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báo cáo khoa học: " Intervening in global markets to improve access to HIV/AIDS treatment: an analysis of international policies and the dynamics of global antiretroviral medicines markets"

Tuyển tập báo cáo các nghiên cứu khoa học quốc tế ngành y học dành cho các bạn tham khảo đề tài: Intervening in global markets to improve access to HIV/AIDS treatment: an analysis of international policies and the dynamics of global antiretroviral medicines markets | Waning et al. Globalization and Health 2010 6 9 http www.globalizationandhealth.eom content 6 1 9 GLOBALIZATION yiy AND HEALTH RESEARCH Open Access Intervening in global markets to improve access to HIV AIDS treatment an analysis of international policies and the dynamics of global antiretroviral medicines markets Brenda Waning 1 2 Margaret Kyle3 4 5 Ellen Diedrichsen1 Lyne Soucy6 Jenny Hochstadt7 Till Barnighausen8 9 and Suerie Moon10 Abstract Background Universal access to antiretroviral therapy ART in low- and middle-income countries faces numerous challenges increasing numbers of people needing ART new guidelines recommending more expensive antiretroviral ARV medicines limited financing and few fixed-dose combination FDC products. Global initiatives aim to promote efficient global ARV markets yet little is known about market dynamics and the impact of global policy interventions. Methods We utilize several data sources including 12 958 donor-funded adult first-line ARV purchase transactions to describe the market from 2002-2008. We examine relationships between market trends and World Health Organization WHO HIV AIDS treatment guidelines WHO Prequalification Programme WHO Prequal and United States US Food and Drug Administration FDA approvals and procurement policies of the Global Fund to Fight AIDS Tuberculosis and Malaria GFATM US President s Emergency Plan for AIDS Relief PEPFAR and UNITAID. Results WHO recommended 7 4 24 and 6 first-line regimens in 2002 2003 2006 and 2009 guidelines respectively. 2009 guidelines replaced a stavudine-based regimen 88 person year with more expensive zidovudine- 154-260 person year or tenofovir-based 244-465 person year regimens. Purchase volumes for ARVs newly-recommended in 2006 emtricitabine tenofovir increased 15-fold from 2006 to 2008. Twenty-four generic FDCs were quality-approved for older regimens but only four for newer regimens. Generic FDCs were available to GFATM recipients in 2004 but to PEPFAR recipients only .