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V. Habiyambere , J. Perriëns , B. Dongmo-Nguimfack, World Health Organization

Demand for ARV medicines in low and middle income countries will exceed 16 million person-years by the end of 2016. V. Habiyambere , J. Perriëns , B. Dongmo-Nguimfack, World Health Organization On behalf of the ARV Forecasting Technical Working Group

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V. Habiyambere , J. Perriëns , B. Dongmo-Nguimfack, World Health Organization

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  1. Demand for ARV medicines in low and middle income countries will exceed 16 million person-years by the end of 2016 V. Habiyambere, J. Perriëns, B. Dongmo-Nguimfack, World Health Organization On behalf of the ARV Forecasting Technical Working Group UNAIDS, CHAI, UNICEF, Global Fund, PEPFAR (SCMS, USAID), and Futures Institute

  2. WHY ? • ART demand increases year by year • production capacity needs to keep pace with demand • Global supply security is an issue • 2013: TDF and EFV • 2014: d4T/3TC pediatric formulation outage; ZDV • Manufacturers need independent assessment of what and how much to produce 2-3 years ahead of time

  3. Methods – forecast of total future demand 3-year linear projection of ARV use in annual Global AIDS reporting Limited to 80% of total number of people needing treatment, from UNAIDS/Futures Institute, according to WHO 2013 criteria Arithmetic average 3-year extrapolation of country targets stated in annual WHO survey 3-year linear extrapolation 22 country quantifications by CHAI Stratification: adult/paediatric ARV use

  4. Total future demand

  5. Total future demand

  6. Forecast of adult/paediatric and first/second line treatment (country targets)

  7. Methods – forecasts of market share Annual WHO survey – 16 countries reporting in each year since 2010 Arithmetic Average Global Price Reporting Mechanism – 75% of LMIC procurement lagged 1 year CHAI 21 country 5-year projections PEPFAR 2-3 year quantification - 15 countries Global Fund quantification – 54 countries in 2014 and 30 in 2015

  8. Share of d4T in adult treatment

  9. Share of ZDV, TDF, d4T in adult treatment

  10. Share of EFV, NVP, LPV and ATV in adult treatment

  11. Limitations and next steps • Overlap between data sets • Limited time horizon • No insight on formulation use • New molecules not included • We will expand time horizon to 5 – 7 years • Will drill down to formulation level

  12. But the bottom line is: • We are on track for 15 million by 2015 • New drugs are being introduced and older ones are disappearing • Without significant impact on the cost of ART in LMIC • More on access to ARV drugs (price, regulatory status, API, forecast of use, issues in MIC) on: http://www.who.int/hiv/amds/en/

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