ARV Therapy in Russia and the EECA Region
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Challenges and opportunities to increase access to ARV treatment in Russia and Eastern Europe and Central Asia.
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ARV Therapy in Russia and the EECA Region
Editor's Notes
- CD4 count of ≤350 cells/mm3 and for those with WHO clinical stage 3 or 4 if CD4 testing is notavailable.Simplified, less toxic antiretroviral drugs for use in first-line and second-line therapyPromoting the initiation of ART for all those with HIV/TB co-infectionPromoting improved HBV diagnosis and more effective treatmentof HIV/HBV co-infectionSecond-line ART should consist of a ritonavir-boosted protease inhibitor (PI) plus two NRTIs, one of which should be zidovudineortenovofir,based on what was used in first-line therapy. Ritonavir-boosted atazanavir (ATV/r) or lopinavir/ritonavir (LPV/r) are the preferredPIs.(WHO treatment guidelines, 2010)
- UNAIDS Strategy – priority country as a center of an epidemic among IDUsFaster growing epidemics in Europe and possibly in the world – EECA is the only region in the world where the HIV epidemic is on the riseUkraine: In 2011 about 360,000 living with HIV. However, low growth of new infections compared to 2010Russia, preliminary data of the the AIDS Center: 664976(2012), growth compared to 2011(650100) - about 2,2%UNAIDS reports that Brazil and Russia are now paying for treatment mostly from their country budgets. Together we can end AIDS document.As a donor, Russia has provided to organizations working on HIV US$ 31 million or more in 2011. 13 million were directly reached towards activities related to HIV Bilateral assistance to other CIS countries in activities against epidemics, including HIV. In 2007-2010 more than 88 to the fund for creating vaccine against HIV. Together we can end AIDS document.Hosted the international MDG 6 Forum in 2011.
- By 50% of the pharmaceuticals on the internal market have to be locally produced.60% increase in innovation medicines, produced locally85% of the active ingredients of “strategic medicines” – locally manufactured by 2020.
- India is using actively patentability criteria flexibilities in order to prevent low quality patents and evergreening of pharmaceutical patents. India has used compulsory licensing. In 2007 Brazil issued a compulsory license on efavirenz.South Africa: In May 2011, a 1.5-fold increase of treatment coverage in less than a year, treating over 1.4 million people, and a decrease in prices of ARVs by 53%, after a government tender with ten competitors. Data exclusivity in Russia: Article 18 of the Law on turnover of medicines – 6 years. Examples of Eurasian patents: N 014446 and № 011924 related to lopinavir/ritonavir, one of the most expensive ARVs. One is method of treatment, the other one on form In addition: now expired (in 2011) Eurasian patent on method for treatment of Hepatitis C with “timazone”, interferon and ribavirin (007785). At the end it was supported in Russia only, in other EAPC countries it ended in 2009.
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