1. IDA Solutions Clarisse Morris, MA January 2006
25 June 2018
Current issues in selection & procurement planning of drugs to treat and prevent opportunistic infections
Clarisse Morris, MA
January 2006

2. HIV treatment is not just about ARVs!
IDA Solutions
25 June 2018
HIV treatment is not just about ARVs!
Source: A Technical Guide to the Contemporary Context of HIV/AIDS: Procurement of Medicines and Supplies under Bank funding. Strengthening Fiduciary Management in Multi-Sectoral National HIV/AIDS Program for Sub-Saharan Africa. Presentation for the Network of National HIV/AIDS Program Practitioners in Africa (NAPPA) and World Bank. July 2003.

3. Most common OIs Bacterial diseases Protozoal diseases Fungal diseases
IDA Solutions
25 June 2018
Most common OIs
Bacterial diseases
Protozoal diseases
Fungal diseases
Viral diseases
HIV associated malignancies

4. Why are OIs complex? Large number of opportunistic infections
IDA Solutions
25 June 2018
Why are OIs complex?
Large number of opportunistic infections
Many OIs have the same symptoms
Some OIs may mask others
Large amount of medicines
OI treatment is not standard
Interaction between ARVs and OI drugs
FDCs and single compound drugs

5. Drug pricing and availability issues
IDA Solutions
25 June 2018
Drug pricing and availability issues
Cytomegalovirus (CMV) retinitis:
Only expensive branded drug available.
MDR-TB:
Much more expensive.
Few manufacturers for some drugs.

6. Drug pricing and availability issues (cont’d)
IDA Solutions
25 June 2018
Drug pricing and availability issues (cont’d)
Price reductions to increase availability
MDR-TB: capreomycin and cycloserine
Fungal diseases: fluconazole

7. References
Sources and prices of selected drugs and diagnostics for PLWAs by UNICEF,UNAIDS, WHO, MSF, May 2002
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Selection of TB medicines and supplies, MSH, 2004
Fluconazole donation programme, E-drug, December 2004