End to Cheap HIV Drugs?
posted: 15/09/2010
A new report shows that the vast majority of HIV drugs keeping people alive in developing countries are made by Indian generics companies, but new trade rules may prevent them making cheap copies in the future.
Several million people are alive today - and fit and active and looking after their children - who would be dead, had it not been for the roll-out of antiretroviral drugs to treat people with HIV. This is a spectacular success story - even though less than half (4 million out of 9.5 million) people who need HIV drugs are so far on treatment.
But will the cheap generic drugs continue to be provided? Much may depend on the cost of the drugs.
Cheap generics
The three-drug antiretroviral combinations now in use in the developing world are cheap - really cheap. The prices came down from over $10,000 a year per person to under $100, because Indian generic drug manufacturers make cheap but effective versions, which are approved for quality by the World Health Organisation.
Just how much that price plunge mattered is made clear in a report from Brenda Waning and colleagues, available free online, published in the Journal of the International Aids Society today. Their research shows that the vast bulk of these HIV drugs - up to 87% by 2008 - were supplied by the Indian generics companies.
Almost all the rest that are used in poor countries are not first-line combinations, but second or even third-line treatments, for use when the first combination won’t work. HIV is adept at developing resistance to the drugs used against it - it also happens across Europe and the USA.
Few 2nd and 3rd line generics
Generic versions of the newer, second and third combination drugs needed to deal with this resistance are not widely available.
Alarm bells TRIP for cheap new generics
Today's report raises the alarming possibility that they may not be made widely available.
Generic companies in India were able to make the basic HIV drugs because India did not recognise the patents on those drugs. But now everything is changing. Since 2005, a global trade agreement called TRIPS (trade-related aspects of intellectual property), has begun to have an impact, restricting the copying of new drugs. Negotiations on further trade agreements are ongoing.
The report’s author Waning works for UNITAID, an organisation dedicated to obtaining greater access to HIV medicines for poor countries. This is what UNITAID's executive secretary Jorge Bermudez had to say about the report:
“The findings of this study raise grave concerns for us because UNITAID relies heavily on Indian generic manufacturers to supply quality-assured, patient-friendly, low cost AIDS medicines in over 50 countries. What we need today is a more flexible approach to scale up treatment and not the opposite.”
If Indian manufacturers cannot meet these demands, a lot of the progress we have made in the last seven years against HIV in the developing world will be reversed.
Source The Guardian
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