Boston Globe Examines Debate Over Rationing of Antiretroviral Drugs

Few attendees of the XV International AIDS Conference in Bangkok, Thailand, last week "talked openly" about the rationing of antiretroviral drugs in many developing countries because of limited supplies, the Boston Globe reports. Fewer than six seminars out of several hundred during the conference discussed the issue, the Globe reports. Jonathon Simon, director of the Center for International Health and Development at Boston University, said, "Countries should decide on their priorities. Do they give preferred access to mothers? To teachers and nurses? You've got to have a public debate." He added that many countries determine eligibility based on economic models based on productivity potential. Some sub-Saharan African nations are "quietly talking" about implementing qualification restrictions for treatment, including supplying drugs for first-line but not second-line treatments, according to the Globe. A study presented by Columbia University at the conference indicates that the lack of a single standard for qualification has resulted in "wide-ranging rules" on eligibility, the Globe reports. About 440,000 people with HIV/AIDS receive treatments, and that number is expected to increase "fairly significantly" in part because of new grants from the Bush administration and the Global Fund to Fight AIDS, Tuberculosis and Malaria and new technical assistance from the World Health Organization and UNAIDS (Donnelly, Boston Globe, 7/16).