SYDNEY, Australia – Leading clinician and past president of the International AIDS Society (IAS), Dr David Cooper, has said the cheapest, most toxic first-line antiretrovirals (ARVs) for HIV-infected persons are being sent to the developing countries, even though some are abandoned in developed countries due to their high levels of toxicity and side effects.

“We are giving the cheapest, toxic first-line regiment that you could possibly give in the developing world,” he told journalists prior to the start of the fourth IAS Conference on Pathogenesis, Treatment and Prevention here.

Cooper said with second and third-line regiments being very expensive, these bad regiments which are being rolled out will have greater implications down the road.

“We are rolling out these bad regiments because they are cheap and we are going to pay for that down the line because people are not going to stick to them because of the toxicity and side effects and that means we are going to need more second-line treatment which is very expensive,” he explained.

Cooper explained that even with the price reduction that could come about by pushing pharmaceutical companies and generic competition, the cost of second- and third-line treatment will always be higher than the first line.

Earlier this year, senior medical officer for the National HIV/STI Control Programme in the Ministry of Health, Dr Kevin Harvey, told the Observer that second- and third-regiment treatment were available in Jamaica. However, checks made by the Observer among persons living with HIV (PLHIVs) found that the majority only had access to first-line treatment.

As such, Cooper said there is a great need for further research to be done to correct why first-line treatment is not working, so there can be a need for less second- and third-line treatment.

The medical professor said that doses of ARV are developed sometimes on an ad-hoc basis because of the urgency of getting the medication to those who need it.

“The reason for this is that people were dying and we took shortcuts in the development of these drugs,” he said.

“It may well be that the kind of doses we are giving right now to people are not necessary. We could get away with smaller doses,” he explained, adding that smaller dosages could result in less toxicity.

It is for this and other reasons why these leading HIV experts are pushing for more funding to be allocated to the research component of the disease.

A major highlight of this year’s conference will be the Sydney Declaration which calls on national governments, bilateral and multi-national private donors to allocate 10 per cent of all resources for HIV programmes into research.