Demand Forecasts for 2006-2008 for HIV/AIDS ARV formulations Clinton Foundation HIV/AIDS Initiative November 7, 2005 09.08.05 Projection Slides v2

AGENDA FOR DISCUSSION Methodology Initial Results 09.08.05 Projection Slides v2

Forecasting Methodology For all projections, the baseline represents actual treatment numbers, as current as possible. In most cases, this data has been updated as of June 2005, from countries directly and/or WHO. Demand estimates are based on national protocols. Protocol and patient distribution are actual data for all consortium and high-volume non-consortium countries (together, these represent 85% of total global volume). For the remaining countries, generalized regional profiles have been compiled based on WHO guidelines. Country data (current treatment numbers, targets and protocols) comes from CHAI country teams and regional managers, working closely with Ministries of Health 09.08.05 Projection Slides v2

Forecast Scenarios HIGH – Country achieves a percentage coverage of their national ART need. Percentage is adjustable, with the default set to 80%. MEDIUM – Country achieves a percentage of their self-defined target. Percentage is adjustable, with the default is set to 80%. In a small number of non-consortium countries, where country targets were unavailable, a percentage of ART need is assumed instead. LOW – Current monthly patient accrual data is projected going forward without any additional growth in the rate of accrual assumed. All scenarios are adjustable on a country by country basis for CHAI consortium countries and high volume non-consortium countries, making up 85% of the total volume. For the remaining countries, the scenario can be adjusted on an aggregated basis. 09.08.05 Projection Slides v2

Country Snapshot (Ethiopia) INPUTS People on Treatment & Country Targets (Country Data) Treatment Failure Rates (CHAI Assumptions) Protocols (Country Data) d4t+3TC+NVP AZT+3TC+NVP AZT+3TC+EFV d4t+3TC+EFV ABC+ddI+NFV 66% 10% 4% End of Year 1 End of Year 2 End of Year 3 End of Year 4 End of Year 5 6% 10% 2004 Q2 05 Q4 05 2006 2007 2008 10,000 20,000 40,920 100,000 163,000 338,000 100% 97% 84% 76% % Adult CALCULATIONS Demand for each Regimen Medium Case Scenario – Assumes 80% of Country Target Achieved 1st Line : # on regimen in year 2 = Total Patients Total Adults Total Children 2004 Q205 2006 2007 2008 10,000 20,000 80,000 77,600 2,400 130,400 109,536 20,864 270,400 205,504 64,896 [% on reg in year 1 * (1 – treatment failure rate)] * # in year 1 + [% on reg in year 1] * new patients in year 2 2nd Line : # on regimen in year 2 = [% on reg in year 1 + [total % on all 1st line reg in yr 1* treatment failure rate * % to start on this regimen ]] * # in yr 1 + [% on regimen in yr 1 * new patients in yr 2] 09.08.05 Projection Slides v2

AGENDA FOR DISCUSSION Methodology Initial Results 09.08.05 Projection Slides v2

There is 56% variance between the scenarios ART access in developing countries could grow from 1M in 2005 to up to 5M by 2008 In the past 2 years, treatment has doubled globally There is 56% variance between the scenarios 09.08.05 Projection Slides v2

80% of current volume is driven by 11 countries Country Current Treatment Low Scenario Medium Scenario High Scenario 2006 2007 2008 Brazil 160,000 174,400 184,000 193,600 200,009 219,500 240,500 217,115 245,000 275,000 China 15,000 20,706 24,510 28,314 27,600 38,000 48,400 35,314 48,857 62,400 Ethiopia 20,000 37,748 49,580 61,412 80,000 130,400 270,400 106,743 164,571 222,400 India 50,000 121,658 169,430 217,202 68,000 96,547 297,714 462,857 628,000 Kenya 37,860 72,132 94,980 117,828 200,000 400,000 115,234 166,817 218,400 Malawi 17,626 44,626 62,626 80,626 44,000 69,600 94,400 68,015 101,607 135,200 Mozambique 16,030 30,232 39,700 49,168 41,727 69,421 95,242 83,217 128,009 172,800 South Africa 93,000 169,320 220,200 271,080 304,942 516,592 801,227 416,587 601,493 786,400 Tanzania 12,000 30,000 42,000 54,000 120,960 219,600 338,800 114,857 183,429 252,000 Uganda 40,200 81,276 108,660 136,044 53,360 72,000 100,000 73,714 96,057 118,400 Zambia 23,000 51,332 70,220 89,108 84,000 112,000 144,000 75,886 111,143 146,400 Total 484,716 833,430 1,065,906 1,298,382 1,104,598 1,727,113 2,629,516 1,604,396 2,309,840 3,017,400 09.08.05 Projection Slides v2

Uptake of 2nd line formulations is expected to vary by region 2nd line* volume as % of total volume procured LAC Asia & EE Global Africa *2nd line assumes all formulations other stavudine, zidovudine, lamivudine, nevirapine and efavirenz 09.08.05 Projection Slides v2

CHAI’s medium scenario falls between UNAIDS’ High and Low cases Patients on ART (millions) 6.6 5.2 4.1 3.1 2.3 Note: UNAIDS Low scenario figures are estimates based on the chart, “Total Income Demand in Low and Middle Income Countries.” Actual figures will be substituted as soon as available. 09.08.05 Projection Slides v2