[Ip-health] Forbes: Showdown Over AIDS Drugs

[Malini Aisola]

Showdown Over AIDS Drugs

Matthew Herper and Megha Bahree
December 11, 2009

A bold new idea for getting the latest breakthroughs in HIV-fighting
medicines to people in poor countries in Africa and Asia will get a big
test next week.

The idea is called a patent pool. The concept is for drug manufacturers
like Merck or Gilead Sciences to give a limited number of generic drug
makers access to the intellectual property for AIDS drugs that are
commonplace in North America and Europe but have not reached places like
sub-Saharan Africa or parts of Asia. Competition between multiple
generic drug makers would then drive prices down dramatically, making
the latest AIDS drugs available in even the poorest parts of the world.

Since the patent pool license would only apply to a select number of
poorer countries, the patent pool could save lives without hurting sales
in rich countries, intellectual property lawyers say.

Unitaid, a Geneva-based group formed by five countries and financed
through a surcharge on airline tickets, has been pushing drug companies
for over a year to agree to the patent pool. But only Merck, Gilead
Sciences and Johnson & Johnson are "actively engaged" in planning the
pool, it says.

The most contentious issue is how many countries will be included. AIDS
activists want to include as many countries outside of Africa as
possible, including Indian, China, Brazil, and Thailand. But this would
make the plan a non-starter for drug companies.

Next Monday, Unitaid's board will start hashing out exactly how the pool
would work, where drugs would be manufactured and where they could be
distributed. All of these issues are stumbling blocks that could sink
the plan.

AIDS activists and drug companies are girding for a fight. Earlier this
week, the aid group M=C3=A9decins Sans Fronti=C3=A8res blasted pharmaceutic=
al
companies for pushing to block countries like Thailand, Brazil, India or
China from participating in the pool. Those countries also have
significant AIDS epidemics.

"We're concerned that Unitaid may give in to the companies' demands and
move away from its commitment to ensure access to medicines for people
living with HIV in all developing countries," said MSF policy director
Michelle Childs in a prepared statement.

On Dec. 4, a group of Thai activists sent a letter to Unitaid raising
"grave concerns" about the way the patent pool was being implemented.
"If Unitaid bows to the demands of the multinational companies to decide
which developing countries will benefit from the pool then Unitaid turns
its back on millions of people who are in desperate need of the
medicines that the patent pool promised them," the letter said. The
letter was signed by the AIDS Access Foundation and nine other groups.

Gilead Sciences Executive Vice President Gregg Alton says that including
countries like China and Brazil in the patent pool would be a
deal-breaker. "I scratch my head at the rhetoric that comes out from
MSF," says Alton. "If they continue to insist on some of these things,
it's going to be difficult to make this happen."

James Love, an activist at the think tank Knowledge Ecology
International, hatched the patent pool idea in 2002. Unitaid picked up
on it in 2006, but it got a big boost after Love, who had filed an
antitrust suit against Gilead, wound up sitting across from Alton at a
charity dinner. The two men found common ground, and Alton began pushing
for a version of the patent pool.

Merck and J&J voiced some support when Alton presented the idea at an
AIDS conference last year. In an Oct. 26 letter to the MSF, Merck wrote
that it supports the patent pool idea "in principle."

Africa is home to 22 million of the 33 million people worldwide who are
infected with HIV. Thanks to aid efforts, cheap Indian generics and
discounted drugs, 2.9 million people with AIDS in sub-Saharan Africa are
on antiviral therapy. But expensive new drugs like Gilead's Atripla or
Merck's Isentress are currently out of the reach of many aid groups.

A Boston University analysis shows that the price of Atripla, a
three-in-one drug combo from Gilead and Bristol-Myers Squibb that is the
second-best-selling AIDS drug in the world, could drop from $465 to
below $100 with a patent pool. In the U.S., the drug costs $19,000 per
year.

For more on the patent pool idea, see: The Next AIDS Crisis
(http://www.forbes.com/forbes/2009/1228/health-gilead-glaxosmithkline-hiv-n=
ext-aids-crisis.html)



--
Malini Aisola
Knowledge Ecology International
1621 Connecticut Avenue NW, Suite 500, Washington DC 20009
malini.aisola@keionline.org|Tel: +1.202.332.2670|Fax: +1.202.332.2673