News / Africa

Will ARVs cost too much?

Nathan Ford, Medical Coordinator, MSF (De Capua)Nathan Ford, Medical Coordinator, MSF (De Capua)
x
Nathan Ford, Medical Coordinator, MSF (De Capua)
Nathan Ford, Medical Coordinator, MSF (De Capua)

Multimedia

Audio
Joe DeCapua
As a new generation of AIDS-fighting drugs emerges, there’s fear the antiretrovirals may be too expensive for low and middle income countries. At the 19th International AIDS Conference, a medical aid group is raising concerns about prices and patents.

Doctors Without Borders, also known as MSF, treats about 220,000 people for HIV/AIDS in 23 countries. Medical Coordinator Nathan Ford said the trend for cheaper AIDS drugs has started to reverse.



“While some of the older antiretrovirals, or ARVs, have seen dramatic price reductions in the last decade, the newer medicines that are needed for patients who are failing first line therapy and second line therapy are dramatically more expensive --tenfold or even twentyfold more expensive than first line treatment,” he said

Ford said the new drugs may be widely needed in the coming years.

“There are real discussions by the World Health Organization and other expert groups about some of these newer medicines being moved earlier into the course of treatment so that patients, who are failing first line medicine already, can benefit from these newer, more powerful, less toxic drugs. So WHO and other groups are saying that these are medicines that we really want to be able to provide patients earlier in the course of treatment,” he said.

MSF reported the problem arises from new World Trade Organization agreements and patent regulations that can block the manufacture of generic drugs. A new report said middle-income countries “are increasingly taking measures to overcome the patents that price drugs out of reach.”

Patients start out on what’s called a first line regimen of medication. If for some reason that fails, or has too many side effects, they are put on a second-line and then a third line of treatment. But second and third line drugs are much more expensive.

Leena Menghaney is with Doctors Without Borders Access Campaign in India, which is a leader in the manufacture of generic drugs. However, she said there’s now a need for newer, expensive antiretrovirals – especially since more patients are co-infected with XDR-TB. That’s a strain of tuberculosis that’s become drug resistant

Leena Menghaney, MSF, Acess campaign, India (De Capua)Leena Menghaney, MSF, Acess campaign, India (De Capua)
x
Leena Menghaney, MSF, Acess campaign, India (De Capua)
Leena Menghaney, MSF, Acess campaign, India (De Capua)
“We are working in Mumbai, which is the epicenter or you can say the heart of where the first few AIDS cases came out. It’s a very complex epidemic in Mumbai. You have patients with XDR, but you also have patients who have been on first line and second line and have now started to need the newer drugs. Unfortunately, for us, what has happened is that we are paying more than $2,100 for just one single drug that we’re using in the third line regimen. And ethically speaking, as doctors, we cannot turn these patients away,” he said.

For the first time India has had to use patented AIDS drugs.

She said, “It has the capacity to make those drugs. The drugs are patented. And now the World Trade Organization’s IP regime is now starting to very much hurt access to medicine in India itself.”

IP regime stands for intellectual property regime. Critics say it creates a monopoly over knowledge that stifles innovation and competition. They say while patent holders may benefit financially, social benefits may lag behind.

India signed a World Trade Agreement in 1995 and had to implement it in 2005. That agreement requires drug patents, which block generic manufacturers.

But, last March, India, for the first time, issued what’s known as a “compulsory license” to override a patent on a cancer drug. Under certain conditions, possibly a health emergency, countries can act to break patents and manufacture generics. The holder of the patent would get some sort of compensation. However, it’s not a simple process and can trigger international legal battles.

MSF said India’s move may set a precedent to gain access to new ARVs. It also says China has now established a system to override patents.

MSF Policy Advocacy Director Michelle Childs said besides compulsory licenses, countries can try to take advantage of a drug manufacturer’s discount plan. But not all countries.

Michelle Childs, MSF Director of Policy Advocacy (De Capua)Michelle Childs, MSF Director of Policy Advocacy (De Capua)
x
Michelle Childs, MSF Director of Policy Advocacy (De Capua)
Michelle Childs, MSF Director of Policy Advocacy (De Capua)


“As we showed last year, in relation to the company discounts schemes, lower-middle income and middle income countries are excluded. And that has continued this year. And we’re starting to see the effect, for example, in relation to third line drugs of what that actually means,” she said.

Other options, she said, are “voluntary licenses.”

“Pharmaceutical companies will enter into agreements with generic companies so that they can make medicines and also export them to a number of countries. The problem with voluntary licenses is twofold. Firstly, they are mostly secret. So you do not know the terms and conditions and that can have an important effect on competition. The other important thing that is clear is that there is no voluntary license that covers all developing countries,” she said.

Childs said the trend is to limit voluntary licenses to least developed countries and some areas of sub-Saharan Africa. Some NGOs have moved to block the granting of drug patents in Brazil, another leader in generic drugs.

“The middle income countries are really facing a kind of pincer movement. They are facing rising costs from patenting. They are excluded from discounts. They are excluded from voluntary licensing, which is why there has been now more of a focus on what measures they can take to remove patent barriers,” she said.

There are about 30 antiretroviral drugs now approved for HIV/AIDS. Newer drugs are needed not only because of potential drug resistance, but also toxicity. For example, MSF said some ARVs can actually disfigure a patient’s face by affecting fat deposits.

Drug makers have said they need to recoup the cost of drugs so they can invest in research and development. MSF Medical Coordinator Nathan Ford agrees. But he said they cannot recoup their investments in all countries where the drugs are used.

“We know that companies recoup their investments in developed countries. If you’re charging a price for a drug in a country [where it’s] unaffordable, you’re not making any money because nobody’s buying that drug. So they don’t recoup their investments in Malawi or Mozambique or Kenya or indeed even potentially South Africa. They recoup their investments in North America and Europe,” he said

Doctors Without Borders said there is a solution to the drug patent issue – a political one.

You May Like

Photogallery Pistorius Sentenced, Taken to Prison

Pistorius, convicted of culpable homicide in shooting death of girlfriend Reeva Steenkamp, will likely serve about 10 months of five-year sentence, before completing it under house arrest More

UN to Aid Central Africa in Polio Vaccinations

Synchronized vaccinations will be conducted after Cameroon reports a fifth case of the wild polio virus in its territory More

WHO: Ebola Vaccine May Be in Use by Jan.

WHO assistant director Dr. Marie Paule Kieny says clinical trials of Ebola vaccines are underway or planned in Europe, US and Africa More

Featured Videos

Your JavaScript is turned off or you have an old version of Adobe's Flash Player. Get the latest Flash player.
After Decades of Pressure, Luxembourg Drops Bank Secrecy Rulesi
X
October 21, 2014 12:20 AM
European Union finance ministers have reached a breakthrough agreement that will make it more difficult for tax cheats to hide their money. The new legislation, which had been blocked for years by countries with a reputation as tax havens, was approved last week after Luxembourg and Austria agreed to lift their vetoes. But as Mil Arcega reports, it doesn’t mean tax cheats have run out of places to keep their money hidden.
Video

Video After Decades of Pressure, Luxembourg Drops Bank Secrecy Rules

European Union finance ministers have reached a breakthrough agreement that will make it more difficult for tax cheats to hide their money. The new legislation, which had been blocked for years by countries with a reputation as tax havens, was approved last week after Luxembourg and Austria agreed to lift their vetoes. But as Mil Arcega reports, it doesn’t mean tax cheats have run out of places to keep their money hidden.
Video

Video Kobani Refugees Welcome, Turkey Criticizes, US Airdrop

Residents of Kobani in northern Syria have welcomed the airdrop of weapons, ammunition and medicine to Kurdish militia who are resisting the seizure of their city by Islamic State militants. The Turkish government, however, has criticized the operation. VOA’s Scott Bobb reports from southeastern Turkey, across the border from Kobani.
Video

Video China Political Meeting Seeks to Improve Rule of Law

China’s communist leaders will host a top level political meeting this week, called the Fourth Plenum, and for the first time in the party’s history, rule of law will be a key item on the agenda. Analysts and Chinese media reports say the meetings could see the approval of long-awaited measures aimed at giving courts more independence and include steps to enhance an already aggressive and high-reaching anti-corruption drive. VOA’s Bill Ide has more from Beijing.
Video

Video US ‘Death Cafes’ Put Focus on the Finale

In contemporary America, death usually is a topic to be avoided. But the growing “death café” movement encourages people to discuss their fears and desires about their final moments. VOA’s Jerome Socolovsky reports.
Video

Video Ebola Orphanage Opens in Sierra Leone

Sierra Leone's first Ebola orphanage has opened in the Kailahun district. Hundreds of children orphaned since the beginning of the Ebola outbreak face stigma and rejection with nobody to care for them. Adam Bailes reports for VOA about a new interim care center that's aimed at helping the growing number of children affected by Ebola.
Video

Video Young Nairobi Tech Innovator on 'Track' in Security Business

A 24-year-old technology innovator in Nairobi has invented a tracking device that monitors and secures cars. He has also come up with what he claims is the most robust audio-visual surveillance system yet. As Lenny Ruvaga reports from the Kenyan capital, his innovations are offering alternative security solutions.
Video

Video Latinas Converting to Islam for Identity, Structure

Latinos are one of the fastest growing groups in the Muslim religion. According to the Pew Research Center, about 6 percent of American Muslims are Latino. And a little more than half of new converts are female. VOA’s Carolyn Presutti travelled to Miami, Florida -- where two out of every three residents is Hispanic -- to learn more.
Video

Video Exclusive: American Joins Kurds' Anti-IS Fight

The United States and other Western nations have expressed alarm about their citizens joining Islamic State forces in Syria and Iraq. In a rare counterpoint to the phenomenon, an American has taken up arms with the militants' Syrian Kurdish opponents. Elizabeth Arrott has more in this exclusive profile by VOA Kurdish reporter Zana Omer in Ras al Ayn, Syria.
Video

Video South Korea Confronts Violence Within Military Ranks

Every able-bodied South Korean male between 18 and 35 must serve for 21 to 36 months in the country’s armed forces, depending upon the specific branch. For many, service is a rite of passage to manhood. But there are growing concerns that bullying and violence come along with the tradition. Reporter Jason Strother has more from Seoul.
Video

Video North Carolina Emerges as Key Election Battleground

U.S. congressional midterm elections will be held on November 4th and most political analysts give Republicans an excellent chance to win a majority in the U.S. Senate, which Democrats now control. So what are the issues driving voters in this congressional election year? VOA National Correspondent Jim Malone traveled to North Carolina, one of the most politically competitive states in the country, to find out.
Video

Video Comanche People Maintain Pride in Their Heritage

The Comanche (Indian nation) once were called the “Lords of the Plains,” with an empire that included half the land area of current day Texas, large parts of Oklahoma, New Mexico, Kansas and Colorado.The fierceness and battle prowess of these warriors on horseback delayed the settlement of most of West Texas for four decades. VOA’s Greg Flakus reports from Lawton, Oklahoma, that while their warrior days are over, the 15,000 members of the Comanche Nation remain a proud people.
Video

Video Turkey Campus Attacks Raise Islamic Radicalization Fears

Concerns are growing in Turkey of Islamic radicalization at some universities, after clashes between supporters of the jihadist group Islamic State (IS) or ISIS, and those opposed to the extremists. Pro-jihadist literature is on sale openly on the streets of Istanbul. Critics accuse the government of turning a blind eye to radicalism at home, while Kurds accuse the president of supporting IS - a charge strongly denied. Henry Ridgwell reports from London.

All About America

AppleAndroid