain the same active ingredients as branded drugs, and have comparable strength, safety, efficacy and quality.

fixed-dose combination (FDC)

Two or more drugs contained in a single dosage form, such as a capsule or tablet. By reducing the number of pills a person must take each day, fixed-dose combination drugs may help improve adherence.

It is hoped that the system will begin to drive down drug prices in the same way as the Global TB Drug Facility has achieved for TB drugs. The cost of first line TB treatment has been reduced to approximately $10 for a six month course of treatment since the Global TB Drug Facility began operations.

The system will also allow WHO to work with National AIDS Programmes and Health Ministries to create reliable and secure systems for distributing drugs and monitoring drug stocks.

A global procurement mechanism will allow WHO to call for tenders to provide drugs from all manufacturers, but its success in driving down costs will require WHO's precertification mechanism for generic antiretrovirals to speed up its review process. As of July 4 2003, none of the fixed dose combinations containing nevirapine currently manufactured in India had been approved for procurement by UN agencies, and many other generic versions of antiretrovirals were still missing from the list published by WHO. Also missing was Gilead's antiretroviral tenofovir.