The director of Cambodia’s largest pilot project to administer new AIDS drugs called the program a success, but expressed skepticism that the drugs can be administered to a wide swath of AIDS victims anytime soon.
Catherine Quillet, chief of the Cambodia mission for Medecins Sans Frontieres France, also blasted both the government and drug manufacturers for allowing the drugs to enter the country without any regulation of their use.
Cambodia has given companies licenses to import the anti-retroviral drugs since 1998, she said, citing government lists. Like virtually all drugs, the expensive anti-retrovirals are available at pharmacies here without a prescription.
Anti-retrovirals must be taken in complicated doses over a long period or they are ineffective and will create resistance to future doses of the drug, AIDS experts say.
Drug companies claim to keep a tight control on sales, but then export to a country where medical staff are improperly trained and doses are not controlled, she said.
As the second National AIDS Conference closed on Wednesday, Quillet accused political leaders of lacking the political will to set up effective regulations. “I don’t see them getting to the point where they would set up a regulatory system,” she said. “You have a lot of money behind this.”
People with AIDS marched on Monday to demand increased access to the drugs, which are not a cure but can prolong life indefinitely. Recent developments have made the drug “cocktail” available for as little as $1 a day in some developing countries.
Last year, Medecins Sans Frontieres established a trial anti-retroviral program at Sihanouk Hospital—also known as Russian Hospital—which now treats 219 patients. All of them, except for the 12 who have died of AIDS, have stayed on the drug—a result rarely found even in more developed countries, she said. Half of the patients were well enough that they returned to work within six months.
“You still hear a message that this is not possible in developing countries…[But] it’s possible. People are very adherent [to the regimen].”
The trial was not a random sampling of AIDS victims, however. The aid organization purposely chose patients who were already regularly attending an HIV clinic, she said. The patients were in the last stages of illness, likely to die within months without the drugs. And the patients consulted with social workers and support groups to get tips on how to endure side effects and stay on the regimen.
Quillet suggested that the next step was for more NGOs to start more programs at a variety of sites. Medical staff require extensive training on how to administer the drugs and monitor patients over time, she said.
“You can’t just have a 15-day training program, and that’s it,” she said.
