The Accelerating Access Initiative: experience with a multinational workplace programme in Africa.
OBJECTIVE
A multinational company with operations in several African countries was committed to offer antiretroviral treatment to its employees and their dependants.


METHODS
The Accelerating Access Initiative (AAI), an initiative of six pharmaceutical companies and five United Nations' agencies, offered the possibility of obtaining brand antiretroviral drugs (ARVs) at 10% of the commercial price. PharmAccess, a foundation aimed at removing barriers to AIDS treatment in Africa, helped to establish an HIV policy and treatment guidelines, and a workplace programme was rolled out from September 2001.


METHODS
Private sector employers in Africa are keen to take more responsibility in HIV prevention and AIDS care. An important hurdle for African employers remains the price and availability of ARVs.


RESULTS
The programme encountered various hurdles, among them the need for multiple contracts with multiple companies, complex importation procedures, taxes levied on ARVs, lack of support from pharmaceutical companies in importation and transportation, slow delivery of the drugs, lack of institutional memory in pharmaceutical companies and government policies excluding the company from access to ARVs under the AAI.


CONCLUSIONS
The launch of the AAI enabled this multinational company to offer access to ARVs to its employees and dependants. The private sector should have access to these discounted drugs under the AAI. A network of local AAI offices should be created to assist in logistics of drugs ordering, purchase and clearance. No taxes should be levied on ARVs.
Van der Borght
S
S
Heineken International Health Affairs, Amsterdam, Netherlands. Stefaan.vanderBorght@heineken.com
Janssens
V
V
Schim van der Loeff
M F
MF
Kajemba
A
A
Rijckborst
H
H
Lange
J M A
JM
Rinke de Wit
T F
TF
D017954:Africa South of the Sahara; D019380:Anti-HIV Agents / Q000191:economics / Q000627:therapeutic use*; D023241:Antiretroviral Therapy, Highly Active; D016208:Databases, Factual; D015658:HIV Infections / Q000188:drug therapy* / Q000191:economics; D006297:Health Services Accessibility / Q000191:economics / Q000706:statistics & numerical data*; D006301:Health Services Needs and Demand / Q000191:economics / Q000706:statistics & numerical data*; D054624:Health Status Disparities; D006801:Humans; D038622:Internationality; D011203:Poverty; D016730:Program Development; D015397:Program Evaluation; D017132:Workplace
D019380:Anti-HIV Agents