Ivory Coast’s HIV-Positive Patients Still Unable to Afford AIDS Drugs, Health Care Infrastructure Needed

While regional AIDS experts consider the Ivory Coast West Africa's "most prosperous" country, with "some medical infrastructure and government interest" in fighting the AIDS epidemic, most HIV-positive citizens in the country are unable to afford anti-AIDS drugs even at sharply discounted prices, the Washington Post reports. Compared to the AIDS "nightmare" facing surrounding countries, the Ivory Coast "has done well," Abdoulie Janneh, assistant administrator and director of the U.N. Development Program in Africa, said. Ivory Coast President Laurent Gbagbo has taken significant steps toward addressing the epidemic, speaking out on the issue that is typically considered "taboo," elevating the National Fight Against AIDS director to a cabinet-level position and budgeting $17 million this year for anti-AIDS efforts. In addition, the country last year accepted offers from pharmaceutical companies to provide AIDS drugs at 90% discounts. But the steep price cuts "will have a limited effect until a host of other issues are dealt with," the Post reports, citing the "grinding poverty that makes almost any charge unaffordable" and the problems associated with "creating a health care infrastructure to deliver the drugs and monitor their use and educating people about AIDS." National Fight Against AIDS Minister Kassim Sidibe said, "Even if the drugs were free, it would not solve our problems. Health care access is a serious problem. ... Cheap drugs are good, free drugs are better, but they are only a piece of the puzzle." And patients who are able to partially afford the drugs may take them intermittently due to "financial pressures" -- halting the regimen when their symptoms improve, and resuming the regimen only when they feel "severely ill" again. Such practices help create drug-resistant HIV, the Post reports. Terence Chorba, director of the CDC office in the Ivory Coast, noted, "We need to be judicious, and to be judicious we have to monitor patients, monitor labs and that infrastructure doesn't exist. Antiretrovirals are a major piece, but a lot of other major pieces also have to be addressed" (Farah, Washington Post, 6/12).