For Lucky Few, 'Recycled' HIV Drugs Keep Hope Alive

Mon Apr 14, 3:54 PM ET <a href=story.news.yahoo.com>Add Health - Reuters to My Yahoo! By E. J. Mundell

NEW YORK (Reuters Health) - Like many Americans living withHIV (news - web sites), New York writer and activist Mike Barr takes regularly scheduled, physician-sanctioned drug 'holidays,' giving his body a temporary break from the side effects of powerful anti-retroviral medications.   What's uncommon about Barr is how he disposes of drugs he has no use for during these treatment interruptions. Partnering with a Manhattan-based nonprofit agency called Aid For AIDS (news - web sites) (aidforaids.org), Barr and hundreds of like-minded patients across the US and Canada sort, ship and distribute these life-saving, 'recycled' drugs to HIV-positive individuals in the developing world.

"If I can take half as much therapy, and give the other half of that therapy to someone in South America or Haiti, then for the same amount of money two lives are being saved instead of one," he explained.

For hundreds of patients spread across Africa, the Caribbean and Central and South America, Aid For AIDS remains a vital lifeline, providing them with a reliable supply of medicines that would otherwise be financially out of reach.

And since many of those enrolled in the program are AIDS educators and activists in their local communities, their continued survival has a ripple effect, helping prevent the spread of HIV/AIDS in these countries.

"We don't pretend to solve the problem, but we're making it a little better for those who are making a real difference," explained Venezuelan-born Jesus Aguais, who started Aid For AIDS in 1996 with just three patients. That number is now 520 -- and growing.

With no advertising, the simple idea behind Aid for AIDS spread quickly via word of mouth through the HIV patient community in the United States and Canada, resulting in a steady supply of donated drugs.

"People for whatever reason -- they die, they change their regimen, they never took the medicine -- they give it to us," Aguais explained in an interview with Reuters Health.

After removing the donor's name from the label on the bottle, donated medicines are carefully inventoried and sorted as per the requirements of individual patients -- or "clients" as Aguais calls them -- in the developing world.

Every foreign patient who applies for assistance from Aid For AIDS must first undergo a careful medical assessment, because the program's small store of medicines is best spent on those who closely adhere to the strict treatment schedules HIV drug therapy requires.

Working via fax and email with doctors in the client's home country, Program Director Dr. Jaime Valencia reviews application forms that outline prospective clients' proof of HIV status, current medical history, and CD4 immune-cell blood counts.

Priority is given to AIDS activists and educators, "people who are making a difference in their countries," Aguais stressed. In this way, donated medicines do more than just keep individual patients alive -- they also help prevent new infections, as individuals helped by the agency spread the wordabout the dangers of HIV.

Once accepted into the program, clients must submit CD4 counts every six months so that Valencia can chart their progress and adherence to the medications. As often happens, specific medications can decline in effectiveness over time, but Valencia said the agency's drug inventory is usually flexible enough to accommodate changes in drug regimens.

"I have to talk with the client's doctor, telling him which medications we have available, and he chooses the (new) treatment for the patient," he explained.

Working out of a few small rooms in lower Manhattan, Aid For AIDS remains unique.

"There are other recycling programs," Aguais said, "but none of them work like we do. We have complete control over where these medicines go." Because there are currently no U.S. laws allowing or prohibiting the export of donated medicines, Aguais said it is important from a legal standpoint "to know who the patients are." He said abuse of the program (such as reselling donated medicines) is almost nonexistent, due to close bonds that have formed over time between the New York office and trusted doctors in the Americas and Africa.

Aid For AIDS also accepts non-HIV-related drugs and devices for distribution in the developing world. Walking into a room stacked floor-to-ceiling with donated medications, Aguais pointed to one pile in a corner.

"Here we are preparing 13 boxes so far of medical supplies," he said. "This is going to an indigenous area between Venezuela and Colombia called Guajira, the Guajira tribe. We send it to a hospital that we know is going to distribute it."

Lynn Shulman, director of communications with the pioneering AIDS outreach group Gay Men's Health Crisis, said initiatives like Aid for AIDS are desperately needed, "because it enables people with HIV/AIDS to have greater access to medications they need."

But money remains a problem. Although the medicines are donated, they still require storage, sorting and shipping.

"We always struggle for money," Aguais said. "Last year with a budget of $240,000 we sent over $5 million of HIV medicines abroad."

"We have proved, though, that things can be done -- and done well -- when you want to do it," he added. "I hope I can raise a million dollars this year. And instead of helping 500 people, help 5,000. If we help 5,000 of the right people, this will multiply into 20,000. This is how it happens."