[Ip-health] BBC: Africa rises to HIV drug challenge

[Mike Palmedo]

http://news.bbc.co.uk/1/hi/business/5027532.stm

Africa rises to HIV drug challenge

BBC News
By Tatum Anderson
Kampala

Africa is stepping up efforts to manufacture its own life-saving
medicines, so that it does not have to rely on supplies from Western
pharmaceutical companies.

A Ugandan drugs importer, Quality Chemicals, plans to begin
manufacturing drugs to treat people living with HIV/Aids at a plant in
the capital, Kampala, from June next year.

It has formed a joint venture with Indian pharmaceutical firm Cipla to
produce the medicines at a fraction of the cost of some Western drugs.

Construction of its new factory is expected imminently.

Quality Chemicals is one of a number of burgeoning ventures in
sub-Saharan Africa to begin local production of HIV/Aids treatments,
known as anti-retroviral drugs, as well as anti-malarial medicines.

Ghana, Tanzania, the Democratic Republic of Congo and Ethiopia are just
a few countries with similar aspirations.

"It's a huge thing, the business of local production. It's becoming
really hot on the African agenda," said Dr Mohga Kamal Smith, health
policy adviser at Oxfam, which campaigns for affordable access to medicines=
.

"African leaders realise that they are totally dependent on the whim of
pharmaceutical companies outside their countries."

Massive shortage

The manufacture of anti-retroviral drugs has been confined to foreign
firms located in Africa and a tiny number of home-grown companies, such
as South Africa's Aspen Pharmacare.

The boost in local production in other countries is driven by the fact
that access to affordable and effective medicines, which is already a
huge challenge, is becoming increasingly unreliable.

According to the World Health Organization (WHO), by the end of last
year, only 17% of the 4.7 million people in sub-Saharan Africa in need
of anti-retroviral treatments were receiving them.

In Africa, there are no national healthcare systems like the NHS to pay
for drugs and campaigns to provide free treatment are not yet able to
cope with the numbers of patients in need of medicines.

As a result, a great many African patients are forced to pay for their
own drugs. Many cannot afford to do so.

Patent problems

There have been high-profile moves by US and European pharmaceutical
companies to slash prices for anti-retroviral drugs.

UK drugs giant GlaxoSmithKline (GSK), for instance, says it has provided
a number of patented anti-retroviral drugs at not-for-profit prices to
the poorest African countries since 2000.

It also signed eight deals allowing other companies to copy some of its
drugs at more affordable prices.

The problem is that some drugs do not fall under these cut-price
schemes: particularly newer, often more effective drugs - so-called
second-line treatments.

These are vital as patients around the world inevitably become resistant
to the current generation of drugs.

In the past, when Western drug prices have been too high, African
countries have traditionally turned to Indian companies, which have made
copies of drugs designed in the West at lower prices.

At those times, up to 80% of these copycat generic drugs supplied to
some African countries came from India.

But the supply of Indian drugs is threatened, say charities. India
tightened up its patent laws last year to satisfy its international
commitments at the World Trade Organization (WTO), so that local
generics firms cannot so readily copy newer foreign drugs.

The expected effect of this controversial law is a dwindling supply of
second-line treatments.

Stifling laws

Medecins Sans Fronti=E8res (MSF), which treats patients in Africa, says
patent laws are already stifling generic drug production. It estimates
second-line drugs can be as much as seven times more expensive than the
most affordable drugs available.

In Kenya, for example, MSF pays $1400 (=A3750) per patient every year for
second-line drugs, compared to only $200 for existing medication.

George Baguma, director of marketing at Quality Chemicals in Uganda,
said: "The Indian patent law will deny countries like Uganda cheaper
generics of new molecules.

"This will mean death to the millions of people on therapy in Africa."

GlaxoSmithKline says these newer drugs, like its own abacavir medicine,
are more expensive because they are far more complex drugs to make than
existing ones, even for generic companies.

However, a GSK spokesperson said the company had begun negotiations to
introduce not-for-profit pricing in the future.

"The situation is really fluid and as demand changes, we will respond to
it," she said.

"We have a good track record of making sure we get drugs to people who
need it most."

Self-sufficiency 'important'

Given the uncertainty over the prices of foreign supplies, Quality
Chemicals' Mr Baguma says it is vital to have a constant supply of drugs
for those Ugandans already being treated, as well as to meet the future
explosion in demand for treatment.

"It is important for us to be self-sufficient," he adds.

The company says it will take advantage of the fact that under WTO
rules, the world's poorest countries are able to copy drugs without
breaking patent laws.

Cipla will bring its considerable resources and know-how in drug
manufacture.

Self-sufficiency seems to be the watchword for numerous other African
countries, from Malawi to Nigeria.

In east Africa, Tanzanian Pharmaceutical Industries (TPI) began
producing drugs at the beginning of the year, and can now manufacture
enough to treat 100,000 people a month for an annual cost of about $150
a patient.

Ramadhan Madabida, chief executive of TPI, says self-sufficiency in
manufacturing drugs is also vital, because it encourages long-term
economic growth in a country such as Tanzania.

A joint venture between the government and private interests, TPI has
invested about $17m from domestic pension funds to upgrade its
facilities in an effort to make effective anti-retroviral and
anti-malaria drugs.

And in west Africa, Dan Adams Pharmaceuticals, formed last year by a
Chinese and Ghanaian tie-up, plans to manufacture anti-retroviral and
anti-malaria drugs for both local and international markets.

Other factors

Two Ethiopian firms are rumoured to have plans to manufacture drugs locally=
.

For these companies, the challenge now is to manufacture drugs to
rigorous international standards, says Philippa Saunders, an external
consultant on pharmaceutical issues with Oxfam.

But not everyone believes patents are the primary cause of poor access
to medicine in the developing world.

Some industry observers say lack of national healthcare funding, medical
staff, transport infrastructure are also to blame.

Indeed, the prices of medicines rarely have anything to do with patents
according to Trevor Jones, director of research and development at the
Wellcome Foundation, quoted in a recent WHO report on intellectual
property and public health.

"Companies set prices largely on the willingness/ability to pay, also
taking into account the country, disease and regulation," he said in a
statement.