MIN/Sp/AU/CAMH3/6 HIV/AIDS Page 16 3.4 ACCESS TO AFFORDABLE MEDICINE AND TREATMENT The Global Price Reporting Mechanism (GPRM) on Antiretroviral Drugs, established in 2004, provides information on transaction prices of antiretroviral (ARVs) medicines purchased in developing countries. The price of first-line ARVs is continuing to fall—up to 40% in 2007. Further reductions are expected to occur in coming years as the ART scale up effort reaches the poor and disadvantaged population groups and local production of ARVs increases. Currently, up to 6 plants in the region are producing generic ARVs—mainly for local consumption, but some, like the South African plant (Aspen) has WHO pre-qualification for exports to other countries. The other 5 plants are in: Zimbabwe, Nigeria, Kenya, Benin, and Uganda. Figure 4.3: Percent of ART sites experiencing ARVs stock outs during the past 12 months, 2007 Togo 100 CAR 100 Uganda 83 Gabon 75 Sao Tomé 43 Madagascar 6 Tanzania 4 Among the 35 countries that reported, 7 (20%) experienced stock outs of ARVs in part or all facilities that provide ART. Figure 4.3 shows proportion of ART sites that experienced stock outs of one or more ARVs during 2007. Six out of these 7 countries, reported not having provisions to address stock outs or shortages of ARVs and commodities, including test kits. Overall, half of all reporting countries (35) have procedures, which allow them to tackle such shortages or stock outs. In most of the EMRO region countries, the bulk of the costs of medicines is by the governments. Whereas in Sudan limited absorption capacity for Global Funds grants and other available financial resources may be an indicator of drugs not being available rather than affordability. Figures 4.4 and 4.5 show progress ART uptake towards Universal Access by 2010 in Southern and Eastern Africa.