Nattrass Nicoli J
AIDS and Society Research Unit, University of Cape Town, Private Bag, Rondebosc, Cape Town 7701, South Africa.
Trends Microbiol. 2008 Dec;16(12):574-9. doi: 10.1016/j.tim.2008.08.012. Epub 2008 Oct 27.
Despite unprecedented international mobilisation to support universal provision of highly active antiretroviral therapy (HAART), national governments continue to play the key role in determining access to treatment. Whereas some AIDS-affected countries have performed as well as or better than expected given their level of development, institutional characteristics and demographic challenges (e.g. Thailand and Brazil), others (notably South Africa) have not. This article argues that the 'economics' of antiretroviral drug delivery is at heart a political-economy of access to treatment. It depends on commitment on the part of national governments to negotiate with pharmaceutical companies over patented antiretroviral drug prices, on their policy towards compulsory licensing, and on the approach they adopt to delivering HAART. Civil society has an important role to play in encouraging governments to become, and remain, committed to taking action to ensure sustainable and widespread access to HAART.
尽管国际社会为支持普遍提供高效抗逆转录病毒疗法（HAART）进行了前所未有的动员，但各国政府在决定治疗可及性方面仍发挥着关键作用。鉴于一些受艾滋病影响国家的发展水平、机构特征和人口挑战，其中一些国家的表现达到或超过预期（如泰国和巴西），而其他国家（尤其是南非）则不然。本文认为，抗逆转录病毒药物供应的“经济学”本质上是治疗可及性的政治经济学。这取决于各国政府与制药公司就抗逆转录病毒专利药物价格进行谈判的承诺、其强制许可政策以及实施HAART所采取的方法。民间社会在鼓励政府致力于并持续采取行动以确保HAART的可持续广泛可及性方面可发挥重要作用。
