E-DRUG: Big Canadian drug companies embrace AIDS plan (2)
-----------------------------------------------------
[WB]
A legislation that could exempt Western generic drug companies from
regulations that make it illegal for them to produce cheaper versions
of brand-name companies' drugs, would be of course a good bit of news, and
Canada has seemingly the lead. It makes quite an impression.
But let's be not mistaken, this is somehow a short term and tactical
solution
as many political proposals.
1. Such a decision will affect only one disease - the HIV-Aids, because as
MSF
analysed it (Trouiller P et al, Lancet 2002), the Western R&D-based
pharmaceutical industry don't care about diseases such as TB or malaria
(apart
from the Western military needs where are the drugs), without mentioning the
other neglected diseases (leishmaniasis, trypanosomiasis...).
As for the HIV-Aids, developing countries are certainly fortunate in getting
sometimes spin-offs of the Western R&D, but definitely at the highest price:
not only from an economic perspective (here in Madagascar 70% of the
population is below the poverty threshold, US$1 a day), but as well for the
total inappropriateness and unsuitability of the proposed presentations to
their field conditions.
Let's think to all the capsules, powders and other tablets that a patient is
supposed to swallow in one day. Then what about the observance and adherence
to the treatment in the long run. And yet galenical research (the science on
how to improve the presentation, the dosage form) made significant progress.
Let's only think to the new route of administration and/or improved
tolerance
of cardiovascular, dermatologic and other pulmonary drugs. But some sectors,
because uneconomic, lag far behind - e.g., the vaccines field where the EPI
vaccine presentations are still the same as 50 years ago with always the
same
difficulties and risks because we still have to inject them and to maintain
a
cold chain... While today we could and should have nasal or spray
presentations at our disposal, in addition thermotolerant formulations.
At the beginning of the HIV-Aids epidemic in Western countries, research to
improve the presentations of products has been done by R&D-based
pharmaceutical industry, but quickly abandoned when people realised that
within the Western context and with the existing tools the Western epidemic
could be controlled, moreover with no significant lobbying from activists
and
authorities to reverse this trend. Pharmaceutical industry saved up.
The Canadian generic drugs are certainly welcome but will bring little hope.
The essentials lie elsewhere.
2. The HIV-Aids is now a developing country problem, and only incidentally
the
one of the industrialised world, for strategic and security reasons. Just
look
at the difficulties to credit the Global Fund.
This is not through importations of generic drugs from industrialised
countries, that developing countries will solve their problem. That can be
good for the Western countries balance of payments and their unemployment
figures, but this will keep again all the developing world in a state of
total
dependence. Many developing countries can produce, technically and legally,
the needed drugs of assured quality. Many developing countries, such as
among
others Brazil, India or South-Africa have a thorough knowledge of the
pharmacy. With a little help - transfer of technology, capacity building
support and dedicated market, they could improve significantly their
capacity
and direct their R&D effort towards their own needs. Remember the
praziquantel
story, rewrote by the South-Koreans and the Egyptians under Western
countries'
nose.
Many countries are already competing with Western generic manufacturers
(particularly in the US market). Definitely promoting through legal
incentives
(the future Canadian law on patents for instance) the export of drugs can be
more or less a way of counter-attacking, disguised with a humanitarian
costume. Only commercial dumping.
Really, we and the politicians are sometimes too na�ve. The industrialists,
they are more clear-sighted.
Patrice Trouiller, PharmD
Madagascar
pattrouiller@netclub.mg
--
To send a message to E-Drug, write to: e-drug@healthnet.org
To subscribe or unsubscribe, write to: majordomo@healthnet.org
in the body of the message type: subscribe e-drug OR unsubscribe e-drug
To contact a person, send a message to: e-drug-help@healthnet.org
Information and archives: http://www.essentialdrugs.org/edrug