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Will access to AIDS drugs in Africa continue?

I remember the first time I saw a woman in Africa die of AIDS. Susan Andukais, just 36, was entombed on the only bed in a tin shack in Naivasha, Kenya, a wasted figure barely able to lift her hand in greeting. Susan left behind four children when she died three weeks after I visited her. It was 2004, when antiretroviral drugs weren’t much available to patients in Africa, and I was stunned - and furious - to see someone die of a disease I knew was eminently treatable.

Since then, more than 4 million people have gained access to these precious, life-giving drugs. And a new study from Stanford researchers says the reason is two-fold: because drug prices have dropped precipitously and because governments have pumped an enormous amount of foreign aid into AIDS treatment.

But neither of these trends is likely to continue, so the prospects for universal access to care - providing drugs to the millions who need them - remains remote indeed. The researchers calculate it would cost a stunning $15 billion a year to reach the oft-heralded goal of universal access.

“The things we have been doing are extraordinary in terms of reducing antiretroviral prices and mobilizing resources from the wealthy countries,” Eran Bendavid, MD, first author of the new study in the British Medical Journal, told me. “But we’re reaching the point where we can’t further reduce drug costs. So it’s up to the people with the purse strings to decide how close we’ll get to universal access.”

Moreover, foreign aid is down amid the global economic downturn, and the major funders of AIDS care, including the U.S. government, aren’t increasing their contributions at the same rate and are changing their priorities. Bendavid says we’ll just have to find a way to make better use of the resources we have. But where does that leave the patients? It troubles me greatly to think of the other Susans who are likely to die now.

Previously: AIDS war in Africa is failing and Trimming treatment for AIDS patients

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