AIDS drugs deal still needs much work -- U.N. body
By Patricia Reaney

LONDON, May 12 (Reuters) - A surprise announcement that major drug firms are to slash prices to tackle the developing world's AIDS epidemic is a vital first step to saving millions of lives but leaves many questions open, experts said on Friday.

Two years after being castigated at the last international AIDS meeting for not doing enough to curb AIDS in the developing world, five of the biggest drug companies promised on Thursday to cut prices in a deal brokered by the United Nations.

But there are still few details of those cuts, of how much money may now be made available by international donors, or of how the drugs will be administered in chaotic health systems.

``Most of the work is very much yet to come,'' said Julia Cleves, the senior technical adviser for UNAIDS, the U.N. agency entrusted with tackling the disease.

``We are continuing negotiations over price. All I can is our level of comfort is going up.''

UNAIDS had not planned to announce the initiative so early but its hand was forced when the media got wind of it.

Although the announcement may have been premature, the disease has already claimed 16.3 million victims and AIDS sufferers and activists said the initiative was long overdue.


``It has been a long haul. There have been about three years of discussions and negotiations behind the scenes to crack what is really a big nut,'' said Derek Bodell, the chief executive of the National AIDS Trust in Britain. ``The devil is going to be in the detail in this.''

Apart from an 85 percent price cut promised by British drugs giant Glaxo-Wellcome Plc there are few specifics.

Switzerland's Roche Holding SA, Merck and Co Inc. and Bristol-Myers Squibb in the United States and Germany's Boehringer Ingelheim have all promised to join in.

Cleves said UNAIDS planned to have much more operational detail in time for the 13th International AIDS Conference in Durban, South Africa, from July 9-14.

It is planning talks with non-government organisations (NGOs), African governments, donors and AIDS sufferers.

It is also setting up working groups to map out criteria for country participation and financing options and to determine what needs to happen in health sectors to make sure the drugs are administered in a safe and rational way.


``Even if they are not instantly affordable to everybody, this initiative will nonetheless make access to drugs much more likely for a much larger number of people,'' Cleves said.

The World Health Organisation (WHO) and the World Bank are expected to play crucial roles. UNAIDS, which has been a leader in the discussions so far, will deal with mediation, communications and the conceptual work.

It hopes to complete the preliminary work by July 31 and wants to see things become operational soon after, and certainly by the autumn or end of the year.

Although the drugs are expected to be sold at a fraction of their original cost, they may still be too expensive for sub-Saharan Africa, the epicentre of the epidemic with 23.3 million HIV/AIDS sufferers.

``Clearly resources need to found from within countries to pay for some of it. The question of what external finance is going to be required and where it is going to come from, and who is prepared to pay are all discussions we are still having,'' Cleves said.

Bodell added: ``Along with the access to treatment there has to be good support around the use of these drugs and an investment in the health care structure in these countries to make sure they can effectively use the drugs.  ``Otherwise they won't be of any value and could produce serious harm.''