The Facts on WHO’s Efforts Against AIDS

Sally Satel’s July 1 commentary, “WHO’s Dubious Bag of HIV Medicines,” is mistaken on a number of counts:

* “3 by 5” is not a World Health Organization plan but a global target. The target to provide 3 million people with antiretroviral treatment by the end of 2005 can only be achieved with the commitment and action of all partners in society.

* Today, 6 million people urgently require AIDS treatment in the developing world. Treatment regimens must be simplified, while high quality has to be maintained. WHO recommends the use of fixed-dose combinations (FDCs) of AIDS drugs, which combine several drugs in one pill, whenever possible.

FDCs make these drugs easier to buy, distribute and store. They are already saving many lives in developing countries. A study by the French National Agency for Research on AIDS confirms that the Triomune pill works as well as brand-name drugs.

* Satel claims that “WHO announced that two medications on (WHO’s) list of approved HIV drugs did not meet quality standards.” This was not the case. These AIDS drugs meet international norms and standards for quality. However, WHO cannot now vouch for their bioequivalence (bioequivalence determines if the blood concentration of the generic drug is similar to that of the patented version). As part of the ongoing monitoring and verification process, WHO inspected the independent laboratory Cipla had contracted to do the bioequivalence tests. The inspection revealed that the laboratory was not compliant with good clinical and manufacturing practices. Though bioequivalence is not ruled out, the necessary proof to demonstrate it is missing.

Jim Yong Kim

Director

WHO HIV/AIDS Dept.

Geneva