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

China Investigates Former Powerful Security Chief

Former security chief and member of Politburo Standing Committee, Zhou Yongkang, under investigation for suspected 'serious disciplinary violation' More

India, US Look to Reset Ties During Kerry Visit

This week's talks will be first high level interaction between two countries since Prime Minister Narendra Modi took charge More

Video Young African Leadership Program Renamed to Honor Mandela

YALI program, launched by President Obama in 2010, aims to build skills in business, entrepreneurship, public management and civic leadership More

Featured Videos

Your JavaScript is turned off or you have an old version of Adobe's Flash Player. Get the latest Flash player.
Vietnamese Staging Chinese Product Boycott After Oil Rig Spati
X
Reasey Poch
July 28, 2014 7:18 PM
China recently pulled an oil rig from an area of the disputed South China Sea that Vietnam also claims. Despite the action, the incident has had a lingering effect on consumers in Vietnam. VOA's Reasey Poch reports from Hanoi on an effort to boycott Chinese products.
Video

Video Vietnamese Staging Chinese Product Boycott After Oil Rig Spat

China recently pulled an oil rig from an area of the disputed South China Sea that Vietnam also claims. Despite the action, the incident has had a lingering effect on consumers in Vietnam. VOA's Reasey Poch reports from Hanoi on an effort to boycott Chinese products.
Video

Video ESA Spacecraft to Land on a Comet

After a long flight through deep space, a European Space Agency probe is finally approaching its target -- a comet millions of kilometers away from earth. Scientists say the mission may lead to some startling discoveries about the origins of the water on earth. VOA’s George Putic has more.
Video

Video Young Africans Arrive in US for Leadership Program

President Barack Obama's Young African Leadership Initiative has brought hundreds of young Africans to the United States for a six-week program aimed at building their knowledge and skills in fields such as public administration and business. Out of the 50,000 young Africans who applied for the program, just one percent was accepted. VOA's Laurel Bowman caught up with some of those who made the cut and has this report.
Video

Video In Honduras, Amnesty Rumors Fuel US Migration Surges

False rumors in Central America are fueling the current surge of undocumented young people being apprehended at the U.S. border. The inaccurate claims suggest the U.S. will give amnesty to young migrants from the region. As VOA's Brian Padden reports from Honduras, these rumors trace back to President Obama's 2012 executive order to halt deportations for some young undocumented immigrants already living in the United States.
Video

Video Students in Business for Themselves

They're only high school students, but they are making accessories for shoes, fabricating backpacks and doing product photography - all through their own businesses. It's the result of a partnership between a non-profit organization that teaches entrepreneurship and their schools. VOA's Mike O'Sullivan and Deyane Moses met the budding entrepreneurs near Los Angeles.
Video

Video Astronauts Train in Underwater Lab

In the world’s only underwater laboratory, four U.S. astronauts train for a planned visit to an asteroid. The lab - called Aquarius- is located five kilometers off Key Largo, in southern Florida. Living in close quarters and making excursions only into the surrounding ocean, they try to simulate the daily routine of a crew that will someday travel to collect samples of a rock orbiting far away from earth. VOA’s George Putic has more.

AppleAndroid