What is at stake in access to anti-HIV/AIDS generic medicines ?  

19 July 2002

Since multitherapies were launched, international donors have been claiming that the cost of such medicines is too high for them to pay for the medical care of people living with HIV/AIDS in poor countries.

The cost of antiretroviral medicines is a difficult problem, but so is the very high cost of some treatments for opportunistic illnesses(nizorat, fluconazol, acyclovir etc), or of diagnostic tests and monitoring tools.

For two years, however, generic copies of particularly expensive antiretrovirals have been produced in developing countries by public institutions (Brazil, Thailand) or private companies (India) and sold at much lower prices than those of brand-name drugs by patent holders.

Thus we are no longer constrained to accept a market monopoly, which has had serious repercussions in terms of prices...

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COPY = RIGHT : Let poor countries access generic ARVs  

11 July 2002

Drug companies are using several ways to block generic access in developing countries :

1. patents : drug companies use their patents to stop poor-country governments from making or importing cheap, generic HIV drugs of their own ;

2. company/government agreements : drug companies use pseudo-philanthropic agreements ("Accelerated Access Initiatives") with needy governments in order to force poor countries to forgo their sovereign WTO-recognized right to make and import generic versions of the drugs, even while the generics remain 5 times cheaper on average ;

3. WTO : drug companies use their corrupt allies in the US and EU administrations in order to block the Doha WTO process that was tasked by the Qatar Trade Ministerial Summit in November with ensuring that poor countries may not only import but also export generic health products.

On the whole, generic versions are still 80% cheaper than "discounted" patent versions. This makes a huge difference in terms of human lives, since high-burden countries are so poor that any unexploited price reduction immediately excludes thousands from accessing lifesaving therapy, thereby condemning them to die of aids.

This further means that the prices of the generics must come down much lower than their present levels - otherwise the very poorest will never have access. The only way to scale up competition between generic makers today is to scale up the drug market for which they must compete : to have every poor country switch its HIV drug supply from the North monopoly patent-based manufacturers to the South generic competition-based manufacturers. Now that WHO is vouching for more and more of the generics' quality, there can be no reason left not to take that essential.

Purportedly philanthropic agreements between monopoly manufacturers and poor countries are thus doubly criminal : in the immediate term they deprive very poor PWAs from cheaper medication that they could afford, and in the medium term they serve to blocks the needed global price war on HIV drugs that is required to ensure broadest and fastest access to aids treatment.

Act Up-Paris therefore demands that patent-based ARV-makers :

Contact media : Gaëlle Krikorian >galk@noos.fr

ACT UP/Paris website

Bridging the gap on drug prices? 

Four years ago the World AIDS Conference in Geneva adopted the slogan "Bridging the Gap" and the organisers were ridiculed for focusing attention on the urgency of getting anti-viral treatments to developing countries. 

At Monday's session on "Treatment: Strategies for Lowering Prices," Jean-Paul Moatti reminded the audience that pharmaceutical company representatives at the 1998 conference refused to entertain the notion of the Antiviral Access Initiative claiming that "differential pricing will be a disaster for research and development". 

At Barcelona 2002 the talk of treatment prices is being led by activists, economists and government officials, and it has moved from rhetoric and soul-searching to concrete solutions to make it happen. 

US activist Jamie Love advocated setting up a "non-voluntary patent pool" and having WHO set up an "Essential Patents List" to sit alongside the "WHO Essential Drugs List". There is precedent: in 1917 the US government forced aircraft patent holders to pool their patents in order to afford to produce airplanes to fight the war. "If we can pool patents to kill people, why can't we pool them to save lives?" asks Love. 

The argument that patents are an essential incentive for industry was rejected by Richard Laing. He pointed out that the total annual spend on pharmaceutical products in Africa is US$5 billion. In the US, Pharmaceutical companies spend $15 billion on promotional activities alone. 

There was fierce discussion about the role of donors. Delegates demanded that the Global Fund adopt procurement policies to acquire only generic drugs, in order for the resources to reach the most people. Alarming anecdotes were shared, suggesting that the Gates Foundation and the US government have threatened to withdraw grants from countries purchasing generic drugs. 

Medecins sans Frontières (MSF) research showed that the lowest prices are found in countries which import both generic and brand drugs, and also manufacture their own treatments. MSF's Carmen Pérez-Casas called on companies to adopt "a systematic differential pricing system, and not case-by-case negotiation.

" French researchers and MSF confirmed that the competition created by generic drugs has lowered prices of both brand and generics. Comparing the fall over time in drug prices, it is clear that serious price cuts occurred when Brazil threatened compulsory licenses and then began to manufacture their own drugs, driving down prices by 72.5%

 "If the drug industry is left to compete among itself there will be no substantial drop in costs," argued the Kenyan Minister for Public Health. "The government must intervene."

Key Correspondent  Health & Development Networks

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