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

Video Obama Announces Plan to Send 3,000 Troops to Liberia in Ebola Fight

At US Centers for Disease Control and Prevention, Obama details troop deployment and other pieces of US plan More

Video China Muslims Work to Change Perceptions After Knife Attacks

Muslims in Kunming say that they condemn the violence, it is not a reflection of the true beliefs of their faith More

Humanitarian Aid, Equipment Blocked in Cameroon

Move is seen as a developing supply crisis in West 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.
Enviropreneur Seeks to Save the Environment, Empower the Communityi
X
September 16, 2014 2:06 PM
Lorna Rutto, a former banker, is now an ‘enviropreneur’ - turning plastic waste into furniture and fences discusses the challenges she faces in Africa with raw materials and the environment.
Video

Video Enviropreneur Seeks to Save the Environment, Empower the Community

Lorna Rutto, a former banker, is now an ‘enviropreneur’ - turning plastic waste into furniture and fences discusses the challenges she faces in Africa with raw materials and the environment.
Video

Video West Trades Accusations Over Ransoms

As world leaders try to forge a common response to the threat posed by Islamic State militants in Iraq and Syria, there is simmering tension over differing policies on paying ransoms. In the past month, the jihadist group has beheaded two Americans and one Briton. Both countries refuse to pay ransom money. As Henry Ridgwell reports for VOA from London, there is uncertainty in the approach of some other European nations.
Video

Video Scotland Independence Bid Stokes Global Interest

The people of Scotland are preparing to vote on whether to become independent and break away from the rest of Britain, in a referendum being watched carefully in many other countries. Some see it as a risky experiment; while others hope a successful vote for independence might energize their own separatist demands. Foreign immigrants to Scotland have a front row seat for the vote. VOA’s Henry Ridgwell spoke to some of them in Edinburgh.
Video

Video Washington DC Mural Artists Help Beautify City

Like many cities, Washington has a graffiti problem. Buildings and homes, especially in low-income neighborhoods, are often targets of illegal artwork. But as we hear from VOA’s Julie Taboh, officials in the nation's capital have come up with an innovative program that uses the talents of local artists to beautify the city.
Video

Video US Muslim Leaders Condemn Islamic State

Leaders of America's Muslim community are condemning the violent extremism of the Islamic State group in Iraq and Syria. The U.S. Muslim leaders say militants are exploiting their faith in a failed effort to justify violent extremism. VOA correspondent Meredith Buel reports.
Video

Video Americans' Reaction Mixed on Obama Strategy for Islamic State Militants

President Barack Obama’s televised speech on how the United States plans to “degrade and destroy” the group known as the Islamic State reached a prime-time audience of millions. And it came as Americans appear more willing to embrace a bolder, tougher approach to foreign policy. VOA producer Katherine Gypson and reporter Jeff Seldin have this report from Washington.
Video

Video Authorities Allege LA Fashion Industry-Cartel Ties

U.S. officials say they have broken up crime rings that funneled tens of millions of dollars from Mexican drug cartels through fashion businesses in Los Angeles. Mike O'Sullivan reports that authorities announced nine arrests, as 1,000 law enforcement agents fanned out through the city on Wednesday.
Video

Video Bedouin Woman Runs Successful Business in Palestinian City

A Bedouin woman is breaking social taboos by running a successful vacation resort in the Palestinian town of Jericho. Bedouins are a sub-group of Arabs known for their semi-nomadic lifestyle. Zlatica Hoke says the resort in the West Bank's Jordan Valley is a model of success for women in the region.


Carnage and mayhem are part of daily life in northern Nigeria, the result of a terror campaign by the Islamist group Boko Haram. Fears are growing that Nigeria’s government may not know how to counter it, and may be making things worse. More

AppleAndroid