E-DRUG: Pfizer to donate fluconazole free of charge
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[1.news message from Wall Street Journal, USA. Circulated as fair use.
2. Formal letter by Pfizer. 3. The response by TAC and MSF.
Bravo for Pfizer - an important step for the millions of HIV+ people in
developing countries, and congrats for the NGOs for a succesfull campaign! WB]
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Pfizer Plans to Provide Diflucan Drug At No Cost to South Africans With AIDS
By Michael Waldholz
04/03/2000
The Wall Street Journal
JOHANNESBURG, South Africa -- Pfizer Inc. is expected today to tell the
government here it will give away its expensive drug, Diflucan, to
thousands of people in South Africa suffering from AIDS. The bold, surprising move is
likely to spur other drug makers to launch drug giveaways and price
reductions in developing nations in coming months.
Pfizer's decision to provide the drug for free is expected to startle
government health officials and AIDS activists here who have been pressing
the New York drug maker to slash the price of Diflucan, a powerful
antifungal medicine.
Pfizer, which sold about $1 billion of the drug last year, hadn't given the
government or activists any advance indication it would respond to the
pressure by providing the drug without charge for South Africans diagnosed
with cryptoccocal meningitis, a lethal brain infection.
It is estimated that about two million of the 27 million people with HIV in
sub-Saharan Africa have become infected by the deadly fungal infection that
can be adequately treated only with one drug,
Diflucan. Until now, however, Diflucan has been out of reach for most South
Africans because of its very high cost -- between $13 and $17 a day at
retail -- and because once therapy is begun, it
must be continued on a daily basis for a person's entire life.
Beginning early in March, several AIDS activist groups, along with the
nonprofit Paris-based organization Doctors Without Borders, launched a
public-relations and letter-writing campaign against Pfizer in about 18
countries. The activists pointed out that generic versions of the drug,
also known as fluconazole , sell for about $1.50 a day in Thailand, where
Pfizer's patent isn't being honored.
The advocacy effort, led here by a coalition called the Treatment Action
Campaign, accelerated several weeks ago when activists in New York slipped
past guards at Pfizer's headquarters and confronted the company's chairman
and chief executive, William Steere, in his 23rd floor office. Pfizer
officials told the activists at that time that it would respond to their
requests by today.
The company, like other drug makers that market high-price AIDS medicines
that are largely unavailable in poor nations, has been struggling for weeks
to find a solution to the activists' demands. It is believed that Pfizer
was worried about the public-relations fallout from a demonstration against the
company's offices here planned for today. Company officials also were
concerned by activists' plans to disrupt the drug maker's annual meeting in
May and take Wall Street's attention away from the company's announcements
regarding the status of its acquisition of Warner-Lambert Co.
Still, giving away the drug wasn't anticipated. The government here hoped
Pfizer would consider either letting generic makers market the drug or
discounting the price significantly. But even an 80% or 90% price cut would
keep the drug out of reach of most Africans, their governments or donor
organizations. Reducing the price also would make it hard for Pfizer to
sustain its high price elsewhere, some critics said.
In a letter dated March 31 to Mark Heywood of the Treatment Action
Campaign, Pfizer said it has requested a meeting today with South Africa's Ministry
of Health to "seek their advice and collaboration in a program to deliver
Diflucan free of charge through appropriate medical specialists . . .
George Flouty, Pfizer's medical director for public-health programs, said
the company is seeking a meeting with the South African health minister to
work out such details as who would be eligible for the free drugs, how the
drugs would be administered and for how long. Mr. Flouty said Pfizer is
offering the drug only to people who can't afford it, though he isn't sure
how eligibility will be determined.
Despite the potentially large size of Pfizer's giveaway program, critics
are expected to be skeptical about some aspects of it. By giving the drug to
patients, the company takes on a responsibility to
provide it to them for life, something that will require an unprecedented
commitment. In addition, other countries in Africa and elsewhere are
certain to press Pfizer for a similar gift.
Between 2% and 8% of people infected by HIV become suceptible to
cryptococcal meningitis, an infection that is harmless to most people whose
immune system hasn't been crippled by AIDS. In Uganda, where 10% of the
nation is infected with HIV, "when we have patients with `crypto,' we
simply try to make the person comfortable, ease their pain and watch them die,"
said Peter Mugenyi, a leading AIDS research physician in Kampala.
"It is frustrating for a doctor to know a treatment exists to keep people
alive and not be able to use it simply because of its cost," said Dr.
Mugenyi last week.
Several major drug companies, including Merck & Co., Bristol-Myers Squibb
Co. and Glaxo Wellcome PLC, in the past two years have somewhat reduced the
prices of their potent anti-AIDS drugs. But even at discounted prices, the
drugs aren't commonly available here because their monthy cost can dwarf a
typical African's annual income. But the drug makers are coming under
increasing pressure to provide help to the developing nations, especially
because the World AIDS conference this year will be held in Durban, South
Africa, in July, where world-wide media attention will be focused on the
lack of access to the drugs in the developing world.
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[letter of Pfizer]
235 East 42nd Street
New York, NY 10027-5755
Pfizer
March 31, 2000
Mr. Mark Heywood
HIV & AIDS Treatment Action Campaign
P.O. Box 31104
Braamfontein 2017, Johannesburg
South Africa
Dear Mr. Heywood
We have received your response to our letter regarding the
availability of Pfizer�s anti-fungal treatment, Diflucan� (fluconazole)
in South Africa.
As you know, Diflucan is an indicated treatment for cryptococcal
meningitis, a serious infection of the brain that affects about eight
percent of people with AIDS. Cryptococcal meningitis is but one of
the numerous serious issues that have to be addressed in a
comprehensive public health approach to dealing with the HIV/AIDS
epidemic. Accurate diagnosis and careful monitoring of treatment
are critical to the effective use of Diflucan.
I am sure you will agree that an appropriate response to the
HIV/AIDS epidemic must be made with consideration for safe,
ethical treatment, in full coordination with the South African
government, and through the appropriate medical infrastructure.
Hence, we have requested a meeting with the Ministry of Health to
seek their advice and collaboration in a program to deliver Diflucan
free of charge through appropriate medical specialists for South
African HIV/AIDS patients suffering from cryptococcal meningitis
who cannot afford this treatment.
We reiterate our request to meet with you to discuss the status of
the program as it develops.
Sincerely
Dr. George Flouty
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[reaction by TAC and MSF]
HIV & AIDS Treatment Action Campaign
808 Dumbarton House, Church Street, Cape Town.
Tel: 021-423 5026 Fax: 4265046
PO Box 31104, Braamfontein 2017, Johannesburg.
Tel: 011-403-6918 Fax: 011-403 2341
E-mail: { HYPERLINK mailto:shasha@netactive.co.za }shasha@netactive.co.za or { HYPERLINK mailto:zackie@pixie.co.za }zackie@pixie.co.za
TAC VICTORY � PFIZER TO PROVIDE FREE FLUCONAZOLE
In an unprecedented development in any developing country the
drug giant Pfizer has listened to activist demands and agreed to
provide Diflucan / Fluconazole to AIDS patients with Cryptococcal
Meningitis free of charge.
The TAC welcomes this enormously significant offer. We urge the
Minister of Health to urgently meet Pfizer to ensure that
Fluconazole / Diflucan can immediately be made available to the
widest possible group of beneficiaries.
This step shows that TAC has been proved correct about the
pricing of drugs and the capacity of major international
pharmaceutical companies to dramatically lower the price of
essential HIV medicines and to offer treatment to people with AIDS.
Pfizer has asked for a meeting with TAC and the government to
ensure that the offer is implemented. TAC will work with Pfizer to
ensure that this offer becomes real to thousands of people who
may otherwise die of Cryptococcal Meningitis. TAC also urges
Pfizer to work with us on a programme to make Fluconazole
available for patients with esophageal thrush.
We call on Glaxo Wellcome, Bristol Meyers Squibb, Roche,
Boerhinger Ingelheim and other producers of essential HIV/AIDS
drugs to dramatically lower prices and meet TAC and the
government to discuss rapid implementation of an essential drugs
programme. In particular, we call on Glaxo Wellcome to follow
Pfizer�s lead and make AZT available free for reducing the risk of
mother to child transmission.
TAC thanks Medicins Sans Frontiers, the Health Gap Coalition,
trade unions, churches and NGOs for their vital support in this
campaign. This struggle has just begun. We call on concerned
people in South African and internationally to join the march for
Affordable Treatment on July 9th 2000 at the beginning of the
International AIDS Conference.
For comment contact:
Mark Heywood: 011 403 6918; a/h 012 650 0270; 083 308 5328
Elize Petoors, Vicky Ahblein: 082 370 5307
Eric Goemare, Medicins Sans Frontiers, 082 370 0542
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