<http://www.jamaicaobserver.com/news/html/20070719T220000-0500_125456_OBS_CONCERN
S_RAISED_OVER_LONG_TERM_EFFECTS_OF_CHEAP__TOXIC_FIRST_LINE_HIV_DRUG.asp>:
"SYDNEY, Australia - Leading clinician and past president of the
International AIDS Society (IAS), Dr David Cooper, has said the
cheapest, most toxic first-line antiretrovirals (ARVs) for
HIV-infected persons are being sent to the developing countries, even
though some are abandoned in developed countries due to their high
levels of toxicity and side effects.

'We are giving the cheapest, toxic first-line regiment that you could
possibly give in the developing world,' he told journalists prior to
the start of the fourth IAS Conference on Pathogenesis, Treatment and
Prevention here.

Cooper said with second and third-line regiments being very expensive,
these bad regiments which are being rolled out will have greater
implications down the road.

'We are rolling out these bad regiments because they are cheap and we
are going to pay for that down the line because people are not going
to stick to them because of the toxicity and side effects and that
means we are going to need more second-line treatment which is very
expensive,' he explained.

Cooper explained that even with the price reduction that could come
about by pushing pharmaceutical companies and generic competition, the
cost of second- and third-line treatment will always be higher than
the first line.

Earlier this year, senior medical officer for the National HIV/STI
Control Programme in the Ministry of Health, Dr Kevin Harvey, told the
Observer that second- and third-regiment treatment were available in
Jamaica. However, checks made by the Observer among persons living
with HIV (PLHIVs) found that the majority only had access to
first-line treatment.

As such, Cooper said there is a great need for further research to be
done to correct why first-line treatment is not working, so there can
be a need for less second- and third-line treatment.

The medical professor said that doses of ARV are developed sometimes
on an ad-hoc basis because of the urgency of getting the medication to
those who need it.

'The reason for this is that people were dying and we took shortcuts
in the development of these drugs,' he said.
'It may well be that the kind of doses we are giving right now to
people are not necessary. We could get away with smaller doses,' he
explained, adding that smaller dosages could result in less toxicity.

It is for this and other reasons why these leading HIV experts are
pushing for more funding to be allocated to the research component of
the disease.

A major highlight of this year's conference will be the Sydney
Declaration which calls on national governments, bilateral and
multi-national private donors to allocate 10 per cent of all resources
for HIV programmes into research."