HIV Digest	HIV Digest Archive

Several nonprofit organizations are collecting unused AIDS and other medicines (not including controlled substances like narcotics) for free distribution abroad to people who otherwise could not afford them. Here are three organizations we have heard from recently. All happen to be located in New York City, but they can receive unused drugs by mail.

United Against AIDS International. UAAI has provided medications to more than 3,000 people in the more than three years it has been active. It works especially in Venezuela, with the help of airlines which donate transportation for a shipment per week, and with strong support from the government and from NGOs (non-governmental organizations) in Venezuela, and from U.S. AIDS organizations. UAAI also sends medications to Honduras and Columbia, and to individuals elsewhere.

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"If you or an organization that you know can help with this project by contributing medicines, supplies, or equipment, as well as by donating money or services, including printing, mailing, paper, advertising, communications, or by participating in a 'buddy' supply program, we urge you to contact Hugh Ward, executive director, UAAI, at 718-639-5696."

Aid for AIDS, a separate but cooperating organization now sending medicines to nine Latin American countries, currently has 80 clients and a waiting list of 30 others. It does not take on new clients for antiretrovirals until it knows that it can assure a continuing supply, to avoid the development of resistance.

"Aid for AIDS needs all types of medication. In particular, the group is looking for antiretrovirals, including nucleoside analogs, NNRTIs, and protease inhibitors. But medication to treat opportunistic infections, and even general medication, are appreciated."

Medicines can be sent to Aid for AIDS, PO Box 1862, Old Chelsea Station, New York, New York 10113, or call or fax to 212-358-9715, e-mail aid4aids@aol.com. Aid for AIDS can also pick up medications in the New York City area.

HIV Medicines for Guatemala, c/o Dr. Matt Anderson, Family Health Center, 360 E 193rd Stret, Bronx, New York 10458, phone 718-933-2400 x644, e-mail andersonma@aol.com.

"The medications we receive are sent to Guatemala by Solidaridad (a Guatemalan AIDS support group). They are distributed free of charge to the HIV positive patients of the San Juan de Dios Hospital and the Roosevelt Hospital, Guatemala City's major public hospitals.

"We accept all donations but prefer unexpired or unopened medications. As a general rule unopened medication is good for up to a year after the printed expiration date. The quality of opened medication declines more quickly.

"Among the most needed medications are the following: antiretrovirals (all types); anti-tuberculosis medications (INH, rifampin, ethambutol, pyrazinamide); antimicrobials (trimethoprim/sulfamethoxazole [Bactrim], pyrimethamine, sulfadiazine, folinic acid, ceftriaxone); antifungals (amphotericin B, fluconazole, itraconazole)."

AIDS Treatment News comment

Everyone knows that there will never be enough discarded medications to provide access to modern medical care to the 90 percent of the world's people who do not have it now. But these projects can help many people, and also provide a practical way to take the first steps to focusing on the problem.

Clearly there will not be a single answer to medical care in the developing world. But there are many approaches that make sense now. The most important medications are usually inexpensive, because they are old drugs which are no longer patented. (Often the most cost-effective health measures are not drugs at all, but clean water and improved nutrition. And in some cases it may be most effective to finance the scientific testing and development of inexpensive treatments, including traditional remedies.)

One area that needs more attention is institutional obstacles to negotiating lower prices for government health programs that cannot afford US/European rates. Unfortunately some companies are setting global prices-- ruling out 90 percent of the potential users of their drugs-- apparently because they fear development of a black market. But this risk is limited, because most of the expensive drugs are paid for by major government or private health plans, which cannot institutionalize a black-market supply.

'Best price' problems

US government policies may unintentionally create another barrier to treatment access in certain countries-- those with government health plans which could afford to pay more than the cost of manufacturing a drug (allowing for profitable sales), although not enough to cover the full "first world" costs for gold-plated drug development and marketing (and also for gold-plated waste and corruption).

Some government purchasing regulations require discounts based on the lowest price a company charges anyone for its drug (for example, Medicaid requires the "best price," and the Veterans Administration requires "most favored customer" pricing). Large private organizations like HMOs can also have such terms in their contracts. These contractual clauses, sometimes also in government regulations or laws, prevent pharmaceutical companies from giving deeper discounts to others even if they want to, because if they did, the government or other purchasers could demand the same price, and the company would have to sell most or all of its product at a price too low for it to survive.

If these clauses apply abroad as they do within the US-- which is likely, although AIDS Treatment News could not confirm that they do by press time-- they would make it impossible for companies to sell proprietary pharmaceuticals to countries like Costa Rica or Thailand at prices allowing general use there, even when the sales themselves would have been profitable for the companies.

Research and activism are needed to make sure that such acquisition policies-- intended to assure that ostensible discounts to U.S. taxpayers are real-- do not also have an accidental consequence of denying medicine to millions of people around the world.

Editor's Note: from AIDS Treatment News