E-DRUG: BMJ: WHO official warns of crisis in supply of low cost AIDS drugs
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Working for MSF, there are several reasons why I don't approve of the
concept of a 'humanitarian corridor' for affordable medicines....
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BMJ, 12 November 2005
WHO official warns of crisis in supply of low cost AIDS drugs
Geneva John Zarocostas
By 2010, poor developing countries will continue to suffer from a shortfall
in supplies of low cost antiretroviral drugs (ARVs) for patients with
HIV/AIDS unless rational measures are taken quickly, a top World Health
Organization official has warned.
"We're going to reach a crisis in terms of supply very very soon . . . of
[antiretrovirals] throughout the developing world because the scale-up is
happening very very quickly," Dr Jim Yong Kim, WHO's outgoing director for
HIV/AIDS, told the BMJ.
The issue now for the public health world, he said, in the aftermath of the
recent summit of the G8 (the world's most industrialised countries) in
Scotland, was that a potential eight to 10 million people will need
treatment. In July, the leaders of the G8 agreed at the Gleneagles summit
"to provide as close as possible to universal treatment for AIDS by 2010."
Dr Kim doubts whether this can be achieved with the current regime: "We
think it's impossible for the holders of intellectual property to supply
that need at the price that we're looking for."
Dr Kim steps down from his post with WHO in December to return to his
academic post at Harvard Medical School. He said that the research based
pharmaceutical industry had made enormous contributions to the struggle
against HIV/AIDS, and, as a result, 500 000 people were now receiving
reduced cost drugs. But he also voiced serious reservations whether the
industry could continue to deliver low cost antiretrovirals.
"We really wonder whether they will be able to reach all the eight to 10
million people. They're taking a loss on each regimen they sell, they tell
us. So something has to be done," he said.
Harvey Bale, the director general of the International Federation of
Pharmaceutical Manufacturers and Associations, countered that, "It's simply
premature to make a forecast for 2010." He said that the federation has
been pressuring WHO for eight months to agree to set up a joint team to
improve the forecasting of demand.
If companies were given good lead times in demand forecasting on what the
needs were for (low cost) antiretrovirals, Dr Bale told the BMJ, then
companies can respond.
Dr Kim believes the way ahead is to find a way of protecting first world
markets, so that the research based industry continues to have an incentive
to develop new HIV/AIDS drugs, and at the same time create a humanitarian
corridor so that low cost producers such as China can sell low cost drugs
to Africa.
Dr Kim, back from a trip to China to look at its capacity to manufacture
both first and second line antiretrovirals, said authorities and
manufacturers had told him that, "With fairly reasonable corroboration they
are now able to produce all the first line and second line drugs except for
the fusion inhibitors. They feel the target price for both first and second
line drugs is around the current lowest cost, which would be around $150
[£86; 127] per person per year."
For first line drugs, Dr Kim said, the Chinese indicated that they "could
go below $100 per year fairly quickly if they have the volume." If the
corridor can be created within a year and a half, the Chinese said they
would "be able to scale up to meet the entire global demand," Dr Kim said.
Dr Bale said that the price offered by companies within his federation to
Africa and some of the other poorest nations were at no profit, at cost, or
below cost. "They're not making any money on these sales," he said but
added that original research companies "can still cut their losses" if they
had more volume.
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Nathan Ford
MSF London
Nathan.FORD@london.msf.org