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International medical humanitarian organization - Doctors Without Borders/Médecins Sans Frontières (MSF) has warned that middle-income countries (MICs), which will be home to 70% of people living with HIV by 2020, face increasing threats to their ability to access affordable generic medicines, which are crucial to countries' ability to reach the global UNAIDS 90-90-90 targets.
"No one can deny the pivotal role that affordable antiretrovirals have played in putting 15 million people on HIV treatment, but as we look ahead to the next 15 million, we see that middle-income countries are increasingly constrained in accessing affordable generic medicines, and this spells disaster for the global HIV response," said Dr Peter Saranchuk, TB/HIV advisor for MSF.
The term ‘middle-income' is an artificial classification that is not linked to public health realities on the ground - in fact, more than half of MSF's medical programmes are in MICs, including India, Kenya, Myanmar, Republic of Congo and South Sudan.
About 70% of the world's poor live in MICs, and sixty percent of people with HIV live in these countries today.
"Multiple threats on MICs are converging to form an unprecedented assault on access to medicines," said Ms Leena Menghaney, head of MSF's access campaign in South Asia. "Amongst other threats, some of the most acute come from trading partners - like the US and Japan - who seek to impose intellectual property rules that will block access to generic medicines; and from several donor agencies, including the Global Fund to Fight AIDS, Tuberculosis and Malaria, whose discriminatory policies are moving towards reducing funding for MICs at a time when global HIV targets call for increasing the pace of treatment scale-up."