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Government Leadership and ARV Provision in Developing Countries

Year: 2008
Working paper number: 236
Author: Nattrass, Nicoli
Unit: ASRU

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 AIDSaffected countries have performed as well 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 paper argues that government leadership affects the 'economics' of antiretroviral (ARV) drug delivery in developing countries in profound ways. Access to HAART for citizens depends crucially on the commitment on the part of their national governments to negotiate with pharmaceutical companies over patented ARV prices, on their policy towards compulsory licensing, and on their commitment to public-health approaches 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.

Publication file: WP236.pdf