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Russia: Lack Of Funds Hinders Access To Anti-AIDS Drugs

By Yevgenia Borisova

At first glance, Russia seems to take an almost paternal role in caring for its citizens with HIV and AIDS. Russian law stipulates that treatment of HIV-positive patients must be funded by the state. Moreover, Russian pharmaceutical companies have recently developed two anti-viral drugs that are as effective -- and cause fewer side effects -- than Western analogs like AZT. But as Yevgenia Borisova reports for RFE/RL, Russia's lack of adequate social funding means only a handful of its growing number of AIDS sufferers have access to the drugs and care they need.

Moscow, 25 April 2001 (RFE/RL) -- In late 1999, Russian drug researchers announced that they had developed an AIDS-treatment medication that could compete with -- and possibly surpass -- AZT, the West's most common anti-viral drug for people suffering from HIV and AIDS.

The Russian drug, phosphazide, is said to offer one notable advantage: it is far less toxic than other anti-viral drugs, and therefore causes fewer side effects. Alexander Yurin, of the Russian Federal AIDS Center in Moscow, says clinical tests indicated that patients taking phosphazide suffer side effects six to eight times less often than patients taking AZT.

"With phosphazide, the only negative effect is nausea and vomiting with some patients taking large doses of it. But it happens much less often than with those [patients] taking AZT."

There are other advantages to phosphazide as well. Marina Kukhanova heads the Krayevsky Laboratory, which spent eight years developing the drug. She says the HIV virus can take five to 10 times longer to build up a resistance to phosphazide than to AZT.

The state-funded AIDS center and the Krayevsky lab are just two members of the pool of Russian organizations working to develop anti-AIDS drugs. Another is the private AZT Association, which manufactures phosphazide and another AZT analog, tymazide.

Mikhail Kaikov, the general director of the AZT Association, says that a major factor in Russia's growing AIDS problem is the state's failure to provide adequate funding for drug development and production:

"When you try to do something here [in Russia], you face something fairly routine -- a [complete] absence of money in the budget, or an insufficient amount. [This is] because the budget does not take into consideration the epidemic growth [of people with HIV infection] throughout Russia and the regions."

The official number of HIV infections in Russia has doubled over the past year alone, with 102,000 people registered as HIV-positive and an additional 448 suffering from full-blown AIDS. The drug manufacturers say the state is only giving them a tenth of the money they need to adequately treat the country's HIV-positive.

This year, the Russian Health Ministry reported that just $4.2 million were allocated for HIV treatment -- three times more than last year but, according to health experts, still far from enough.

Last year, the Russian AZT Association was given $1 million from the state -- enough to produce phosphazide and tymazide treatments for only 1,000 patients.

Although tymazide is relatively inexpensive at $90 per monthly prescription, phosphazide is markedly higher at $240 a month. Kaikov says his firm simply does not have the money to produce sufficient amounts of either drug.

Kaikov adds that the state has yet to sign a contract with his firm this year, meaning he does not know how much cash he can rely on getting. In the meantime, he says, the AZT Association is looking for alternative ways of raising funds so that it can increase production.

One possible solution is selling the drugs abroad. Phosphazide has already passed pre-clinical tests at Canada's McGill University and could move on to clinical tests in other Western countries.

The AZT Association already holds the license to make and sell drugs in the United States, Japan, South Korea, and several European Union countries. But Kaikov says it will take at least five more years -- and $50 million -- to complete all the necessary clinical tests and approvals to begin sales abroad.

"We are looking for investments -- there might be absolutely different forms of attracting investments, and there are different approaches to it in different countries."

At the same time, the Krayevsky Laboratory is actively working on a new anti-viral drug. Kukhanova says the new drugs could produce even fewer side effects than phosphazide.

"We have obtained several substances that at the first stage of biological tests on HIV-infected cells show activities comparable with existing drugs, but with toxicity levels that are up to 60 times lower than that of phosphazide. We are now testing the most promising substances on animals."

But Kukhanova's cash-strapped laboratory cannot count on making fast progress: she has only $13,000 in state grants to work on HIV and AIDS programs this year. Once salaries are paid, she says, there will be nothing left for supplies or new equipment.