[e-drug] Bhatia: Why EU seizes Indian drugs (Former India WTO Amb)

E-DRUG: Bhatia: Why EU seizes Indian drugs (Former India WTO Amb)
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[While many in the non-governmental movement who support work on
counterfeits (not to imply there is not a problem, particularly in
Africa) they refuse to acknowledge that the prescription has little (if
anything) to do with the diagnosis. Get anyone of these astroturf groups
to issue a statement that the dangers posed by Prozac or Vioxx are of
equal concern, then progress could be said to be made...faux radicalism,
faux concern parading as public health... with the WHO neatly in toe...]

http://www.business-standard.com/india/news/u-s-bhatiaeu-seizes-indian-d
rugs/413153/

U S Bhatia October 30, 2010, 0:51 IST

India's status as the pharmacy of the world is at stake

During 2008 and 2009, at least 16 consignments of Indian generic drugs
were seized by Dutch authorities while in transit through the
Netherlands. Most of these were essential drugs destined for developing
countries in Africa and Latin America. Perceiving a clear violation of
GATT and TRIPS provisions, India along with Brazil had sought
consultations with the EU under the WTO dispute settlement process.
India and Brazil have now to decide whether to request for a panel to
adjudicate the dispute.

The Indian generics industry has played a crucial role in ensuring
availability of low-priced but high-quality drugs not only in India, but
in much of the developing world. According to a UNITAID study, Indian
generics manufacturers supply over 80 per cent of donor-funded AIDS
medicines to developing countries. Domestically, the Indian industry now
faces challenges due to the implementation of the commitments that India
undertook under the TRIPS Agreement. In overseas markets, the renewed
push for enforcement of IPRs being spearheaded by some developed
countries threatens to circumscribe the market access that Indian
industry has enjoyed so far.

India's emergence as the pharmacy of the world is not a fortuitous
development. It took place in a facilitative policy environment which
has changed significantly in recent years. Domestically, the biggest
change involves the implementation of commitments that India undertook
under the TRIPS Agreement. While it is too early to arrive at definitive
conclusions about the impact of the re-introduction of the product
patent regime in India from 2005, some indications are clearly visible.

The earlier often antagonistic relationship between the generics
industry and pharma MNCs is being increasingly replaced by a more
cooperative relationship as the Ranbaxy-Daiichi Sankyo deal evidences.
More such consolidation of the Indian pharma industry can be expected
either through M&A activity or through partnership arrangements. An
intensification of such consolidation has implications from the public
health standpoint, an issue which the Parliamentary Standing Committee
on Health and Family Welfare addressed in its report to Parliament in
early August.

These concerns include the continuing willingness of the industry to use
TRIPS flexibilities as well as on the issue of drug pricing. While R&D
activities in India have certainly increased, the outcomes are not yet
visible in the marketplace. There is little to suggest that research on
neglected diseases has increased. The USP of the Indian generics
industry remains the development of low-priced generics, but the focus
of the industry, at least of the bigger players, appears to be
increasingly on development of generic versions of drugs going off
patent in developed country markets for sale in such markets.

Given the close relationship between a robust generics industry and
public health, policy-makers would need to keep a close watch over
developments in the industry to ensure that competitive conditions are
maintained and that the generics industry continues to play its role in
providing affordable, quality-assured medicines to India and the world.
In this connection, the Discussion Paper issued by the Department of
Industrial Policy and Promotion on Compulsory Licensing is a positive
development. However, given that India has not used the facility after
the coming into force of the TRIPS Agreement, it would be interesting to
see how this matter progresses.

The role that the Indian generics industry plays in public health
regimes in a large number of developing countries is often not
adequately appreciated in the Indian discourse. While the Indian
generics industry has only a 20 per cent market share globally, it has a
predominant share in supplies of ARVs for treatment of HIV/AIDS in
developing countries. It can be safely argued that if Indian companies
had not intervened in this sector with their significantly cheaper
versions, a very large number of HIV/AIDS patients would have gone
untreated. Indian generic drugs play a similar role in the treatment of
other diseases in a large number of developing countries, especially in
Africa. India's generic industry has, through its interventions in such
countries, created much goodwill for the country. There are few better
examples of India's soft power.

However, Indian generics companies continue to face stiff opposition in
a number of foreign markets from pharma MNCs and their host governments.
The gist of the strategy deployed by them is to deliberately confuse
"counterfeits" with generic products. In the TRIPS Agreement, the words
"counterfeit" and "pirated" are used only in the context of trademarks
and copyrights, respectively, and not in the context of patents. Patents
are territorial in nature and enforceable only in the national
jurisdictions where they are granted. The crux of the dispute between
India and the EU involves an extra-territorial enforcement of patent
rights by the EU in the case of goods in transit to third countries
without there being any threat of diversion to EU markets.

In the last few years, determined efforts have been made by a number of
developed countries to push through an activist agenda on enforcement of
IPRs for fighting counterfeits and piracy. Generic drugs are also a
target in this effort. A number of inter-governmental organisations like
the World Customs Organisation, World Health Organisation, and World
Intellectual Property Organisation have witnessed skirmishes on this
issue. However, due to the determined opposition of developing countries
like India, these efforts have not been successful.

Africa is a major battleground in this battle given the huge public
health challenges it faces. Efforts have been made to influence domestic
IPR legislation in a number of African countries by equating generic
drugs with counterfeits. Thanks to the role played by vigilant NGOs like
Medecins Sans Frontieres, Action Aid, Oxfam, etc. as well as African
NGOs, the vital role being played by generic drugs in combating
pandemics like HIV/AIDS in Africa has been highlighted and such national
and regional legislation prevented from being finalised or notified for
enforcement. However, this is a continuing battle and should be a major
focus of India's economic diplomacy in Africa in the near future.

The author is former Indian ambassador to the World Trade Organisation

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Dear colleagues,
If I may speak on behalf of the many governments that are faced with the challenges of counterfeit medicines (be they patents or generics), and specifically those countries that are investing time, effort and funds into ensuring that public health is safeguarded, I find it astonishing that this fight cannot be recognized for what it is. To suggest that governments (LDCs, etc) are confusing 'counterfeit' with 'generics' is too simplistic a position to take. It is also, in my view, a misrepresentation of those governments, NGOs, international organisations (yes, and this includes WTO, WIPO, WHO and its IMPACT programme, etc) and indeed the generic pharmaceutical industry itself that are involved in supporting governments to protect the public from the scourge of counterfeit drugs. Seriously, one needs to be on the ground (and you are welcome to Zambia to do this), to witness what damage counterfeits have done to patient health, and what cost this trade is imposing on a landlocked country such as Zambia. Recently, Interpol- Zambia, working with our drug regulatory authority (PRA), set up an operation to try and tackle the cross-border trade in imitation drugs (counterfeits).

From where I sit, we have developed positions through MeTA, and have supported the Ministry of Health in educating Parliament in Zambia on this very matter. In all these documents, we have strictly separated counterfeits from generics, as much as we have made a strong link between patents and generics.

It is such efforts that we must support to preserve the legitimate pharmaceutical industry.

The fact that the world seems to chose to confuse counterfeit with generic does not and should not weaken government position to prevent the trade in counterfeit (be they of patents or generics), through the use of specific national/international laws and agreements.

One would have to be blind to the realities around public health if one where not to recognize the value and contribution that the global pharmaceutical generic industry (India, China, etc) has made to public health, particularly on the African continent. Certainly many developing countries recognise that service, and value the role played by those credible generic companies. Indeed, this makes it imperative that international laws affecting generic drugs must be applied efficiently so as not to undermine what is a recognised business. However, we need to focus on targeting those that are taking advantage of the generic drug industry and indeed public safety and welfare, through the deliberate manufacture and trade in counterfeit products.

Regards,
Bonnie

Bonface Fundafunda PhD., MBA., B.Pharm
Manager, Drug Supply Budget Line
Ministry of Health,
P.O. Box 30205,
Ndeke House,
Lusaka,
Zambia
Tel: +260 211 25 41 83
Fax: +260 211 25 33 44
Mobile: + 260 979 25 29 00
Email: bcfunda@hotmail.com

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Dear Colleagues,

I fully agree with Bonface - generics and counterfeits for most in the developing countries are two distinct issues and must not be confused with each other. A study conducted on quality of ofloxacin in Pakistan showed that the highest priced leading (by sales) brands were counterfeited. There is a serious and real threat to control of infectious diseases, especially TB and malaria, in my country where even the Government has accepted the presence of counterfeit medicines to be as high as 50%. However, one wonders where is the evidence regarding counterfeits and their distribution across band and generic lines?

Best regards,
Ayyaz

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Dear All.

Please I need to be educated, is there no other route for these generic drugs to pass without going via Netherlands or any other European country, so that these oppressors can be avoided and the people needing these essential medications get them without stress.

Dr. (Mrs.) B.A. Aina Dept. of Clinical Pharmacy and Biopharmacy Faculty of Pharmacy University of Lagos CMUL Campus, Idi Araba,Lagos, NIGERA Tel +234 8023091623
ajokoaina@yahoo.com

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Dear colleagues,

In reply to Ayazz Gul Kiani's question about info on counterfeits, I would suggest that drug regulatory authorities will have the evidence he may be seeking, if I have understood his question correctly.

Regards,
Bonnie

Bonface Fundafunda PhD., MBA., B.Pharm
Manager, Drug Supply Budget Line
Ministry of Health,
P.O. Box 30205,
Ndeke House,
Lusaka,
Zambia
Tel: +260 211 25 41 83
Fax: +260 211 25 33 44
Mobile: + 260 979 25 29 00
Email: bcfunda@hotmail.com

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[There was a very important and comprehensive discussion on the possibility of local manufacture in Africa in May 2010. Look at the archives following the thread 'Quality pharmaceutical manufacturing in LDCs -possible?' Moderator]

Dear All,
I believe EU is telling African local pharmaceutical manufacturers to wake
up and "smell the coffee". That the destiny of our people are in our hands.
Producing generic Antiretrovirals, antimalarials and anti-tuberculosis
medicines is not a "rocket science".If Indians have done it, why cant
African Local pharmaceutical manufacturers do. At least we can go ahead
with secondary stage of producing quality finished goods while procuring the
API's from reputable pharma companies from anywhere in the world. This is a
true wake-up call and challenge for all. "Some" people will continue to
carry on with the notion of sub-standard products being manufactured
locally, but it is left for us to prove ourselves to the entire world what
Africans are capable of doing for their own. A lot of them thought FIFA
World Cup in Africa is not possible, and they have been proven wrong.

It is time for Africa local pharmaceutical manufacturers to prove that they are
capable of producing quality, safe and efficacious medicines just like the
ones imported from India or elsewhere, if we are given local governmental
support, and if Developmental Partners of Africa will support local
companies to rise up to this change. A great deal can be accomplished. Thank
you.

Dr. Yaw Adu Gyamfi
Danadams,
67 Nungua Link, Spintex Road, Accra, Ghana
Tel: +233244104720

DR. YAW ADU GYAMFI
Chief Executive Officer
Danadams Pharmaceuticals Industry Limited
*Leader in Health Sector
6th Position, Ghana Club 100
Ghana Investment Promotion Centre Awards, 2009*
E-MAIL:danadamsgh@gmail.com

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[In answer to your first question: In the archives you will find the contribution from Wilbert Bannenberg, March 6, 2009, 'Seizure of Indian generic ARVs in Netherlands en route to Nigeria' that explains the 'rationale' for the seizure (that the drugs were patent protected in the Netherlands). Moderator]

All,

This has been an interesting trail.

In as much as I agree that generics are quite good and have further made
treatments accessible to the majority of the needy we should also emphasize
quality. Why were these drugs seized? Were the authorities approached for
answers re their actions? I believe they are part of the questions we should
be asking. It is also a wake-up call for the various NRAs that are not
necessarily SRAs to look at their SOPs for upgrade if need be. The care
should be applied on the side of the exporting NRA as well as the importing
NRA.

Conclusively, we in the developing world really need these generics but the
developed countries too should continually remember that diseases find it
much easier to cross borders now than before. I think it is basic to fight
these diseases from their buds than to attempt killing the monsters once
grown.

Regards,

Jiru

Jiru Bako
Technical Manager (Health)
Crown Agents Nigeria Limited
Abuja-Nigeria
jiru.bako@ng.crownagents.com

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Dear all,
Dr. Aina asks a question that has also been bothering me. Why pass via the
Netherlands?? Have other alternatives been tried? Gibraltar? South
Africa? Airlifts? Maybe expensive but at cost of human life maybe worth
investigating?

Dr Eva Ombaka
Retired Pharmacist
Private consultant
P.O.Box 60559
Dar es Salaam, Tanzania.
"Eva Ombaka" <e.ombaka@gmail.com>

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It is a peculiarity of Dutch law that products transhipped through its
ports "enter the territory". Other EU countries like the UK do not have
this peculiarity.

But bypassing hostile jurisdictions for life saving drugs should be
done, ideally by WHO who was asked this question by me during the Swine
Flu pandemic. The WHO said not to worry because none of its shipments
had been seized. This at the time when another large institution
experienced "seizures".

Riaz K Tayob
Third World Network
<riaz.tayob@gmail.com>
[details added by Moderator - signature, affiliation and country must be supplied with each message.]

E-DRUG: Why EU seizes Indian drugs (Former India WTO Amb) (10)
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I totally concur with the writer of this mail.
[E-Drug Nov 9 - 'It is time for Africa local pharmaceutical manufacturers to prove that they are
capable of producing quality, safe and efficacious medicines just like the
ones imported from India or elsewhere']

Pharmaceutical companies in Africa should move towards building capacity to
manufacture the needs for Africa. Apart from perhaps improving the GDP's of the
countries doing such kind of local manufacturing, the lag periods would be
shortened and it provides a conducive platform to address the ever-present
counterfeit challenge in Africa.

Tapiwa Mupereki
Pharmacist
tapiwa mupereki <tapiwamupereki@yahoo.co.uk>
[Please include affiliation and country]

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Dear Tapiwa Mupereki and E-druggers,

It is very easy to make statements like yours [Why EU seizes Indian drugs (Former India WTO Amb) (10)] that African manufacturers should take a step ahead and produce effective, safe and quality medicines. However, no body is providing practical solutions on how to accomplish this. It should be noted medicines production is still seen as 'rocket science' in most parts of the continent therefore a less attractive area for investment. The regulatory and certification bottlenecks also compound this problem. I will suggest the following long term solutions:

- Companies with no experience in medicine production could start with simple options such as medicine packaging (of imported bulk formulated products). This could be a first step towards producing generics

- Countries with experience in medicines production such as Nigeria, South Africa, Morocco should take up their place as the 'India' , 'China' and 'Malaysia' of Africa by producing affordable quality generic medicines. In turn neighbouring countries can easily start up similar production units by acquiring local or regional technology transfer skills

- Break down medicine production to simple science by creating suitable learning and training environments; incorporate pharmaceutical technology as separate courses in the curriculum. If no pharmacy schools are present, chemistry depts can take up this challenge.

- Increase capacity for pharmacists and other front end medical practitioners. These are the persons who have direct contact with the public and who can be relied upon for providing reliable and accurate information on the use of medicines. With certified pharmacies existing in every community, interested entrepreneurs can venture into the medicine production business.

Kind regards.

Magnus A. Atemnkeng
(Quality Assurance Personnel, Montreal, Canada)
magnusajong@yahoo.com

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Thanks Magnus for your suggestions. I do agree we need to stop looking at
production as rocket science!

One of the comments against producing locally, is the issue of economies of
scale and that our products will be more expensive than those we import. So

if you look at India, China or Brazil these are huge countries with a
population that is enticing for production even if only for the country.
Compare that for example with Malawi and you start seeing the "economies of
scale" issue.

How can this be addressed?
Cheers.

Eva Ombaka
Retiring(?) Pharmacist,
Dar es Salaam, Tanzania.
Eva Ombaka <e.ombaka@gmail.com>

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Dear All;

I thank Magnus Ajong for his suggestions and statements; I agree that African nations must institute sustainable production quality-assured medicines. But, it is not true that nothing is being done.

In Tanzania, the St. Luke Foundation / Kilimanjaro School of Pharmacy teaches a Professional Certificate Program in Drug Development, cGMP and Quality Assurance. The program consists of four, two-week courses taught by myself, Stephen Byrn of Purdue University and Sister Zita Ekeocha. Attendees are from African Pharmaceutical companies, National Drug Regulatory Authorities and University faculty. We have graduated 23 Professionals through this Program in 2-1/2 years (6 sessions). With funding from the GTZ and UNIDO; SLF/KSP has built classrooms and a drug development laboratory (50L scale) for finished product production. Most industrial attendees have 50% support and academics 100% from the GTZ.

In 2011 we hope to be offering an expanded program towards an MSc degree. Professor Byrn and I have a great deal of real-life experience with global pharma, Indian and Chinese generic companies, ICH and the US FDA. The end objective of this training is to enable companies to achieve WHO PQ, making them eligible to sell to International Donor Agencies. I love seeing the companies we train progress towards WHO PQ.

We are certainly not alone in aiming for international standards of cGMP in Africa. BUT, African countries need some funding (eg, from the Global Fund) directed to training National Drug Regulators and assuring quality for African companies and for imported drugs. This is not a lot of funding, but it is not going to happen unless these are defined as NATIONAL PRIORITIES.

Feedback from the Global Fund, is that they are ready and eager to incorporate such training into their Programmatic Support, provided that countries recognize and articulate these needs.

All of you out there who might be able to assist with this ---- those who have access to their respective National Global Fund Boards --- what are your thoughts on this?

Joseph M. Fortunak
Associate Professor
Chemistry and Pharmaceutical Sciences
Howard University
525 College Street NW
Washington, DC 20059 USA
+1 202 806 6880 (office)
+1 301 928 7568 (mobile)
jfortunak@comcast.net

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Dear Eva Ombaka,

Economies of scale - these can be misleading. There are many Indian producers in free-market competition for most essential medicines, so the actual scale of production for any single producer is most often not huge. And, the economy of scale for many types of production provides only very small advantages when one goes beyond the equivalent of 5-10 metric tonnes per year of product.

BUT, the bigger issue is that Indian producers have local access to solvents, reagents and excipients - because they are produced locally. For excipients the difference is not so large. For solvents and reagents - API producers in India have a significant advantage.

Joseph M. Fortunak
Associate Professor
Chemistry and Pharmaceutical Sciences
Howard University
525 College Street NW
Washington, DC 20059 USA
+1 202 806 6880 (office)
+1 301 928 7568 (mobile)
jfortunak@comcast.net