Access to HIV/AIDS Medicines The 3x5 strategy

WHO/EDM Technical Briefing Seminar

15-19 March 2004

Three by Five

The goal is universal access to anti-retroviral therapy as a human right

The target is three million people on treatment by the end of 2005

The treatment gap was declared a global health emergency Sept 22nd at UNGA

Pillar 1: WHO and global level activities

1. Visible WHO leadership and commitment to urgent action to reach the goal of universal access to ART

2. Locate the rights-based 3x5 initiative within the broader development context

3. Support all national efforts whilst focusing WHO resources on high-burden and strategic countries to achieve maximal impact of 3x5 initiative

4. Align and mobilize partner support to achieve 3x5 target at global level Member States

UNAIDS Co-sponsors

Other partners

Momentum created

Country owned process

Pillar 2: Country Support Efforts

5. Secure the key elements required at the national level to deliver the 3x5 target as part of a comprehensive response to HIV/AIDS

6. Strengthen and support the renewal of health systems and national operational capacity for scaling up ART programs

7. Strengthen and build human capacity for scaling up ART

8. Expand capacity of communities to be fully

involved in ART program planning and delivery

National Medicines Policy

(Selection, procurement, regulation, supply chain management, rational use)

Pillar 3: simplified, standardised tools

9. Simplify and standardize procedures to identify individuals in need of therapy and facilitate entry to ART programs

10. Simplify and standardize ARV therapy to facilitate adherence and enable rapid scale-up to be implemented

11. Simplify and standardize tools for tracking ART program performance including drug resistance surveillance

Rapid test based approach

4 First-line treatmentsFDCs and Blisters

Standardized M&E Guidelines

Pillar 4: Effective medicines and

diagnostics supply

12. Support country access to , and efficient distribution of high quality, low cost medicines and diagnostics

Pillar 5: Success stories and learning by doing

13. Build on success

14. Continuously learn by doing - with ongoing evaluation and analysis of program performance and a focused operational research agenda.

Ensure that the supply of quality commodities is never an obstacle to expanding treatment, care and support

Use improved commodity supply to catalyze rapid expansion of treatment, to promote equity, to support prevention

AMDS objectives

Use partners to best capacity Don’t develop new structures/systems All partners involved in planning and

further expansion Support all available channels

(government, NGOs, insurances)

AMDS general principles

What the AMDS will doAssist/support a country-driven process……

Create information hub Bring together strategic information from existing

sources (ensure ease of access) Develop new tools as needed (self or contracted)

Serve as “one-stop-shop” for specific support Initiate and act as gateway for information and

Technical Assistance by partners inside and outside WHO

Support operational staff (Recruit), train and support dedicated procurement

and supply chain management staff

What the AMDS does not plan to do………

No procurement itself but Support countries to buy/manage supplies Direct to appropriate services

ARVs: PQ Procurement agenciesDiagnostics: WHO bulk procurement scheme

No repeat /duplicate effort Use ongoing work, available expertise and information No new structures MOH, NGO.

No funding to purchase commodities

Examples of EDM action and guidance on Access to HIV-Related Medicines*

13th WHO Model List of Essential Medicines, including (since 12th edition including ARVs)

2nd WHO Model Formulary, including section on ARVs

Pre-qualification of HIV medicines and manufacturers (R&D and generic)

Annual Reports on “Sources and Prices of Selected Drugs and Diagnostics for People Living With HIV/AIDS; jointly with UNICEF, UNAIDS, MSF

Operational Principles for Good Pharmaceutical Procurement – IPC group

Globalization, TRIPS and Access to Pharmaceuticals. WHO Policy Perspectives on Medicines

* Available on EDM web site (http://www.who.int/medicines/)

For further information……….

Peter Graaffgraaffp@who.int