WORKING PAPER 08/236
Title:
Government Leadership and ARV Provision in Developing Countries
Author(s): Nicoli Nattrass
Date of Publication: December 2008
Price: R 5.00
Abstract
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.
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