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T I Working Paper
Transparency International
Transparency International
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TiWPNo2__HIV_AIDS.pdf
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"In Africa, it is estimated that people live an average of six and a half years after infection. But if anti-retroviral drugs (ARVs) treatment is started at the appropriate time, life expectancy is doubled or tripled. Even with massive and rapid scaling-up of ARVs, however, treatment is still not available to all who need it and by June 2005 UNAIDS/WHO estimated that in sub-Saharan Africa, only 11 per cent of those who needed treatment were receiving ARVs. This means that even where ARVs are provided for free or at heavily subsidised rates through donor-funded programmes, requests for ‘topup payments’ are common and the pressure to corrupt is intense. A 29-year-old Nigerian father of three spoke for many across the continent in the 2005 civil society organisation statement to the OAU Summit of Heads of States: ‘The ARVs that come to the centre are not given to those of us who have come out to declare our status, but to those “big men” who bribe their way through, and we are left to suffer and scout round for the drug.’iv ‘Scouting around for the drug’ often involves buying ARVs from informal sources, which is highly problematic, as drug traders know little about the appropriate combinations, side effects or dosage. Substituting one drug for another depending upon availability means treatment is likely to become ineffective and result in the development of resistance to ARVs. Moreover, the product may be expired or fake. The great human need for ARV drugs, so often from people on low incomes, feeds the already extensive international market in counterfeit drugs, which appear to offer a cure at low cost. Faking ARVs is potentially far more profitable than faking other drugs, and finances the bribery of customs, regulatory and hospital officials.
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2006
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With permission of the license/copyright holder