Thai Strategy for Generic Drugs to Africa

The Thailand government has supplied free technology for the manufacture of AIDS generic drugs to five African countries to cut drug prices for HIV up to ten-fold. It has pledged not to rest until every African country has generic drugs for HIV.

Twenty-eight million of the world's 40 million HIV-infected people live in Africa.

The Thai effort, which is at present directed toward some of Africa's most populous countries, is likely to produce a revolution in drug accessibility and pricing in Africa. Although the prices of patented HIV drugs have dropped significantly over the last year, UNAIDS has warned that they still remain unaffordable for most Africans. Thailand's Director of Research and Development for the Government Pharmaceutical Organization, Dr Kirsana Kraisintu said: "we transfer this technology free for humanitarian reasons. We charge nothing, there are no licensing fees. But as a government agency, we can only do this on a government-to-government basis.

"I personally will not rest until every single African country has access to cheaper medication." She was interviewed at the Fifth International Conference on Home and Community Care for Persons Living with HIV/AIDS at Chiang Mai, Thailand. The conference theme is 'The Power of Humanity.'

Zimbabwe will be the first country to begin manufacturing the generic equivalent of Fluconazole, a broad spectrum anti-fungal for use against thrush, to be followed next month (January) by Ghana. By February, the first production line of generic drugs will come offline from Cameroon manufacturers, followed by Uganda and then Nigeria.

The government of President Robert Mugabe, which faces presidential elections in March, is likely to use the step as a key component of its election strategy. One in three Zimbabweans are HIV-infected and the government has previously been criticized for doing little to address the epidemic.

The generic equivalent of Fluconazole sells at US13cents per tablet - almost 10 times cheaper than the pharmaceutical price.

Dr Kraisintu who has just returned from Zimbabwe said she personally goes to each country to assess production capacity and capabilities, "Zimbabwe and Ghana have very good manufacturing capacity."

She said that once the five countries had successfully manufactured Fluconazole, they would go on to produce antiretrovirals such as DDI, AZT and 3TC among others.

Thailand first began researching the potential of manufacturing generic drugs for HIV in 1992 and began manufacturing more than 300 generic drugs three years ago, resulting in price drops to consumers of five to 10 times the list price of multinational pharmaceutical companies.

Generic equivalents are manufactured for antiretrovirals including Combovir (US66 cents per tablet), AZT (US15 cents per 100mg capsule or US$1,33 per 60ml syrup), 3TC (US22cents per capsule), Nevirapine (US55 cents per capsule), Stavudine capsules (US6 cents per capsule). Rifampicin, an essential medicine for treatment of tuberculosis, costs US12c per generic capsule. The generic equivalent of Ketonazole, used for treating fungal infections of the lungs and oesophagus, costs USfive cents per tablet.

Thailand, which has 1.5 million HIV-infected people among a population of 62 million, has seen new infections of HIV drop with effective prevention and treatment programs. Thailand began manufacturing drugs to treat HIV when it was realized that the average costs of antiretroviral triple drug therapy was US$675 per month, while minimum salaries in Thailand hover at less than US$120 a month. Dr Kraisintu said although South Africa's Treatment Action Campaign had approached the Thai government to supply generic drugs to South Africa, "but as a government we cannot supply NGOs. South Africa has two problems, one is that many antiretrovirals, such as AZT, are patented in SA - but not all drugs are patented there, and there are ways of getting around some agreements.

"But too, there is a lack of political will in South Africa. I am willing to transfer technology if South Africa gives the green light, they have a very good manufacturing infrastructure and if they made the request, they could begin rolling out generic drugs within six months."

However, Dr Kraisintu said: "We intend supplying drugs and providing manufacturing capacity to every country that surrounds South Africa, whether it is Zimbabwe, Namibia, Lesotho, Swaziland to ensure that one way or another the South African people can access medication."

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January 18, 2002

South African Government refuses Thailand's offer of cheaper drugs

JOHANNESBURG - The South African government has not taken up a Thai government offer of free technology for the production of 300 generic drug labels that could reduce prices for HIV/AIDS medicines even further.

In the past three years, Thailand has produced more than 300 different types of generic drugs at between a fifth and a tenth of the price of multinational pharmaceutical companies.

Thailand has promised not to rest until every African country has generic drugs for HIV/AIDS and has vowed to "ring South Africa with countries producing cheap drugs if it refuses to help its people," the Mail and Guardian newspaper reported this week.

Sibani Mngadi, spokesperson for the department of health, told PlusNews on Friday that there was "no need to pursue" Thailand's offer of manufacturing a generic version of Fluconazole as the government had an existing arrangement with pharmaceutical company Pfizer.

The government entered into a partnership programme with Pfizer in 2000 to provide Diflucan to treat cryptococcal meningitis in patients with HIV/AIDS at government hospitals.

Regarding the manufacture of other generic drugs, minister of health, Manto Tshabalala-Msimang had recently undertaken a fact-finding mission to Brazil and India to investigate "what's best for South Africa," Mngadi said. Brazil and India have managed to sidestep pharmaceutical patents and are producing cheaper, generic drugs.

Mngadi stressed that neither the minister nor the department had received any offer from Thailand. "We still need to look at the details (of the offer) and decide how it will benefit South Africa," he added.

The government could not currently provide long-term antiretroviral (ARV) treatment, as there were several challenges to overcome, he said. The cost of providing ARV drugs was still prohibitive and the health system lacked the capacity for such a programme.

Sustainability was another obstacle, as "these offers don't state for how long they will provide this assistance," he added.

The government was engaged in continuous discussions with pharmaceutical companies and other interested parties to find solutions to these problems he said.

"There is a lack of political will in South Africa. I am willing to transfer technology if South Africa gives the green light. They have a very good manufacturing infrastructure and if they made the request, they could begin rolling out generic drugs within six months," Dr Kirsana Kraisintu, director of research and development for the Thai government pharmaceutical organisation was quoted as saying.

Wednesday, January 30, 2002 6:08 PM

Thailand to Assist Zimbabwe in Production of Generic AIDS Drugs

Zimbabwe, a country where at least 2,000 people die of AIDS-related illnesses each week, will soon begin to manufacture 300 generic drugs, including AIDS drugs, Health and Child Welfare Deputy Minister David Parirenyatwa announced on Tuesday, Xinhua News Agency reports. The generic drugs -- which will include rifampin, an "essential" tuberculosis medication, and ketoconazole, a treatment for fungal infections in the lungs and esophagus -- will be made with the free technological help of Thailand and its Zimbabwe-based drug companies. Few AIDS drugs are affordable to most Africans, according to UNAIDS; however, the generic drugs would cut the prices of those drugs tenfold. "Zimbabwe is one of the countries severely struck by the HIV/AIDS pandemic, and if it means manufacturing drugs to control this scourge then we will do it," Parirenyatwa said. Thailand has indicated that, if the attempt in Zimbabwe is successful, the country also would offer its help to Ghana (Xinhua News Agency, 1/29).

from today's kaiser report


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