UNAIDS to map AIDS funding (Oluatoyin Alleyne)

Stabroek News
November 14, 2006

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In an effort to avoid duplication in the HIV/AIDS fight where donor agencies may be tripping over each other, UNAIDS will introduce a mapping tool, which would indicate the areas in which funding is being channelled

This was disclosed by UNAIDS Country Coordina-tor, Dr Ruben del Prado during a recent interview with Stabroek News.

Asked whether it was possible that donors in Guyana might be tripping over each other causing duplication in some areas, Dr del Prado said it was quite possible. This has been an area of concern since Guyana began to receive funding from various donor agencies in the fight against HIV/AIDUNAIDS to map AIDS fundingS.

"This is why mapping is important. UNAIDS is putting into place in countries a tool called CHAT‚€¦ It maps who does what, where, and with what budget and what are the areas are they covering‚€¦ It is giving us an overview of exactly what they are doing‚€¦" Dr del Prado said.

However, he said there was nothing wrong with a "little duplication" because sometimes one programme might focus on one angle of something and another programme reinforced that angle.

"Duplications are not bad sometimes‚€¦ when duplications become bad is when they [donor agencies] are tripping over each other and depleting other areas where nothing is happening," he said. He said the tool and mapping exercise was very important to ensure that the money was put to work exactly where the priorities were.

"It [duplications] happens in most countries and I will be surprised if it does not happen in Guyana, where similar funding goes to similar programmes. I can't tell you where [in Guyana] it is happening but it happens in most countries‚€¦," he said.

Meanwhile, Dr del Prado feels Guyana should spend the money to get the bio-equivalence test done on the locally manufactured anti-retroviral drugs.

Told about Minister of Health Dr Leslie Ramsammy's hesitancy to have the drug accredited because of the cost, Dr del Prado said: "If there is a lot of money available in the country for HIV, I think getting [the drug's] accreditation even if it is expensive it is a cost that is worth paying."

But he cautioned: "But again‚€¦ I haven't been briefed on this so everything I say on this is totally, totally uninformed." He said that he would find out about the issue.

"‚€¦ I have to admit I don't know where the drugs are coming from. If the drugs are being produced in a laboratory around the corner that I don't know of and if they are accredited by the World Health Organisation they are good‚€¦ I know for a fact that the drugs that the [US] President's Emergency Prevention Fund for AIDS Relief (PEPFAR) uses are accredited‚€¦" Dr del Prado said when asked whether UNAIDS was concerned about the antiretroviral drugs being produced here.

Recently the international donor community has been increasing the pressure on Guyana for the locally manufactured drugs to undergo a bio-equivalence test or for the drugs to come from approved source.

The issue of locally manufactured drugs undergoing bio-equivalence studies arose again at last June's United Nations General Assembly Special Session on HIV/AIDS (UNGASS+5) in New York; Dr Ramsammy had touched on it during his address to the assembly.

Guyana manufactures generic antiretroviral drugs, which should contain the same active substances as original brand name ARV drugs. A key element for a generic drug is establishing bio-equivalency, which means that the drug when evaluated must produce essentially the same biological availability of the active substance in the body when given in the same quantity as the original.

Guyana's ARVs are procured from the New Guyana Pharmaceutical Corporation, which is not a Food and Drug Administration (FDA) ap-proved supplier. The Global Fund to fight HIV/AIDS, Tuberculosis and Malaria has set such approval as a condition for its financing of the purchase of ARVs.

The implications are that Guyana would have to source its ARVs from Brazil, as the Organisation of Eastern Caribbean States now does, or another state which produces generic FDA-approved drugs as it would be unable to purchase the branded ARVs.

In September 2005, Stabroek News spoke with Minister Ramsammy and Dr Ranjisinghi Ramroop of the New GPC about the local drugs and whether bio-equivalence studies were going to be done.

Ramsammy said then that government was not prepared to adhere to this condition as it would be too costly - around US$4M per drug. He attributed this to the high cost of the process, adding that he was aware of the stipulations that some funding comes with. Ramsammy had added that as far as he knew no demands were being made.