Concerns over Cost of New HIV/AIDS Treatment Regime

Malawi's adoption of updated HIV treatment guidelines has some AIDS advocates worried the costlier regimen will hamper patients' access to therapy. Malawi provides free antiretroviral (ARV) drugs to about 250,000 of the 1 million Malawians who have HIV. Twelve percent of Malawians are HIV-positive, and 65 percent live on less than $1 a day, according to the UN.

"At the moment, not all people who require treatment are getting it," said George Kampango of the Malawi Network of People Living with HIV/AIDS (MANET+). "Government is failing to provide free treatment for many poor people and children including orphans who need it most."

"Malawi is changing the treatment in line with World Health Organization [WHO] guidelines which are urging countries to phase-out the current first line of treatment, which is blamed for increased side-effects," said Dr. Mary Shawa, the nation's principal secretary for HIV/AIDS.

The government has been providing the first-line course of stavudine, lamivudine, and nevirapine for about $33 per patient each month. In comparison, the new WHO-endorsed ARV regimen will cost $100. [PNU editor's note: The WHO recommendations were summarized in the July 19 edition of PNU.]

"The new drugs are even much more expensive, and we fear that government will struggle even more to make them available even to those people who are already accessing treatment free of charge," Kampango said. "Poor children are likely to be penalized from accessing the drugs because they are not usually a priority for treatment."

WHO's guidelines also recommend initiating ARVs for patients with a CD4 count of 350 cells/mm3 or less, instead of the previous guidance of 200 cells or less. Kampango said this, too, could overtax treatment efforts.

Malawi's government has increased its HIV budget for 2010-11, including $75 million for the National AIDS Commission for fiscal 2010, said Ken Kandodo, Malawi's finance minister.

The Friends of AIDS Foundation is dedicated to enhancing the quality of life for HIV positive individuals and empowering people to make healthy choices to prevent the spread of the HIV virus. To learn more about The Friends of AIDS Foundation, please visit: http://www.friendsofaids.org.


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