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

2. AGENDA FOR DISCUSSION Methodology Initial Results
Projection Slides v2

3. 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
Projection Slides v2

4. 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.
Projection Slides v2

5. 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]
Projection Slides v2

6. AGENDA FOR DISCUSSION Methodology Initial Results
Projection Slides v2

7. 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
Projection Slides v2

8. 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
Projection Slides v2

9. 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
Projection Slides v2

10. 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.
Projection Slides v2