The Challenges of Providing Long-Term Treatment in Resource-Limited Settings.

Moderator:
Nathan Ford, MSF Thailand

Introduction:
• Dr. Karim Laouabdia, Director, MSF Campaign for Access to Essential Medicines

Responding to the Need for Second-Line Treatment: When and Why?
• Dr. Alexandra Calmy, MSF Campaign for Access to Essential Medicines
• Dr. Bill Rodriguez, Clinton Foundation HIV/AIDS Initiative
• Professor Scott Hammer, Columbia University
• Dr. Delphine Sauvageot, Epicentre

Challenges in Securing Sustainable Access to Newer ARVs
• Lawan Sarovat, MSF Thailand
• Ibrahim Umoru, MSF Nigeria
• Dr. Shaheed Mathee, Principal Medical Officer, Khayelitsha, South Africa
• Anand Grover, Indian Lawyers Collective

What Can the International Community do to Ensure Equitable Access to New Drugs and New Tools?
• Stephen Lewis, UN Special Envoy for HIV/AIDS in Africa

While some barriers to starting treatment for people living in developing countries can be addressed through generic competition, regimen simplification, decentralization, and increased community involvement, new clinical and political challenges emerged. Speakers will discuss the increasing need for patients to switch to alternative treatment due to toxicities or treatment failure; the prohibitive cost of second-line drugs; the urgency for needs-based R&D for affordable and field-adapted new tools; and will explore strategies to overcome barriers to long-term treatment.

Challenges and Opportunities of Decentralizing Antiretroviral Treatment in High HIV Prevalence Rural Districts of Africa: The Experience of MSF.

• Dr. Martha Bedelu, MSF South Africa
• Dr. Daniel O’Brien, MSF HIV/AIDS Advisor
• Dr. Pierre Humblet, MSF AIDS Working Group
• Dr. Moses Masaquoi, MSF Malawi
• Dr. Wim Van Damme, Institute of Tropical Medicine, Belgium

In high HIV prevalence rural districts of Africa, thousands of people need ART, but only a minority has access. One response is to decentralize ART delivery to peripheral points of care. MSF will present its experience of decentralizing ART and highlight advantages and obstacles of approaches that make PLWHAs themselves the cornerstone of ART delivery.

Decentralization, Scaling-Out Antiretroviral Treatment to Health Centres in a Rural District in Malawi: Process, Progress and Lessons Learnt After Two Years.

Presented by Dr. Maragaret Fitzgerald, MSF Malawi

Outcomes of Children, Stratified by Immune Status, Receiving ART in MSF Supported Projects in Resource-Poor Countries.

Presented by Dr. Daniel O’Brien, MSF Holland.

ART Outcomes in Children <13 Years of Age in Resource-Poor Countries: A Médecins Sans Frontières Cohort.

Presented by Dr. David Olson, MSF USA.

Monitoring Treatment Efficiency in the Context of Resource-Limited Settings: Why and When to Measure Plasma Viral Load ?

Presented by Dr. Alexandra Calmy, MSF Campaign for Access to Essential Medicines.

Will it Deliver? WTO Rules and Canada’s Law on Compulsory Licensing: The Continuing Challenge of Scaling-up Global Treatment Access.

• Brigitte Zirger, Health Canada
• Dr. Luka Siyame, Minister of State for Disaster Management and HIV/AIDS, Tanzania
• Bruce Clark, Apotex
• Anil Soni, Clinton Foundation
• Rachel Kiddell-Monroe, MSF Canada
• Richard Elliott, Canadian HIV/AIDS Legal Network

Speakers will examine experiences with the Canadian law and the 2003 WTO August 30th Decision, and consider whether such mechanisms will or can improve access to ARVs and other medicines urgently needed in developing countries. Co-hosted by the Canadian HIV/AIDS Legal Network.

Another Access to Medicines Crisis Facing Patients: Tackling Increased Patenting and Higher Prices.

Moderator: Nathan Ford, MSF Thailand
• Michel Lotrowska, MSF Brazil
• Ibrahim Umoru, MSF Nigeria
• Kajal Bhardwaj, Indian Lawyers Collective
• Lawan Sarovat, MSF Thailand
• Rachel Kiddell-Monroe, MSF Canada

Médecins Sans Frontières (MSF) will present case studies from Nigeria to Thailand and offer strategies for tackling the alarming access to medicines crisis. Speakers will share experiences on joint advocacy efforts to reduce the impact of increased patent protection in India, and will outline attempts to use patent flexibilities in Canada.

Adverse Consequences of User Fees for Patients Started on ART in the Governmental HIV Programmes in Nigeria. Analyzed in the Integrated Free of Charge ART Programme of Médecins Sans Frontières (MSF) in Lagos.

Presented by Dr. Jens Wenkel, MSF Nigeria.