Last January 15, 2002, the Philippines hosted the 2nd of the four series of Distance Learning Seminar on HIV/AIDS with support from the Vietnam Development Information Center and the UNAIDS Secretariat Office in Hanoi, collaboration with UNAIDS cosponsors, the World Bank in Vietnam using the Global Development Learning Network (GDLN) facilities in the East Asia Pacific Region.
The topic is on "Access to Drugs and Treatment" facilitated by Dr Jose NMC Sescon Executive Director of Remedios AIDS Foundation, Inc. Two objectives were set for the meeting. First, to provide an ideal vehicle for conveying the latest information on policy issues, comprehensive care and support programmes related to HIV/AIDS. Second, to discuss and review challenges and opportunities among participants in the East Asia Pacific Region. The said DLS meeting has been attended by six (6) participating countries namely: Cambodia, Vietnam, Laos, Thailand, China and East Timor.
Two invited speakers talked about the said topic namely Mr Joshua Formentera President Positive Action Foundation, Inc Philippines and Dr Anupong Chitwarakorn, Director of AIDS Division Department of Communicable Diseases Ministry of Health. Bangkok Thailand. After their presentation, an open forum was conducted followed by the in country discussion. The following is the Philippines summary of in-country discussion to be followed by the synthesis of the DLS workshop.
Issues Regarding Access to Treatment: The Philippine Experience
The in country discussion identified the following issues:
1. High cost of drugs
2. Quality of drugs
3. Need for regular health monitoring through CD4 count and viral load
4. Some proposed solutions seem to be of conflicting interests. For example, drug companies are willing to reduce prices of drugs provided that there is NO parallel importation. It was noted that the discussion on access to treatment is based on economics alone.
Looking for the Possible Solutions : Philippines
Short term: parallel importation maybe doable but there is a need to be keen on the quality and authenticity of drugs being brought in any patent or license holder.
Medium term: improve capabilities of health workers to provide care and support which is very essential to the so called continuum of care and quality of care regardless if it is hospital, home, and community based caring.
Long term: development of local drug manufacturers to produce low cost, quality drugs making it available and affordable to all possible clients.
The role of the Philippines' National Insurance System to include insurance schemes for PHAs. This is provided for in Philippine Law, but so far nothing yet has been done on this area. This has been long overdue and the need to implement this area as reflected on the law.
Some Concrete Steps
The Department of Health has allocated 1 million pesos or $ 20,000 for AVR to prevent mother-to-child transmission.
In addition to government efforts, NGOs are also initiating their own efforts to have access to drugs. like client contact and negotiation with countries like India thru CIPLA. Donations by alliances NGOs and contacts like USA and Australia.
Finally, the urgency of the need to access drugs should be emphasized. We need true political will. If we don't find the solutions, bureaucracy can be life threatening.
Distance Learning Seminar : "Access to Drugs and Treatment" Synthesis
Common Concerns
* Parallel importation to lower drug prices but need to ensure quality of drugs
* Access to treatment is not just ARV, but we must also pay attention to treatment of opportunistic infections (OI)
* Advocate government to prioritize treatment
* Capacity building for health personnel
* Need for referral system and networking
* Need to improve laboratory testing
* Health insurance should be mobilized for persons living with HIV/AIDS (PHAs)
* Whether high or low prevalence, political leadership is essential
* Government, NGOs and community need to work together
* Uphold human rights as a basic principle
* Need to consolidate data through serological and behavioral surveillance, and develop a national plan based on these data
* Access to treatment is note just economics, but political will is also needed.
Country Specific Concerns
China: There's a big difference between the actual number of cases vis-a-vis estimate of HIV cases.
Laos: Stigmatization still exists, and it is a problem
East Timor: What do we do now in the absence of a national policy?
Finally , countries need to study their own situation and develop appropriate strategies applicable at their own resource limited settings.
