The use of low-cost and generic ARVs in high-income countries has been limited. In contrast, in low- and lower-middle-income countries (LICs/LMICs) generic ARVs have helped put millions on treatment.

Now, many generics are becoming available in the U.S. and Europe. In LICs/LMICs a low-cost, “universal” regimen is being discussed. Upper-middle income countries (UMICs) face reduced support from donors, as they struggle with budgetary constraints.

Must (and which) trade-offs be made between cost, clinical benefits, patient choice, equity, and program priorities? Issues of ARV-pricing, health-budgets, insurance coverage and barriers to scale-up will be considered.

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