1Triple therapy was considered too expensive (EUR 1,500/day) and too difficult to manage to be applied to Africa. It was assumed that hospital teams would be unable to manage the administration of medication at regular times or the side effects generated. To put this misconception to rest, in 1998 a Senegalese physician convinced his government to fund a pilot project designed to test triple therapy on 400 patients. With help from IRD, he proved that triple therapy could be implemented in Africa with some minor adjustments, notably in terms of medication to be administered in the evening rather than at lunchtime to protect medical confidentiality. This practice was subsequently adopted by the countries of the Global North. The demonstration came into its own in 2000 when, during the Durban conference, politicians and NGOs managed to drive the price of triple therapy down by 80-90% as part of the Access programme, which targeted Senegal as one of the pilot countries.

AIDS research, Yaoundé hospital, Cameroon.

2Generic triple therapy drugs appeared that same year, although donors and international agencies were reluctant to purchase them for lack of scientific assessment. This is why, from 2000 to 2002, in Cameroon this time, IRD researchers demonstrated the effectiveness of generic antiretroviral drugs, the purchase of which subsequently quadrupled.

3In addition, from 2002 to 2004, they showed that the level of HIV must be monitored in treated patients to prevent the emergence of resistance. This analysis was not commissioned by the Worl Health Organisation (WHO) for cost reasons. IRD continues to play a prominent role in AIDS control in Africa as the Institute and its partners are currently assessing first-line therapies, in a continent where patients are still too late in seeking treatment, and where 45% of HIV patients are not treated.

••• IRD demonstrated that triple therapy could be applied in Africa •••

AIDS prevention campaign, Cameroon.

“The partnership between IRD and developing countries in research into universal access to antiretroviral therapy in Africa, which is well into its second decade, fits into a pattern of performance, proactivity, innovation, efficiency and sustainability. It has helped train high-level French and African researchers: clinicians, virologists, immunologists, epidemiologists, health economists, etc.”
Dr Ibra Ndoye, coordinator of Senegal’s ANRS site and former director of Senegal’s National AIDS programme