[Ip-health] Big Pharma vs. desperate need for HIV drugs

[Benjamin Krohmal]

http://www.spcm.org/Journal/spip.php?article11441


Journal Chretien

Big Pharma vs. desperate need for HIV drugs
lundi, 28 mai 2007
by Diana Fong

Pharmaceuticals have an imperative beyond the profit motive, since
they are in the business of saving lives. Despite deep discounts,
critics argue that the cost of vital drugs in poor countries is still
too high.

How much should multi-national drug companies charge for life-saving
medicine in the world=92s poorest countries ?

It is clear that pharmaceutical companies are not in the charity
business. They need to recoup the billions invested in breakthrough
drugs, and do this by acquiring a patent that protects their
proprietary know-how for years, even decades. The patent allows them
to reap the benefits of a virtual monopoly for an essential drug, and
legally prevents cheap copycat versions from flooding the market and
drastically bringing down prices.

Yet on the other hand, can we let millions in Africa and elsewhere
suffer and die, when the medicine that could save them is available,
but costs too much because of such patent protection ?

Big Pharma vs. desperate need for HIV drugs

It=92s a debate that has been heating up in the run up to the G8 summit
where the interests of multinational pharmaceuticals are pitted
against the desperate health needs of a poverty stricken continent.

Africa will once again top the agenda on June 6-8 at the Baltic
seaside resort of Heiligendamm, where leaders of the world=92s richest
industrial nations, hosted by German Chancellor Angela Merkel, are
expected to renew their pledges to increase aid to the developing world.

The biggest scourge in sub-Saharan Africa is AIDS. Even though a cure
for the disease is a long way off, a new generation of antiretroviral
drugs has made living with HIV at least manageable in the West. But
these treatments are far less available where they are needed most.

The vast majority of the 40 million worldwide who test HIV positive,
live in sub-Saharan Africa. Due to the time delay in the onset of
AIDS, an estimated 7 million currently require therapy, but only 28
percent are getting any treatment at all, meaning a premature death
sentence for the rest, including millions of babies who are born with
the virus, transmitted by their mothers.

Producing generic drugs more cheaply and legally

Since the AIDS virus keeps mutating and more resistant strains keep
cropping up, what is at issue is access to =AB second line =BB
antiretroviral therapy, which costs at least ten times as much as the
older drugs.

=AB After five years of treatment, some 20 percent of our patients need
to switch to second line drugs, so we are seeing a doubling of drug
costs in the next two years if prices remain at the current level, =BB
Dr. Tido von Sch=F6n-Angerer, a German paediatrician who heads the
campaign for Access to Essential Medicines at Doctors Without Borders
(MSF), told DW-WORLD.DE.

And in spite of deep discounts, those price levels are still way too
high for the developing world, so von Sch=F6n-Angerer has strongly
backed Thailand=92s decision earlier this month to defy patents through
a legal mechanism called TRIPS that was established by the World
Trade Organization in 2001.

The WTO ruling allows governments to circumvent international patent
laws to ensure the public health of its citizens. That means either
producing their own cheaper generic versions or importing them from
India, which has been the biggest supplier of HIV drugs.

Diseases of poverty not profitable

Until a month ago, the sticker price for Kaletra, the patented
antiretroviral drug produced by US based Abbott Laboratories was
$2,200 (1,635 euros) per patient for a year=92s supply in developing
countries defined as =AB middle tier, =BB such as Thailand. Abbott has
since lowered its price to $1,000.

In comparison Kaletra costs $7,000 in the United States and $500 for
the least developed nations in Africa, with the huge profit margins
from the rich industrial nations cross-subsidizing the poorest
countries.

=AB We believe in differential pricing, =BB said Abbott spokesman Dirk
van Eeden. =AB Our approach is to charge the lowest possible price
where the need is greatest in the least developed countries. We are
making no profit whatsoever in Africa. =BB Eeden also pointed out that
the lowest generic price at $695 for the same drug is even higher
than the original Kaletra brand.

=AB Generics have not matched Kaletra=92s prices in Africa, =BB countered
Dr. von Sch=F6n-Angerer. =AB At least not yet, but once we see much
greater generic competition, Abbott=92s prices will be undercut even
further. =BB

Logistic problems and lack of healthcare workers

Thailand leads the fight against patent monopolies

Although tremendous public pressure has led to lower prices for life-
saving drugs, Africa=92s vulnerability to AIDS cannot be explained away
by the lack of access to affordable medicine alone, according to
Markus Preissner, head of the Research Division for Pharmaceutical
Distribution at the University of Cologne.

=AB Even if governments in Africa could guarantee fully stocked
pharmacies at rock bottom prices, there is still the problem of
whether essential medicines and vaccines wind up with the end users=97
the patients who need them, =BB he said.

The logistics of delivering supplies to patients in remote areas, the
overwhelming lack of doctors and health workers to administer the
medicines, and even the huge price differential between the same pill
sold in Africa and Europe are massive problems.

=AB There need to be control mechanisms in place, so that life-saving
medication that has been sold cheaply in Africa does not wind up
being resold in Europe at a much higher price, with only the
profiteers benefiting, =BB said Preissner.