The Political Economy of HIV/AIDS in Developing Countries
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The Political Economy of HIV/AIDS in Developing Countries

TRIPS, Public Health Systems and Free Access

9781848440777 Edward Elgar Publishing
Edited by Benjamin Coriat, Professor of Economics, Université Paris 13, France and Chairman, Coordinated Action on Socio-economic Research on Aids in Developing Countries, ANRS, France
Publication Date: 2008 ISBN: 978 1 84844 077 7 Extent: 352 pp
The book is based on original data and field studies from Brazil, Thailand, India and Sub-Saharan Africa. Focusing on the issue of universal and free access to treatment (a goal now taken to heart by the international community), it assesses the progress made and presents a rigorous diagnosis of the obstacles that remain, especially the constraints imposed by TRIPS and the poor state of most public health systems in Southern countries. In so doing, the book renews our understanding of the political economy of HIV/AIDS in these vast regions, where it continues to spread with devastating social and economic consequences.

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The issue of universal and free access to treatment is now a fundamental goal of the international community. Based on original data and field studies from Brazil, Thailand, India and Sub-Saharan Africa under the aegis of ANRS (the French nationalagency for research on Aids and viral hepatitis, this timely and significant book both assesses the progress made in achieving this objective and presents a rigorous diagnosis of the obstacles that remain.

Placing particular emphasis on the constraints imposed by TRIPS as well as the poor state of most public health systems in Southern countries, the contributing authors provide a comprehensive analysis of the huge barriers that have yet to be overcome in order to attain free access to care and offer innovative suggestions of how they might be confronted. In doing this, the book renews our understanding of the political economy of HIV/AIDS in these vast regions, where the disease continues to spread with devastating social and economic consequences.

This volume will be a valuable addition to the current literature on HIV/AIDS in developing countries and will find widespread appeal amongst students and academics studying economics, sociology and public health. It will also be of interest to international organizations and professional associations involved in the fight against pandemics.
Contributors
Contributors: M. Camara, M. Cassier, J. Chauveau, B. Coriat, M. Correa, M.H. Costa-Couto, C. de Albuquerque Possas, C. d’Almeida, E. Delaporte, K. Diop, S. Fleury, K.A. Freedberg, L. Hasenclever, S. Koulla-Shiro, G. Krikorian, J. Larmarange, B. Larouzé, G. Le Loup, S. Luchini, C.M. Meiners, J.-P. Moatti, F. Orsi, A. Robine, K. Rochel de Camargo Jr., C.E. Sloan, C. Sweet, B. Taverne, J.-C. Thoenig, B. Ventelou, Y. Videau, P. Vinard, Y. Yazdanpanah
Contents
Contents:

Foreword
Jean François Delfraissy

Introduction: A New Stage in the Fight Against the HIV/AIDS Pandemic – An Economic Perspective
Benjamin Coriat

PART I: TRIPS, GENERIC DRUGS AND ACCESS TO CARE: THE POST-2005 ISSUES
1. New Antiretroviral Treatments and Post-2005 TRIPS Constraints: First Moves Towards IP Flexibilization in Developing Countries
Cristina d’Almeida, Lia Hasenclever, Gaëlle Krikorian, Fabienne Orsi, Cassandra Sweet and Benjamin Coriat

2. New Trends in IP Protection and Health Issues in FTA Negotiations
Gaëlle Krikorian

3. Evolution of Prices and Quantities for ARV Drugs in African Countries: From Emerging to Strategic Markets
Julien Chauveau, Constance Marie Meiners, Stéphane Luchini and Jean-Paul Moatti

PART II: SECURING FREE AND UNIVERSAL ACCESS: LESSONS FROM BRAZIL
4. The Brazilian Experience of ‘Scaling-up’: A Public Policy Approach
Guillaume Le Loup, Andreia Pereira de Assis, Maria Helena Costa-Couto, Jean-Claude Thoenig, Sonia Fleury, Kenneth Rochel de Camargo Jr and Bernard Larouzé

5. Technology Transfer Agreements and Access to HIV/AIDS Drugs: The Brazilian Case
Amélie Robine

6. Scaling Up and Reverse Engineering: Acquisition of Industrial Knowledge by Copying Drugs in Brazil
Maurice Cassier and Marilena Correa

7. Compulsory Licensing in the Real World: The Case of ARV Drugs in Brazil
Cristina de Albuquerque Possas

PART III: FIGHTING AIDS IN THE HEART OF THE PANDEMIC: SUB-SAHARAN AND LOW-INCOME COUNTRIES
8. HIV Prevalence Estimates: The New Deal in Sub-Saharan Africa Since 2000
Joseph Larmarange

9. Cost-effectiveness of HIV Antiretroviral Therapies in Resource-limited Settings
Yazdan Yazdanpanah, Caroline E. Sloan and Kenneth A. Freedberg

10. ‘Fragility’: A Macro-dynamic Motive to Offer Quick and General Access to ART in LDC
Bruno Ventelou, Yann Videau and Jean-Paul Moatti

11. Procurement Policies, Governance Models and ARV Availability in French-speaking African Countries: An Overview
Mamadou Camara, Cristina d’Almeida, Fabienne Orsi and Benjamin Coriat

PART IV: BUILDING THE FUTURE: PUBLIC HEALTH SYSTEMS AND THE FREE ACCESS CHALLENGE
12. The Public Health Approach to Antitretroviral Treatment: The Case of Cameroon
Sinata Koulla-Shiro and Eric Delaporte

13. The Cost of Universal Free Access for Treating HIV/AIDS in Low-Income Countries: The Case of Senegal
Bernard Taverne, Karim Diop and Philippe Vinard

14. Implementing Funding Modalities for Free Access: The Case for a ‘Purchasing Fund System’ to Cover Medical Care for PLWHA
Philippe Vinard, Karim Diop and Bernard Taverne

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