By Marie Rosenthal, MS
The burden of the HIV epidemic varies considerably among countries, with poorer nations bearing the brunt of the disease.
Countries in Africa—which accounts for more than two-thirds of people living with HIV—are the most severely affected with one in every 25 adults living with HIV.
Helping to overcome this inequity is the goal of Harald Nusser, PhD, MBA, the vice president and head of Global Patient Solutions (GPS) at Gilead.
Dr. Nusser’s goal is to help assure that everyone, regardless of where they live or their socioeconomic status “have the same opportunity to access a product and not fall into financial hardship [as a result of using an HIV medication].”
Voluntary licenses—where companies wave intellectual property rights and allow licensing companies to create generic versions of branded HIV medications—are often used to achieve this goal.
However, just because the medication is less expensive for another company to create and distribute does not mean that every patient who needs it will be able to afford it. The generics companies “sell to governments. They sell to procurement organizations, and they also sell into the private sector. So, the big question is, ‘Is the final patient in that community eventually reached, or do they have to pay more?’ Is the product available in remote areas far away from the capital cities?”
This type of in-depth look at the supply chain is rarely examined, according to Dr. Nusser, but the data are sorely needed. Often, the poor pay more, he told Infectious Disease Special Edition.
This is an inequity that Dr. Nusser is dedicated to solving, but he realizes that it cannot be solved by one man, one program, one company, one organization or one country. The solution lies in collaborations between public and private stakeholders.
One of GPS’s most successful partner organizations, mothers2mothers (https://m2m.org), supports women and helps them become regional health counselors for maternal–child health. By creating mothers who are mentors to others, m2m employs local women living with HIV as community health workers to meet the urgent health needs of the communities. These “Mentor Mothers” deliver integrated primary healthcare services to dramatically improve the health and well-being of the community.
The organization has created nearly 12,000 jobs for women living with HIV as front-line health workers; provided health services to more than 15 million people in sub-Saharan Africa; and achieved virtual elimination of vertical HIV transmission for clients.
In addition to ensuring that availability and affordability are equitable, other issues need to be addressed. “The real health equity,” he said, “is ensuring that patients—irrespective of their gender, irrespective of their race—have the same or comparable health outcomes by consuming the commodity or by enjoying health intervention services.
“Only then is it equitable,” he said.
For more, check out our print issue which mails in December.
