[Pharm-policy] Note on AIDS crisis

[James Love]

Right now we are receiving a lot of calls about the drug companies
announced donations policy.  I'll stand corrected, but it seems as
though these offers are not particularly new, in terms of the discounts.
I've been hearing about discount offers of 70 to 80 percent for some
time, at least since 1997 in some markets, based upon my own
recollections.  

I also don't think it is particularly helpful or honest at this point to
sit around and talk as if the big pharma drug companies are going to
solve the access problem.   Basically, they are trying to defend high
prices all around the world.  When they offer donations of various types
they are usually to avoid deeper cuts in prices, and the manage and
control the process. 

If people really are concerned about not sounding too radical, then I
can see how it makes sense to pay lots of attention to the various big
pharma dialogue type efforts, because that's what they define as
respectable.    But at the end of the day and after the body count
mounts, people should begin to address the obvious:

1.  Prices can come down much much more, but only if production and
distribution are done with some intelligence and seriousness of purpose,

2.  For low cost generic production, there are many barriers to entry in
national markets, that will have to be solved.  These will include both
regulatory and IPR issues.

3.  It is important to get generic production runs as high as possible,
and to have procurement be as competitive as possible, to get good (low)
prices.  This would be best, by far, if done at a global level.  (I
mentioned earier, based upon discussions with a producer, that if
everything was done right, it might be possible to get 3 drug cocktails
manufactured at $20 per month.  But whatever the number, it would be
quite a bit lower than the 70 to 80 percent discounts off the US price
that big Pharma is talking about.)

4.  There is no international leadership on this now, because
intellectual property rights are too controversial, so action in the
short term is unlikely.

5.  The US, the EU and probably Japan oppose doing much more than
talking to big Pharma about charity and discounts.  This will only go so
far.

6.  I should add that even a serious effort to obtain very cheap generic
production will be inadequate for huge numbers of the infected
populations, due to poor infrastructure.  But that doesn't mean it isn't
helpful, useful or moral to expand treatment opportunties where it is
possible.


   Jamie

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James Love, Consumer Project on Technology    
P.O. Box 19367        | http://www.cptech.org 
Washington, DC 20036  | love@cptech.org       
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