E-DRUG: ART for 38 cents per day?
---------------------------------
[This Wall Street Journal article is good news for ARV treatment in Africa!
It would be a breakthrough if we can supply ART for USD 0.38 per day!
NOTE: $0.38 * 365 = $138.70 for a years supply of triple combination AIDS
medications. The IP issues must become a key issue in the 2004 race.
Crossposted from IP-Health, copied as fair use. WB]
October 23, 2003
Clinton Program Would Help
Poor Nations Get AIDS Drugs
By MARK SCHOOFS
Staff Reporter of THE WALL STREET JOURNAL
Former President Bill Clinton plans to announce Thursday a landmark program
that attacks two of the toughest obstacles to treating AIDS in the
developing world: high drug prices and low-quality health infrastructures.
The Clinton Foundation HIV/AIDS Initiative has clinched a deal with four
generic-drug companies, including one in South Africa, to slash the price of
antiretroviral AIDS medicine.
Engineered by longtime Clinton adviser Ira Magaziner, the agreement will cut
the price of a commonly used triple-drug regimen by almost a third, to about
38 cents a day per patient from an already cut-rate generic price of about
55 cents. The lowest available price for the same regimen using patented
versions of the drugs in developing nations is $1.54. For a key drug,
nevirapine, the price will be cut by almost half.
The agreement also establishes a way of working that is rare in the
secretive pharmaceutical industry. The companies involved -- Ranbaxy
Laboratories Ltd., Cipla Ltd. and Matrix Laboratories Ltd., all of India,
and the South African company Aspen Pharmacare Holdings Ltd. -- opened their
books and manufacturing processes to a group of Clinton business advisers.
Then the advisers and the companies hunted for ways to cut costs, starting
with raw-material suppliers in China and ending with the products'
packaging. Mr. Clinton's team plans to use this approach to try to lower the
price of diagnostic tests, which are still very expensive.
Under the supervision of Mr. Magaziner, the Clinton Foundation HIV/AIDS
Initiative also helped several Caribbean states and three African countries
prepare detailed government-approved plans for rolling out the drugs
nationwide, instead of just in selected regions. The plans aim to improve
the entire health-care system by preparing budgets for hiring and training
nurses and doctors, building and upgrading laboratories and clinics,
developing patient-information systems, and improving drug warehousing and
delivery. Only a handful of other sub-Saharan countries, such as Botswana
and Senegal, have created similarly ambitious, government-approved plans.
In the past, South Africa, which has more HIV-infected people than any other
country, resisted public pressure to roll out full AIDS treatment in public
hospitals and clinics. But the South African government recently named Mr.
Clinton's AIDS Initiative as its main advisory group on HIV treatment, and
the Clinton team has helped draft a detailed operational plan for treating
AIDS patients that the cabinet is expected to approve shortly.
To pay for the drugs, and for the necessary improvements in the countries'
tattered health systems, Mr. Clinton has secured partial funding by
personally lobbying leaders of rich nations, such as Ireland and Canada.
Ireland has committed Euro 50 million ($58.3 million) over five years,
mainly to
Mozambique. Canada hasn't yet finalized its donation, but it will be in the
"tens of millions," according to a senior government official there.
The money will go directly to the governments of the countries that Mr.
Clinton's team is assisting. "All I do is procure," Mr. Clinton said in an
interview, "I don't receive." Mr. Clinton has also raised more than $1
million from private sources.
"Usually I just call the prime minister or the president," Mr. Clinton said,
"and tell them what we're doing and ask them to have somebody look at it.
And I always tell them that even though we're friends they don't have to do
this for me -- don't do it unless they think it's a good thing. But I think
it's the best thing going in the world in AIDS care."
To develop the programs, Mr. Magaziner has been working with a team of
medical experts from such institutions as Harvard and Columbia universities,
as well as business executives and consultants. All but one -- a Kenyan who
can't afford to work free of charge -- volunteer their time or get support
from their organizations.
It's unclear whether enough money can be raised to support millions of
patients on lifelong AIDS therapy, and Mr. Clinton concedes his efforts
don't always work out. In any case, he isn't expected to raise all of the
money. Rwanda, Mozambique and Tanzania have each secured partial funding
from other sources, such as the World Bank and the Global Fund to Fight
AIDS, Tuberculosis and Malaria.
Mr. Clinton vehemently denies any partisan motivation, but his efforts
threaten to steal some thunder from President Bush. Months after Mr. Clinton
began working on his initiative, Mr. Bush called for $15 billion over five
years to fight AIDS in poor nations. That proposal still hasn't cleared the
congressional budget-authorization process.
Getting other governments to prepare and approve ambitious treatment plans
was critical to securing the drugs deal, because the plans promised the drug
makers large numbers of patients over time -- up to 1.5 million by 2008.
Essentially, the Clinton Foundation is becoming a market maker. "This is the
first time a group has come forward with predictable volumes," said Yusuf
Hamied, chairman of Cipla.
Mr. Magaziner then approached drug companies and asked them to follow what
he calls a total quality management approach: open up their cost structures
to lock in prices that would give the companies a small profit but make the
drug available at the lowest possible cost. He says he first approached the
patent-holding pharmaceutical companies "because President Clinton believes
in intellectual property." So far, though, none of the Western companies are
involved.
Bristol-Myers Squibb Co. says it never received a Clinton proposal, and
Merck & Co. says it is in early-stage discussions.
There is a chance that the Western companies will try to block the deal by
charging patent infringement. But they have damaged their images when they
have tried to do that with AIDS drugs in the past. In South Africa, which
has the strongest patent protection in Africa, GlaxoSmithKline PLC and
Boehringer Ingelheim GmbH have licensed some of their AIDS drugs to Aspen,
one of the Clinton partner companies.
---------
[Sidebar]
DEADLY GAP
The estimated number of people in 2002 who needed 'triple
therapy' AIDS treatment, compared with the number who
received treatment, in thousands.
IN NEED OF TREATMENT RECEIVED TREATMENT
Latin America and the Caribbean: 370 196
North Africa and Middle East: 7 3
Eastern Europe and Central Asia: 80 7
Asia Pacific: 1,000 43
Sub-Saharan Africa: 4,100 50
Source: UNAIDS
Paul Davis
Health GAP (Global Access Project)
e: pdavis@healthgap.org
t: +1 215.833.4102 (mobile)
f: +1 215.474.4793
w: www.healthgap.org
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