20th International AIDS Conference - Melbourne, Australia


WEAE0101 - Oral Abstract Session

Demand for ARV medicines in low and middle income countries will exceed 16 million person-years by the end of 2016

Presented by Joseph Perriens (Switzerland).

V. Habiyambere, J. Perriens, B. Dongmo-Nguimfack, ARV Forecasting Technical Working Group

WHO, HIV, Geneva, Switzerland

Background: In 2013, the global capacity to supply tenofovir and efavirenz has come under strain. To ensure that enough ARVs are produced globally, WHO convened a global ARV Forecasting Technical Working Group, with UNAIDS, CHAI, UNICEF, Global Fund, PEPFAR, and Futures Institute to develop annual 3-year forecasts of the demand of ARVs since 2005. The forecasts for 2013 to the end of 2016 are presented.
Methods: Forecast based on 1) annual WHO survey on ARV use, 2) volume of individual ARVs in the global procurement reporting mechanism, 3) CHAI projections for 22 high volume countries, 4) Global Fund and PEPFAR/SCMS quantification data, and 5) projected evolution of ART needs from UNAIDS and the Futures Institute. Three forecast scenarios were used and averaged arithmetically to generate the projected demand. Forecasts were broken down by active ingredient and adults vs. children.
Results: Demand of ART will increase from 11.5 million (M) person-years (PYR) by end 2013 to 15.0 M by end 2015 and 16.8 M by end 2016. By 2016, the projected demand will be 15.7 M PYR of adult and 1.1 M PYR of paediatric formulation. Demand for paediatric ART will continue well beyond. The market share of tenofovir will increase from 50% in 2013 to reach 62% in 2016, that of AZT will decrease from 40% to 34 % and that of d4T will decrease from 8% to 2%. That of EFV will increase from 48% in 2013 to 63%, and NVP will gradually lose market share. Second line ART uptake will increase slowly from 4.4% now to 5.0% in 2016. Insufficient amounts of data were available to project the uptake of third line drugs.
Conclusions: Scale up of ART will reach 15 M by 2015 and continue beyond. Meeting demand is a challenge, which requires reliable forecasts of future ARV demand which WHO and its technical partners will continue to produce.

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