E-DRUG: NYT on Clinton deal
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[first response on the Clinton deal. Cipla already talks of USD 120/year!
Copied as fair use. WB]
Plan to Bring Generic AIDS Drugs to Poor Nations
New York Times April 6, 2004
By DONALD G. McNEIL Jr.
Four organizations with an interest in international health announced
yesterday that they would join forces to help more than 100 countries get
inexpensive generic AIDS drugs and discounted AIDS tests.
If they succeed, generic drugs made by Indian and South African companies
could reach virtually every poor country at prices as low as $140 per
patient per year.
The organizations are the William J. Clinton Presidential Foundation; the
Global Fund to Fight AIDS, Tuberculosis and Malaria; the World Bank; and
Unicef. Arranging the deal would be a coup for the Clinton Foundation, which
cannot by itself raise the billions of dollars for treatment. The foundation
needs the financial clout of the Global Fund and the World Bank, which have
each spent about $1.5 billion on the disease, and of Unicef, which procures
drugs for many countries too poor or too disorganized to negotiate the
complex world of pharmaceuticals and international trade rules.
It was unclear yesterday, however, whether the ambitious plan would be
realized. The drug and diagnostics companies named in the deal have not all
agreed to sell their products at the low prices they offered to a few
African and Caribbean countries under two other deals brokered by the
Clinton Foundation last year.
An executive of the Global Fund conceded that it was "a mistake on our part"
to announce the deal before making sure all the suppliers were in agreement.
Nonetheless, the executive, Anil Soni, chief adviser to the Global Fund's
executive director, said the organizations wanted to signal quickly that
they endorsed the use of the generics approved by the World Health
Organization. The Bush administration has questioned whether American
taxpayer dollars should be spent on generic drugs instead of pricier
patented ones.
"We want to make clear to our recipients that it is possible to purchase
generics that are up to the W.H.O. quality standard," Mr. Soni said.
The drug makers named in the announcement included Aspen Pharmacare of South
Africa and four Indian makers, Cipla Ltd., Ranbaxy Laboratories Ltd., Hetero
Drugs Ltd. and Matrix Laboratories Ltd.
The diagnostic test makers were two American companies, Beckman Coulter Inc.
and Becton Dickinson & Company; and three European companies, Bayer
Diagnostics, a unit of the Bayer HealthCare Group; bioM�rieux; and Roche
Diagnostics, a division of F. Hoffmann-La Roche Ltd. They hold patents on
CD-4 and viral load tests, which tell whether antiretroviral drugs are
working.
In January, the Clinton Foundation announced that it had brokered deals for
the diagnostics companies to provide the testing machines, as well as
chemicals and training in a dozen African and Caribbean countries at
discounts up to 80 percent.
When news of yesterday's announcement began leaking on Friday, two top
executives of Cipla, the first company to offer an AIDS triple-therapy
cocktail for less than $300, complained that they had not been consulted.
Dr. Yusuf K. Hamied, Cipla's chairman, said yesterday that his company had
sold its drugs for $240 to $280 per patient per year in 59 countries. He
said that his company was not willing to expand the number of markets, now
seven, where it offers the drugs for $140 until he had "something in
writing" from the foundation and the fund.
"That doesn't mean I don't intend to participate," Dr. Hamied said. "I want
to know more."
A spokesman for Ranbaxy, which makes the only other W.H.O.-approved
three-in-one drug combination, said that the official who dealt with the
Clinton Foundation could not yet confirm whether the company would
participate.
At Aspen Pharmacare, Stavros Nicolaou, vice president for trade development,
said it would sell its first-line cocktail, a two-drug pill and a one-drug
pill, through the foundation for roughly $140, but only in Africa.
Prasad Nimmagadda, chief executive of Matrix, said his company only supplied
raw materials but would be willing to expand its capacity.
A spokeswoman for Becton, Dickinson said the company "was aware" of the
announcement but had not decided whether to offer low prices elsewhere. A
spokeswoman for Beckman Coulter said whether the company would cooperate
would depend on the bidding process.
The other companies could not be reached.
Ira Magaziner, chairman of the Clinton Foundation's AIDS initiative, said
bringing all the participants in line for the complicated buying deals would
take time.
"We're going to pave the way for this deal to be extended to many
countries," Mr. Magaziner said. "That doesn't flick a light switch and make
a deal."
The agreement is politically delicate because it pits former President Bill
Clinton's endorsement of generics against what appears to be the prevailing
opinion of the Bush administration, which has not allowed taxpayer dollars
to be used to buy them.
President Bush's secretary of health and human services, Tommy G. Thompson,
is chairman of the board of the Global Fund, to which the United States is a
major contributor. The announcement, planned last week, was delayed until
the secretary could be told about it.
Mr. Soni, said he did not expect resistance from the Bush administration
because buying generic drugs was "consistent with policies that were
approved in 2002" for the fund.
Lost in the publicity over the previous foundation deals were the strict
conditions each country must meet to qualify for the $140 price.
Dr. Hamied said each country must submit large, irrevocable purchase orders
and pay cash. Someone other than the drug company must bear the costs of
registering each drug in each country, which might include lobbying
Parliament or fighting patent lawsuits. There also must be a guaranteed
supply of the raw active ingredients at fixed prices.
Each country must also show how it will keep cheap drugs from being diverted
and resold in wealthy countries, Mr. Soni said.
Dr. Hamied said he had been repeatedly asked for the $140 price by countries
and charities unaware of the strict conditions. "It caused us a lot of
damage," he said.
But he added, "If someone wanted to give me an advance of $50 million and
guarantee that I supply them for five years, I might do it for $120."
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