Antiretroviral therapy in Thai adults and children with HIV-1 infection - Chapter 14: Creation of a drug fund for post-clinical trial access to antiretrovirals

Hele tekst

(1)UvA-DARE (Digital Academic Repository). Antiretroviral therapy in Thai adults and children with HIV-1 infection Ananworanich, J. Publication date 2008. Link to publication Citation for published version (APA): Ananworanich, J. (2008). Antiretroviral therapy in Thai adults and children with HIV-1 infection.. General rights It is not permitted to download or to forward/distribute the text or part of it without the consent of the author(s) and/or copyright holder(s), other than for strictly personal, individual use, unless the work is under an open content license (like Creative Commons). Disclaimer/Complaints regulations If you believe that digital publication of certain material infringes any of your rights or (privacy) interests, please let the Library know, stating your reasons. In case of a legitimate complaint, the Library will make the material inaccessible and/or remove it from the website. Please Ask the Library: https://uba.uva.nl/en/contact, or a letter to: Library of the University of Amsterdam, Secretariat, Singel 425, 1012 WP Amsterdam, The Netherlands. You will be contacted as soon as possible.. UvA-DARE is a service provided by the library of the University of Amsterdam (https://dare.uva.nl) Download date:21 Jun 2021.

(2) £{\Ê. >«ÌiÀÊ. Ài>ÌÊvÊ>Ê`ÀÕ}ÊvÕ`ÊÊÊ vÀÊ«ÃÌVV>ÊÌÀ>Ê>VViÃÃÊÌÊ>ÌÀiÌÀÛÀ>ÃÊ >ViÌÊÓää{\ÎÈ{{Ón®\£ä£ÓÊ.

(3) ££È. >«ÌiÀÊ£{\Ê*ÃÌÊÌÀ>Ê`ÀÕ}ÊvÕ`Ê. )+!'&'),,&')('*+$!&!$+)!$**+' &+!)+)'-!)$* !# #

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

(5) *63 >@=>=A32 @3D7A7=< B= >/@/5@/>6 E=C:2 7<B@=2C13 BE= ;/7< 16/<53A B6/B B63 >6GA717/< A6=C:2 ;/93 3D3@G 344=@B B= A33 B6/B >/B73<BA@3137D3B@3/B;3<B=<137B6/A033</>>@=D320G />>@=>@7/B3 /CB6=@7B73A /<2 B6/B B63 >6GA717/< 7A @3?C7@32B=3F>:717B:GB3::>/B73<BA74B63G/@3C<:793:GB= 1=<B7<C3 @3137D7<5 B@3/B;3=<A=@A /4B3@ B63G :3/D3B63ABC2G *63 3B671/: 1=<13@<A =D3@ B63 C<23@B/97<5 =4 1:7<71/: B@7/:A7<23D3:=>7<51=C<B@73A3A>317/::GE7B6@3A>31BB= B63AB/<2/@2=4B@3/B;3<BB6/BA6=C:203>@=D7232B=B@7/: >/@B717>/<BA6/D3@3AC:B327<:7BB:3@3A3/@167<1=C<B@73A E63@3 7<B3@D3<B7=<A /@3 <33232 ;=AB *63 7<7B7/B7=< =4 >@3D3<B/B7D3 , D/117<3 B@7/:A 6/A 033< 23:/G32 0G 230/B3 /0=CB B63 >@=D7A7=< =4 /<B7@3B@=D7@/:A B= >/@B717>/<BA L *6/7:/<2 6/A 033< A33< 0G ;/<G /A /< 3F/;>:3 =4 / @3A=C@13:7;7B32 1=C<B@G B6/B 6/A 033< AC113AA4C: 7< 23/:7<5 E7B6 B63 , 3>723;71 *63 *6/7 $7<7AB@G =4 'C0:71 3/:B6 035/< 7BA >@=5@/;;3 B= >@=D723 /<B7@3B@=D7@/:A 7<

(6) <

(7) /0=CB

(8) >/B73<BA E3@3@3137D7<5B63A32@C5A :B6=C56/5==2AB/@BB63 >@=5@/;;31:3/@:G272<=B4C:J:B63=D3@E63:;7<5<332 4=@/<B7@3B@=D7@/:A/BB6/BB7;3 <

(9) *63 , %3B63@:/<2A CAB@/:7/ *6/7:/<2 (3A3/@16 =::/0=@/B7=< ,%* E/A 4=@;32 /A / <=<5=D3@<;3<B/: /<2 <=<>@=JB =@5/<7A/B7=< E7B6 B6@331=::/0=@/B=@AB63*6/7(32@=AA )(3A3/@16 3<B@3 7< *6/7:/<2 B63 %/B7=</: 3<B@3 7< , >723;7=:=5G /<2 :7<71/: (3A3/@16 7< )G2<3G CAB@/:7/ /<2 B63 <B3@</B7=</: <B7D7@/: *63@/>G D/:C/B7=< 3<B@3 7< ;AB3@2/; B63 %3B63@:/<2A ,%*A >@7;/@G /7;A E3@3 B= C<23@B/93 1:7<71/: ABC273A=4/<B7@3B@=D7@/:A/<2B=>@=D723/113AAB=2@C5A /<2 , 1/@3 < B63 >/AB G3/@A ,%* 6/A 3<@=::32=D3@

(10) >/@B717>/<BA7< 1:7<71/:B@7/:A/<2 6/A A3@D32 /A /< 3F/;>:3 =4 / 1:7<71/: @3A3/@16 7<AB7BCB7=<7</@3A=C@13:7;7B32A3BB7<5 . :B6=C56 B63 1C@@3/@B717>/7<5 1=C<B@73A 7A 274J1C:B 7< >@/1B713 +<B7:

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

(12) ,%*@31=5<7A32B6/B/:;=AB

(13) >/B73<BA E=C:2A==<03E7B6=CB4C@B63@2@C5AC>>:73A </AC@D3G ;=AB=4B63A3>/B73<BAA/72B6/BB63GE=C:2AB=>B@3/B;3@3D3/G7<5B633<B7@3/;=C<B0CB/:;=AB/::A/72B63GE=C:2 03E7::7<5B=A6/@3B631=AB :B6=C56E3AB/B321:3/@:G7< =C@ 1=<A3@=;7A3 >=ABB@7/: 2@C5 AC>>:G E3 E3@3 1=;>3::32 B= B/93 /1B7=< E63< 4/132 E7B6 B63 B@/571 >@=A>31B =4 E/B167<5 >/B73<BA @3D3@A7<5 B637@ 3F13::3/B73<BA7<1=;3A/<2=C@ >@7<17>:3 03:734 7< A6/@32 @3A>=<A707:7BG E3 0/A32 =C@ AC0A7273A=</1=>/G;3<B/<2A:727<5A1/:3AGAB3; -63< >/B73<BA />>:G B= B63 ,%* 2@C5 4C<2 B63 93G AB3> 7< B63 >@=132C@3 7A /< /AA3AA;33<233@73<132 A=17/: E=@93@A =4 B637@ /07:7BGB=>/G *632@C54C<21=;;7BB33E67161=<A7ABA =4 BE= >6GA717/<A BE= <C@A3A /<2 / ;/</53@ @3D73EA B63 A=17/: E=@93@A @31=;;3<2/B7=< 7< 3/16 1/A3 /<2 A=;3B7;3A27A1CAA3AB631/A3E7B6B63>@=831B>6GA717/< /<2<C@A3E6=9<=EB63>/B73<B034=@3231727<5=<B63 /;=C<BB=03AC0A727A32 *631=;;7BB33;756B/A9B63 >@=831B >6GA717/< B= 1=<A723@ ;=274G7<5 /<B7@3B@=D7@/: @357;3<A=@4=@;C:/B7=<AB=@32C13B631=AB/A:=<5/A B63 ;=27J1/B7=< 2=3A <=B 6/D3 / 23:3B3@7=CA 34431B =< B63>/B73>=@B>@=D7232B=>/B73<BA;756B037<.

(15) 1 + )$&*,*+)$! !$&*) '$$')+!'&+ ,%.& &#'# !$& & " %( "$%!#" (

(16) %'"%$ " " !" " %! ""#! $ " $$ & " "!&+&+ ,$+.

(17) >«ÌiÀÊ£{\Ê*ÃÌÊÌÀ>Ê`ÀÕ}ÊvÕ`Ê ££Ç. B63 4=@; =4 1/A6 2@C5A =@ 0=B6 *63 1=;;7BB33 /:A= =D3@A33AB630C:9>C@16/A3=4A=;32@C5AB==0B/7<:=E >@713A *63A=17/:E=@9B3/;@3/AA3AAB63J</<17/:AB/BCA =4 B63 >/B73<BA 3D3@G

(18) ;=<B6A )7<13 E3 /@3 / A;/:: =@5/<7A/B7=< E7B6 JD3 2=1B=@A /<2

(19)

(20) <C@A3A A=;3 1=;;7BB33 ;3;03@A ;756B /B B7;3A 1=;3 4@=; B63 >/B73<BAABC2GB3/;>=AA70:G7<B@=2C17<507/A7<B=B63 2317A7=< ;/97<5 >@=13AA =E3D3@ E3 03:73D3 B6/B 9<=E7<5 B63 >/B73A CA ;/93 / ;=@3 7<4=@;32 2317A7=< 11=@27<5B==C@3AB/0:7A632AB/<2/@2B63>/B73/GA /B :3/AB +) >3@ ;=<B6 /<2 ,%* >/GA /B ;=AB +)

(21) >3@ ;=<B6 *67A AC; 7A 0/A32 7< >/@B =< , %*A G3/@ J</<17/: >@=831B7=/B73<BAB=;33B #793;=AB@3A=C@13:7;7B321=C<B@73A *6/7:/<26/A/E72327A>/@7BG=47<1=;3A :B6=C56;/<G =4 =C@ >/B73<BA 1=C:2 >/G +) >3@ ;=<B6 E7B6=CB 274J1C:BGE32=<=B3F>31B/::=4B63;B=03/0:3B=A7<13 B63;7<7;C;E/537<*6/7:/<27A=<:G+)>3@2/G G &1B=03@ ,%* 6/2

(22) >/B73<BA >/@B717>/B7<57<B@7/:A/<2E6=6/21=;>:3B32B@7/:A &4 B63 >=ABB@7/: >/B73<BA 3<@=::32 7< <3E ABC273A >/724=@1=<B7<C7<52@C5AB63;A3:D3AE7B6 BE=B67@2A @3137D7<5 >/@B AC0A727A/B7=< 4@=; B63 *6/7 5=D3@<;3<B/<2 @3137D322@C54C<2AC>>=@B *63 >/B73<BA /07:7BG B= >/G E/A 63:>32 0G B63 *6/7 5=D3@<;3<BA >@=2C1B7=< =4 53<3@71 JF322=A3 1=;07</B7=< =4 AB/DC27<3 :/;7DC27<3 /<2 <3D7@/>7<3 E67161=ABA+) >3@;=<B6 &4B637<27D72C/:AE6=@3137D322@C54C<2AC>>=@B E3@3/0:3B=>/GB63;7<7;C;;=<B6:G@3?C7@3;3/72 :3AA B6/< B63 B67A /;=C/G/<GB67<5 &</D3@/53B63 >/B73/72 +) @/<53 L /<2 +) ML

(23) >3@ ;=<B6 @3A>31B7D3:G %= >/B73<BA /B ,%* 6/D3 6/2 B= AB=> /<B7@3B@=D7@/:A 031/CA3 =4 :/19 =4 J</<17/: AC>>=@B

(24) >/B73<BA<33232:/@53AC0A7273AB=4C<2B637@A31=<2:7<3 @357;3<A <1=;3 4=@ B63 2@C5 4C<2 1=;3A 4@=; @3D3<C3A 23@7D32 4@=; @3A3/@16 ABC273A =D3@63/2 1=ABA /<2;=23AB>@=JBA4@=;=B63@/1B7D7B73AAC16/A=443@7<5 AG;>=A7/ /<2 B@/7<7<5 1=C@A3A

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

(26) @/<97A6 -$>=AB>=<3A2317A7=<B=/;3<231:/@/B7=<=4 3:A7<97 . <53::$ <D3AB75/B=@A@3A>=<A707:7B73A4=@6C;/<AC0831BA7< 23D3:=>7<51=C<B@73A L #=/G3@( AB/0:7A67<53B671/:B@7/:A4=@B@3/B;3<B/<2 >@3D3<B7=<=4 )7<23D3:=>7<51=C<B@73A L 7BH53@/:2-'/>3!--/AA3@637B!%=C<BA-=@3G# '@=D7A7=<=4B@3/B;3<B7< ,

(27) D/117<3B@7/:A7<23D3:=>7<5 1=C<B@73A L "C</<CA=<B'6==:16/@=3<-=2/@/;79. D=:CB7=<=4;3271/: A3@D713A4=@ , )7<*6/7:/<2

(28) L ,3@;C<2)'=E23@:G- 3D3:=>7<5/6C;/< 7;;C<=23J173<1GD7@CA /1?C7@327;;C<=23J173<1GAG<2@=;3 B63@/>3CB71@3A3/@16/53<2/4=@@3A=C@13:7;7B321=C<B@73A/ 1=<A3<ACAAB/B3;3@7A3

(30) L *C193@*):/19 %=B740CB6=E/@7<54=@ ,

(31) D/117<3B@7/: >/@B717>/<BA7<)=CB64@71/ .

(32)

(33)

No results found