E-DRUG: MSF/TAC Fluconazole Compulsory License campaign
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[MSF-International and TAC (Treatment Access Campaign, a South African NGO)
have launched a campaign to convince Pfizer to lower its prices of fluconazole,
an essential drug for the treatment of cryptococcus meningitis, a common
opportunistic infection of African AIDS patients.
Below the MSF Letter to Pfizer and the press releases of MSF and TAC. WB]
MSF Letter to Pfizer:
Dear (name of General Manager or most senior Pfizer corporate official
in your country),
As a medical humanitarian organization, Medecins Sans Frontieres (MSF)
believes it is unacceptable when patients die of treatable diseases.
Our medical volunteers can no longer stand by and watch as their
patients in developing countries are denied access to life-saving
medicines.
Currently, in several of our AIDS programs, our volunteer physicians
and their local colleagues working in the public and private sectors
are diagnosing cryptococcal meningitis, but are unable to treat this
life-threatening disease.
Please consider the following two scenarios:
1) A person living with AIDS in Bangkok is diagnosed with cryptococcal
meningitis:
This patient will be treated with initial therapy of amphotericin B
i.v. for 2 weeks and 6 weeks of fluconazole, and will then remain on
maintenance therapy of fluconazole indefinitely. This patient's life
will likely be prolonged by several years and the quality of his or
her life will be substantially improved.
2) A person living with AIDS in Cape Town or Nairobi, for example, is
diagnosed with cryptococcal meningitis:
This patient will be told that he or she is suffering from a treatable
disease but that the treatment is too expensive. In most cases the
patient will be released from the hospital and will die within one
month.
What distinguishes these two scenarios from one another is the fact
that Pfizer has exclusive marketing rights in South Africa and Kenya.
In practical terms, this means that the retail price of fluconazole is
15 to 17 times higher in these countries than in Thailand, where the
drug is not patent protected.
People in poor countries should pay less for essential medicines.
While we appreciate that patents can be an important motor of research
and development funding, there must be a balance to ensure that people
in developing countries have access to life-saving medicines.
M�decins Sans Fronti�res demands that Pfizer take one of the following
two actions in poor countries where the company has exclusive patent
protection for fluconazole:
1. Lower the retail price of fluconazole (200 mg tablet) to $0.60 USD
or less, the price at which the drug can be purchased in generic form
in countries where Pfizer does not have exclusive marketing rights. 2.
If you decide that you are not willing or able to sell fluconazole at
this price, grant voluntary licenses to governments or NGOs that
formally make this request.
MSF explicitly supports the request made on March 13 by the Treatment
Action Campaign (TAC) in South Africa. If Pfizer grants a voluntary
license to TAC, the South African regulatory authority could then
authorize the manufacture or importation of low-cost, high-quality
generic fluconazole.
Your decision on this issue is a matter of life and death for people
living with AIDS in poor countries.
We would appreciate the opportunity to meet with you in person to share
information about the current situation of people with AIDS whom we are
treating. We think it is important that we explain the full scope of
our approach to treating people with AIDS so that you understand that
we are not blindly advocating treatment for all, but rather a more
realistic, medically responsible approach.
We will contact you shortly to set up an appointment to discuss this
matter further.
Sincerely,
MSF
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PRESS RELEASE MSF:
One World, One Price Means Death for People with AIDS in Poor
Countries
MSF Calls on Pfizer to Lower Price of Drug Used in AIDS Care
March 13, 2000 - Today, M�decins Sans Fronti�res (MSF) demanded that
the pharmaceutical company Pfizer dramatically reduce the price of a
life-saving AIDS drug in poor countries. In a communication delivered
to Pfizer today in 18 countries, MSF explicitly supported the
Treatment Action Campaign (TAC), a non-governmental coalition of South
African AIDS activists, in their call for Pfizer to lower the price of
fluconazole or authorize sale of less expensive generic versions of
the drug in South Africa.
"As physicians, we understand first-hand the frustration of watching
people die of AIDS-related meningitis when we know that an effective
medicine exists," says Bernard P�coul, director of the MSF Access to
Essential Medicines Campaign. "In South Africa, where one company
holds exclusive marketing rights, the cost of fluconazole is nearly 15
times higher than in Thailand where the drug is not patent protected.
People are dying because the price of the drug that can save them is
too high."
Cryptococcal meningitis is the most common systemic fungal infection
in HIV-positive people. Without treatment, life expectancy is less
than one month. Ongoing treatment with fluconazole can extend and
substantially improve the life of a person living with AIDS by several
years.
In South Africa approximately 4.5 million people are currently
infected with HIV and AIDS accounts for 100,000 deaths yearly. The
daily dose (400 mg) of fluconazole needed to treat cryptococcal
meningitis currently costs $17.84 USD, more than two times the daily
wage of an average employed South African who earns just $7.69 USD.
In Thailand, however, the daily dose of fluconazole costs just $1.20.
It is illegal for any company other than Pfizer to sell or produce
cheaper versions of fluconazole in South Africa because the company
has exclusive marketing rights.
In a communication addressed to Pfizer, MSF stated: "People in poor
countries should pay less for essential medicines. While we appreciate
that patents can be an important motor of research and development
funding, there must be a balance to ensure that people in developing
countries have access to life-saving medicines."
MSF is conducting an international campaign to improve access to
essential medicines in poor countries.