E-DRUG: Kenyan battle over access to medicines
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[Any E-drugger in Kenya who can provide some more info
on what is happening? Copied as fair use.
http://allafrica.com/stories/200105180401.html
NN]
A Cross-Roads On Cheap AIDS Drugs
The Nation (Nairobi), May 19, 2001
by Dennis Onyango
Now that the battle over cheap Aids drugs has shifted to Kenya,
"pundits" and "experts" are all-over with all the reasons why Kenya is
not ready for the generics. Most of the reasons are things we already
know, that there is no cure yet and emphasis should be on prevention.
There is also the already known idea that Aids drugs are highly toxic
and the longer patients keep off them the better. Then there is the view
that Kenya has no infrastructure to monitor the highly complex
administration of Aids drugs.
Another explanation has emerged lately; that Kenya has no capacity to
test the efficacy and soundness of cheap generic drugs. All these come
on top of the traditional objection raised by the drug manufacturers;
that allowing generics will kill research.
On the surface, it would appear like the pharmaceutical companies are
being good, trying to save Kenyans from taking drugs that may only end
up killing them.
What the "pundits" and "experts" are not telling us, however, is that
pharmaceutical companies have a history of being at war with people.
When the companies are caged as they are now, they do not deal with
their opponents directly. They do it through third parties whom they
sponsor. The war is not about how to treat people better. It about how
to keep profits high.
The pharmaceutical industry makes life-saving products. But it has never
been warmly embraced by patients who take those products.
A recent case in the US illustrated how Abbot Laboratories struggled and
managed to keep a generic version of its $500 million-dollar a year high
blood pressure drug out of the market. Abbot was worried about what
generics would do to its profits.
In a report entitled How Companies Stall Generics and Keep Themselves
Healthy, The New York Times reported last year that Abbot agreed to pay
Zenith Goldline Pharmaceuticals as much as $2 million per month up to a
maximum of $4.5 million if Zenith agreed not to produce the generic.
Abbot also agreed to pay another rival, Geneva Pharmaceuticals up to
$4.5 million a month, up to a maximum $101 million over the life of the
contract, as long Geneva never produced the generic.
Geneva Pharmaceuticals is an affiliate of the larger Norvatis AG, the
Swiss health and agricultural conglomerate. The generic version of
Hytrin, the contested drug, stayed out of the market until 1999 when the
US began antitrust investigations against Abbot.
Last week, The New York Times reported that a coalition of 17 consumer
groups have filed several lawsuits against two companies, Barr
Laboratories and AstraZeneca, charging that the companies colluded to
keep a generic version of an important breast cancer drug off the
market.
According to the suit, Zeneca paid Barr $21 million and Barr agreed to
sell Zeneca's drug rather than produce its own generic version.
Prescription Access Litigation Project, the consumer group that has
sued, promises "to stop these abusive drug company practices by going
after them drug by drug."
Given the secretive nature of the world's most lucrative industry, no
one knows how many such deals exist. But the deals are known to have
kept antibiotics, cancer and heart generic drugs out of the market.
It is war over profits, not infrastructure or some danger that lies
ahead for users of generic drugs.
The Kenya Coalition on Access to Essential Medicines fear that the
multinationals may try to do here what they do in the West. They could
put pressure on the Kenyan government "to drop or amend these vital,
legal and internationally recognized safeguards, which could ensure the
right of access to affordable medicines for millions of people suffering
from AIDS and other diseases," Dr Christopher Ouma says on behalf of the
coalition.
"Kenya cannot afford to rely on the charity of profit making companies
for its future," Ouma says.
Revelations of conspiracy in the industry have only tarnished the
industry's image, and the drug makers know it.
It is for this reason that the industry spends millions every year in
trying to make its image good. When it comes to spending money on
lobbying and public relations, pharmaceutical industry is only gun,
tobacco and insurance industries rival the pharmaceuticals. The industry
stands alone as the organisation with links to all sorts of groups. It
maintains a broad and usually unseen reach where its critics are.
In the US, the industry sponsors all sorts of political organisations.
Because it is lucrative and powerful, it usually hires well-placed
former government officials as lobbyists. The industry finances studies
that advance its views, then run heavy advertising campaigns that
cleanse their image.
In 1999, according to the Journal of American Medical Association, top
15 pharmaceutical companies in the US spent about $60 million, up from
$45million in 1998. The money was spent on lobbying, sponsoring studies
that advanced the industry's views and on advertising to save its image,
not on research.
In the US, where there are several patient advocacy groups, the industry
stems criticism by financing those groups. It also contributes to public
policy groups. Such lobbying ensures the industry of patent extensions
and tax breaks. In Africa where there are no such groups, the industry
has had a field day.
Pharmaceutical companies are known to sponsor studies then heavily
advertise the results, without disclosing that it is them who sponsored
the study.
In places like the US where the industry is caged, it creates seemingly
independent groups who promote the industry's agenda. Last year, as the
US campaigns focused more on the industry, a "consumer organisation,"
Citizens for Better Medicare emerged. It waged a $50 million campaign
against plans for a government-controlled drug industry just as another,
Alliance for Better Medicare came up to do the same thing.
What the companies did not say was that they sponsored all these
"consumer organisations" to protest against the government. The idea was
to make it look like it is the people who don't want the government to
control the industry.
It would not matter if these activities were only applicable abroad. But
the industry has branches all-over the world and what they resolve in
Washington and London apply in Africa too.
The permanent secretary in the ministry of health, prof. Julius Meme,
says what exists in Kenya are just branches of multinationals in the US
and Europe.
"The decision on whether to allow generics will be made out there, not
here."
To save its image, the pharmaceutical industry has toyed with all sorts
of names, changing them to suit the times.
In the 1900s when the drug makers had no enemies, they came together
under the name of Ethical Pharmaceutical Companies. That was to
distinguish them from sellers of herbs, snake oil and all other sorts of
cures that competed with the industry.
The name served them well until around 1984 when the word generic drugs
began to enter the public vocabulary. That year, the US Congress, pushed
into action by mounting complaints about the cost of brand-name drugs,
passed the Drug Price Competition and Patent Restoration Act. The
intention of the Act was to push prices down by speeding up the
emergence of generic drugs.
So fed up was Congress that it eased the regulatory burden on generics.
Generic manufacturers were not required to run costly clinical trials to
prove the effectiveness of their products.
All that was required was for them to prove bioequivalence---that the
generics contain the same key ingredients as the brand, and that they
work the same way. Congress went a step further. It offered a six-month
competition-free period for the first generic drug maker to seek
approval for a particular medicine. Seven months after the law took
effect, 800 generics had lined up, seeking approval.
In exchange, brand name manufacturers were given five-year patent
extensions.
The pharmaceutical industry began to see red. That is when they came up
with the scare they have stuck to: Research. They reasoned that the
world risked getting sicker if generics were allowed into the market as
they would kill research. No new drugs would be invented.
Research remained a low-key idea until 1994 when the Clinton
administration proposed sweeping changes that favoured cheap, generic
drugs. The administration was toying with allowing the government to
shop around the world and get cheap drugs for its citizens.
The industry changed its name from Pharmaceutical Manufacturers
Association to a more appealing and intimidating one; Pharmaceutical
Research and Manufacturers of America, PhRMA. Research had entered the
industry's central vocabulary to scare and entice the public at the same
time.
Some companies became so scared of losing profits that they patent the
colour of their pills. Some even patent the shape of the bottle the drug
comes in.
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