Kaiser Daily HIV/AIDS Report (2) - Tue, 24 Apr 2001
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Indian Generic AIDS Drug Manufacturers Poised to Enter African Market
Following the withdrawal of the lawsuit filed by 39 pharmaceutical
companies against South Africa, several Indian generic drug manufac-
turers are poised to enter the South African AIDS drug market, the
Hindu Business Line reports. While Indian drug manufacturers Cipla
and Hetero Drugs already sell drugs in Africa, other Indian companies
manufacturing generic AIDS drugs -- Zydus Cadila, Ambalal Sarabhai
and Ginix Pharma -- hope to "tap" into the market as well. Africa,
with its large number of HIV/AIDS cases, has "huge" potential as a
drug market, according to analysts. One analyst said, "If one would
take into account the number of infected people in Africa, the esti-
mate varies from 17 million to 20 million. Hence, due to the sizeable
volume of the market, pharma companies would be eyeing that market in
a big way" (Hindu Business Line, 4/23). Pankaj Patel, managing direc-
tor and CEO of Zydus Cadila, added, "Africa has 25 million people in-
fected with HIV and South Africa has the largest population of 4.7
million. With the present reach, for Indian companies ... the market
size is estimated to be valued at around $1.75 billion" (Hindu Busi-
ness Line, 4/23). However, the industry is "cautious" of the true
size of Africa's market, which is determined by countries' drug dis-
tribution mechanisms. Cipla Joint Managing Director M.K. Hamied said,
"The mechanism of distributing drugs mainly for HIV/AIDS is associ-
ated with that of the government and the non-governmental agencies
that work for this cause. It is heavily subsidized and largely de-
pends on the [g]overnment's health care expenditure, as most people
are not in a position to buy these drugs at the prevalent prices"
(Hindu Business Line, 4/23).
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Financial Times Profiles South African AIDS Drug 'Campaigner' Zackie
Achmat
"Zackie Achmat is that most dangerous of things for political and
business establishments: an embodiment of the moral ... high ground,"
the Financial Times reports in a piece on the founder of the South
African Treatment Action Campaign. For many involved in the South Af-
rican battle over AIDS drugs and treatment, Achmat has "come to per-
sonify" HIV, a virus that is "still taboo" in the country. A member
of the African National Congress, Achmat is also a "veteran" of the
battle to overturn South Africa's apartheid regime. In 1998 he
founded TAC, a lobbying group that was the "spearhead" of the move-
ment to bring low-cost AIDS medications to South Africa. The group
was instrumental in the lawsuit brought by 39 drug companies against
South Africa's 1997 Medicines and Related Substances Control Act,
which would allow the manufacture and importation of cheaper generic
AIDS medicines. TAC caused a six-week delay in the trial, which was
settled last week, when the group won the right to submit a legal
brief detailing the "damage caused by the disease." Achmat, who is
HIV-positive, in 1998 came down with candidiasis, or thrush, a type
of yeast infection that affects people with weakened immune systems.
He was treated using Diflucan, a patented antifungal drug made by
Pfizer Inc. In addition to the treatment for thrush, Achmat was of-
fered antiretroviral medications to treat his HIV infection. Although
such treatments can help keep potentially life-threatening infections
like thrush from occurring, Achmat "refused" to take the medications
because their $500 a month price tag kept them "beyond the reach" of
most South Africans. Since then he has become an "articulate cam-
paigner for affordable HIV medicines." Achmat explained, "When I
raised the issue of treatment for AIDS in South Africa, people
thought I was mad. I don't want to live in a world where people die
every day simply because they are poor." Achmat began investigating
AIDS medications and found a generic copy of Diflucan available for
one-tenth of the price in Thailand, a discovery that "convinced him
that, contrary to what the [drug] industry said, patents were indeed
an obstacle to affordable medicines." Achmat said drug companies like
Pfizer, which recently made a large-scale donation of Diflucan to
South Africa, have been "goaded" into offering discounts by "terrible
publicity" and would not have done so without pressure. Even the
lower prices, he said, come with "strings attached."
Taking on the Government
Achmat's activism has not been limited to battling the drug compa-
nies. He has also criticized the South African government's reticence
to provide medications to HIV-positive people. He recently accused
Nono Simelela, head of the government's AIDS program, of "having the
blood of children on her hands," after the government delayed approv-
ing a special license for the drug nevirapine to help reduce vertical
transmission. The government "handcuff[s]" its ministers, Achmat
says, partly because of President Thabo Mbeki's "public equivoca-
tions" about the cause of AIDS and his desire to find a "magic-
bullet" cure. A lack of financial resources also hampers efforts. "It
will become impossible to treat opportunistic infections on this
scale. There will be millions of people with pneumonia and sweeping
epidemics of meningitis" unless the government "faces the [AIDS] epi-
demic squarely," Achmat said. TAC has worked with the government on
the lawsuit during a "cautious truce," and Achmat said that the end
of the trial does not mean the alliance is over. "As in any marriage
we are the foremost supporters when necessary and the staunchest
critics when necessary," he added (Pilling/Degli Innocenti, Financial
Times, 4/21-22).
--
Cecilia Snyder
mailto:csnyder@ccmc.org
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