Distribution of AIDS Drugs Should be Based on UNICEF Vaccination Efforts, Op-Ed Says

Delivering and administering AIDS drugs to people in developing nations is "no simple proposition, but it is feasible," and previous vaccination efforts against various diseases show that such actions can be accomplished, UNICEF Executive Director Carol Bellamy writes in a New York Times op-ed. UNICEF is poised to "step forward as the lead United Nations agency in the procurement of antiretroviral drugs" and has already begun to identify and publish sources and prices of drugs needed to fight HIV, Bellamy states. Bellamy suggests patterning distribution programs after a model developed by UNICEF to immunize "millions of desperately vulnerable children" against various diseases. She adds that these vaccination efforts "succeeded because we were able to develop effective strategies for funding, procurement and distribution of vaccines ... approaches [that] can help the world fight AIDS." Bellamy writes that, in the beginning, vaccination efforts were perceived as "too complex," as local governments and wealthy nations were "thought to lack commitment," and many developing countries had an infrastructure that was considered "too fragile to support a sustained campaign." However, this perception was "wrong," Bellamy asserts, adding that the global immunization campaign "is arguably the most successful public health initiative ever." She writes that efforts to distribute AIDS drugs could work as well. UNICEF's global supply center in Copenhagen has already worked with drug companies to obtain vaccines and drugs for other diseases, but more work is needed, Bellamy states. She adds that donors must provide additional funding for the cause, and governments, private donors and the United Nations could establish an international fund to subsidize already discounted medicines, which remain too costly for many developing nations. To distribute the medicines, Bellamy writes, UNICEF and WHO could help develop distribution strategies "tailored to each country's strengths and weaknesses." However, she warns, support is needed in such areas as basic health services, monitoring and oversight and "political commitment from the affected countries." Bellamy concludes, "We're crossing the first hurdle -- reducing prices. UNICEF's immunization programs offer models for funding, procurement and distribution. Now it's time for action" (Bellamy, New York Times, 3/26).