Date of Award
Master of Public Health (MPH)
Dr. Richard Rothenberg
Tonya Ross Walker
In 2015, the World Health Organization expanded eligibility for anti-retroviral therapy (ART) to all individuals affected with HIV, regardless of CD4 count. Although, anti-retroviral drugs (ARVs) are essential to HIV/AIDS treatment and therapy, ARVs may also pose a financial burden on low-income countries affected by a high prevalence of HIV. Programs funded by global donor organizations such as the President’s Emergency Plan for AIDS Relief (PEPFAR) may provide assistance to these HIV-affected populations through the procurement of ARVs. The objective of this analysis was to determine total ARV expenditures for SCMS participating countries from fiscal years 2012 to 2014 and to discuss the implications of generic ARV procurement under the WHO and UNAIDS guidelines.
The SCMS Delivery History Dataset was used to determine the number of purchase orders for generic and brand name ARVs, as well as calculate the expenditures for overall, brand name and generic ARVS for 2012-2014.
From 2012 to 2013, the procurement of overall and generic ARVs increased, however, from 2013 to 2014, there was a decrease in generic and overall ARV procurement. The number of brand name ARV transactions increased during this three year period from 78 in FY 2012, 144 in FY 2013, and 164 in FY 2014 respectively. The anti-retroviral drug Keletra was the most frequently purchased ARV in FY 2012 and FY 2014. In FY 2013, the most frequently purchased ARV was Aluvia.
It is recommended that the international public health community continues to develop more cost-effective methods of procuring ARVs to resource-limited, HIV-affected populations. Although there are barriers to obtaining generic formulations for anti-retrovirals, there are possible consequences of low uptake of generic ARV procurement. If a country is unable to efficiently secure enough ARVs for HIV-affected individuals, it is more unlikely that HIV/AIDS will be eliminated in that location within the next several years, according to the UNAIDS and WHO recommendations.
Marshall, Dejene', "Analysis of Anti-Retroviral Procurement for HIV-Affected Countries from Fiscal Years 2012 to 2014." , Georgia State University, 2017.