E-DRUG: African Nations Discuss Possibility Of Buying Generic AIDS Drugs
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[There is huge interest in the Brazilian, Indian and Thai generic antiretrovirals
here in Durban. Below a report by no less than Michael Waldholz of the Wall Street
Journal. Copied as Fair-Use. Thanks to PHARM-POLICY for passing it on. WB]
http://interactive.wsj.com/articles/SB963441683664871026.htm
July 13, 2000
African Nations Discuss Possibility Of Buying Generic AIDS Drugs
By MICHAEL WALDHOLZ
Staff Reporter of THE WALL STREET JOURNAL
DURBAN, South Africa -- Stepping up pressure on the U.S. and European
pharmaceuticals industries to reduce drug prices, officials from more
than a dozen African nations hard hit by the AIDS pandemic have opened
preliminary talks here with representatives of generic-drug producers in
Brazil and India aimed at buying AIDS drugs at prices sharply lower than
those charged by major drug companies.
The first-of-their-kind discussions are being coordinated in closed-door
meetings at the 13th International Aids Conference by officials of the
United Nations AIDS Program, or U.N. AIDS. The organization hopes that
by exploring the option of buying generic versions of the drugs, the
countries will be better able to negotiate lower prices with companies
such as Merck & Co. and Bristol-Myers Squibb Co. that make and sell the
potent AIDS treatments.
The development represents a significant threat to the big drug makers,
which are already under fierce political pressure to cut prices to poor
nations and which have unveiled several initiatives at the
meeting here to donate drugs and health services to AIDS-ravaged
communities. Pharmaceuticals companies are concerned that wide use in
poor countries of generic versions of drugs that are still protected by
patents in many parts of the world will undercut their ability to charge
premium prices for medicines in Western countries.
A weakening of prices, or the widespread global use of generics, could
significantly hurt the drug makers' profitability, according to many
analysts. Indeed, the companies' prices are under attack
even in the U.S., where high prices are a hot issue in this year's
presidential campaign.
At present, few of the 26 million people in Africa infected with HIV,
the AIDS virus, have access to the life-prolonging drug therapies
because they can cost $4,000 to $9,000 a year. That is far beyond the
grasp of many African countries, where the per capita average income is
less than $1,000 a year. Dealing with Brazilian and other generic
makers, which operate in countries without patent laws and thus produce
the drugs despite the brand-name drug manufacturers' patents, could make
the drugs available at from one-half to one-tenth current prices,
according to a report prepared by U.N. AIDS.
For instance, a combination of two AIDS drugs, AZT and 3TC, made by
Glaxo Wellcome PLC that sells for about $18 a day in the U.S., and for
$7 a day in Uganda, is marketed by generic makers in Brazil
for about $1.50.
<SNIP>
"I've told the big drug makers who we are negotiating with right now
that my goal is to get the countries information so they can use the
free market to help their people," Dr. Piot said.
<SNIP>
The present talks are the culmination of nine months of work by Badara
Samb, a Senegalese staffer of U.N. AIDS, and amount to an especially
aggressive step for the four-year-old group, which to date has largely
seen its role as an advocate for the nations wracked by AIDS. In recent
weeks, Dr. Samb has produced the report comparing the prices of drugs
produced by generic makers in Brazil, Thailand and India, where the
patents aren't protected by national law, with those currently charged
by drug companies. The report shows that the prices are significantly
lower than those charged in the U.S., or even those being offered in a
special drug-access program in Uganda and the Ivory Coast.
Dr. Samb's report also found that when the Ivory Coast imported some
generic drugs, the prices charged by the large drug makers also fell
faster than prices in Uganda, which doesn't import generic drugs. "What
we are seeing is that competition can drive down the prices," Dr. Samb
said. "We simply are telling the governments that may want to bring this
kind of competition into their country."
One official especially interested in the option of buying generic drugs
and who has been involved in the private talks in Durban is Chrispus
Kiyonga, Uganda's health minister. "There are many people in Uganda who
could benefit from these drugs if the prices were lower," Dr. Kiyonga
said. The AIDS drugs don't have
patent protection in Uganda and Dr. Kiyonga said he believes his country
can import the drugs. He said Uganda hadn't explored the possibility of
doing so before because "we simply didn't have the information U.N. AIDS
is providing us now."
Dr. Kiyonga said he spoke this week with a representative of Brazil's
government at the Durban meeting, and discussed the possibility of
buying a small amount of the medicines at first. Paulo Roberto Teixeira,
director of Brazil's National AIDS Program, told Dr. Kiyonga and others
in the meeting that his company has only a limited capacity to produce
generic drugs for export. But Dr. Kiyonga said he is hopeful that if a
coalition of countries in East Africa banded together, they might create
the "market large enough for the Brazilians to be encouraged to increase
production."
Dr. Teixeira spent much of the week meeting with health officials from
Africa and other parts of the world, telling them that Brazil is
prepared to provide the expertise to build their own generic drug
manufacturers. "It is a gesture of humanitarian goodwill," he said,
noting that "it may also eventually generate more business" for
Brazilian companies.
One sticking point is whether the importation or production of the drugs
violates World Trade Organization rules regarding patents. Because the
drug makers don't have patent protection in most African countries,
however, U.N. AIDS staffers believe importing drugs won't violate patent
rules. Many of the drugs do have patent protection in South Africa; that
country has passed a law seeking to annul the patents because of the
health crisis, but the law is being challenged in court by the
pharmaceuticals industry."
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This is a very interesting article. The print and online version have
chart comparing the prices of AZT, ddI, d4t, indinavir, saquinavir, and
efavirenz in Brazil, Uganda, and the U.S. (from the recent UNAIDS
study). Does anyone know if Dr. Badara Samb's (UNAIDS) report is
available on the UNAIDS site or does one have to order it directly from
UNAIDS?
Thiru