Saturday 17:54:38
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4:
This decision will foster competition and is likely to lower the cost of the drugs very significantly. However, lowered drug prices will not completely solve the "insufficiency of funds" -- considering the estimated and actual funds available -- to combat AIDS worldwide.
The calculations presented below were based from the lowest cost of generic drugs from international generic drug companies like Cipla, and 50% of the actual high end cost (full drug costs, about $10,000-12,000) of antiretroviral and combination drug therapies in Western countries.
| AIDS/HIV Cases (million) |
Monthly Cost (US$) |
Annual Cost (US$) |
Total Annual Cost (US$ Billion) |
| 5 | $ 36 | $ 432 | $ 2.2 |
| 28 | $ 36 | $ 432 | $ 12.1 |
| 40 | $ 36 | $ 432 | $ 17.3 |
| 50 | $ 36 | $ 432 | $ 21.6 |
| 5 | $ 100 | $ 1,200 | $ 6.0 |
| 28 | $ 100 | $ 1,200 | $ 33.6 |
| 40 | $ 100 | $ 1,200 | $ 48.0 |
| 50 | $ 100 | $ 1,200 | $ 60.0 |
| 5 | $ 500 | $ 6,000 | $ 30.0 |
| 28 | $ 500 | $ 6,000 | $ 168.0 |
| 40 | $ 500 | $ 6,000 | $ 240.0 |
| 50 | $ 500 | $ 6,000 | $ 300.0 |
Based on the above estimates, here are some harsh realities just for AIDS drugs costs alone:
- South Africa, with highest number of people living with HIV/AIDS (PLWHA) in the world, at more than 4.7 million , would need to allocate $2-6 billion annually, based on $432-1200 annual cost per recipient for antiretroviral drugs alone.
- India, with a population greater than 1 billion, has about 4 million PLWHA that is estimated to double every 14 months if the AIDS epidemic is left unabated. At this rate, India could easily overtake South Africa at the top, if it has not already done so, with the highest number of PLWHA. At present, India would need a budget for the antiretroviral drugs alone that is almost equivalent to that of South Africa, but this would have to be doubled every 14 months based on the estimated doubling time of PLWHA in this country.
- Sub-Saharan Africa, with about 28 million of PLWHA, would need to allocate $12-34 billion annually, based on $432-1200 annual cost per recipient for antiretroviral drugs alone.
- Worldwide, with about 40 million of PLWHA, would need to allocate $17-48 billion annually, based on $432-1200 annual cost per recipient for antiretroviral drugs alone.
There are reports suggesting that the population of people living with HIV/AIDS is underestimated and is closer to 50 million; based on these numbers about $22-60 billion would be needed annually (based on $432-1200 annual cost per recipient).
The above estimated budgets were calculated using the lower estimates of the actual cost of antiretroviral drugs. Moreover, the budgets have to be increased annually to keep pace with inflation, as well as the rate of increase in the population of PLWHA.
If the AIDS epidemic is not curbed in other parts of the world (e.g., East Europe, some countries in Asia, including India and China), the new cases of AIDS in the future may dwarf the population of PLWHA in Africa. In such a scenario, the needed budgets for the antiretroviral drugs alone would be mind boggling -- the estimated UNAIDS Fund would not even suffice to deal with the needs of countries with the highest population of PLWHA, like India, South Africa, etc.
It cannot be overemphasized that the above costs estimates are for the antiretroviral drugs alone. The UNAIDS Initiative have more ambitious goals: "... prevention including interventions focusing on youth, workplace programs, mother-to-child transmission and condom distribution... palliative care, treatment and prophylaxis of opportunistic infections, support for orphans, and antiretroviral therapy...." (from Resource Needs for HIV/AIDS).
Based from the simple calculations presented above, the ambitious goals of the UNAIDS Initiative could balloon the total cost by 5-10 fold, perhaps even more. It is unclear therefore how the UNAIDS Initiative is expected to accomplish all its intended goals with just a budget of $9-10 billion each year. However, even with this "unrealistic budget", the world is not responding as enthusiastically to the appeal of the United Nations to provide the much needed funds.
The Brazilian governments decision to provide "free drugs" to "all" those living with HIV/AIDS (PLWHA) is lauded by AIDS policy makers as a model project. The flaw in using the Brazilian initiative as a model is that many countries, like South Africa, have a population of PLWHAs that are 5-10 times greater than Brazil, but without the resources needed to subsidize such drug initiatives.
Even many of the richer countries in the world, like the United States, do not have universal subsidy programs to treat HIV/AIDS or any other disease for that matter.
A world with limited resources brings up moral issues with political undertones:
- Should people living with HIV/AIDS (PLWHA) in less developed countries have access to AIDS drugs at reduced prices; but not the poor PLWHA in Western countries?
- Is it moral for the US Federal government (or for that matter other Western governments) to provide more subsidy to the world AIDS initiative, but not initiate similar programs for its growing number of poor minorities, especially African-Americans and Hispanics, who are disproportionately affected, as ethnic groups by the AIDS epidemic?
The issue of targeting scarce foreign aid resources mainly to the "poorest" countries has been raised. Many countries that may not be in these ranks could have even more poor people, numerically speaking, than the numbers found among those considered as "poorest" countries.
In light of the above estimates, for the actual cost of combating the AIDS epidemic, it is prudent for the UNAIDS Initiative to emphasize prevention as its cornerstone in the fight against the world AIDS epidemic. But the question remains, can it achieve its goal to subsidize the high cost of treatment also? If the UNAIDS Initiative faces the reality that it can not have the resources to provide treatment subsidy, the moral issue raised by others deserves consideration: Can we just let them [the PLWHA] die?
These logistic realities and moral issues demand a rethinking of the approachto combat the worldwide AIDS epidemic.
Please click on AIDS Primer, if you do not see the A-Z navigation links, specific for this section. This page is a part of a much larger website -- "Treasures of the Internet" -- that includes other health-related sections, as well as other more general sections on the arts, literature, science, etc. If this is your first visit, please read "navigating this site", for further guidance.