Financial Times: HIV/AIDS drugs for developing world face threat of disruption
Brian Elliott, chief executive of Procela Consultants

“…Fifteen generic manufacturers supply more than 95 percent of [antiretroviral drugs (ARVs)] to [low- to middle-income countries (LMICs)], of which four supply the bulk — 83 percent. … Reliance on so few suppliers for continuing treatment for millions of people is dangerous because, unlike other diseases, there are no alternatives to ARVs for the treatment of HIV. This dependence creates serious risks. Today, the risk of supply interruption is at a worrying level. … The danger of supply interruptions will increase as the world moves towards meeting the UNAIDS target of ’90-90-90,’ which requires treating 30m people by 2030. … Procurement of AIDS drugs in LMICs is controlled by just three major buyers: the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR), the Global Fund, and South Africa, who together purchase 80 percent of all LMIC requirements. … To ensure treatment for 30m people by 2030, the major buyers must become much less dependent on so few suppliers. They must allocate their purchases to all manufacturers that meet quality standards, and allow excluded or limited suppliers the opportunity to quickly increase their volumes…” (3/16).