HOUSTON The impact of HIV/AIDS on the developing world is enormous. "Every day our teams in the field see the devastating and tragic effects of people's lack of access to life-saving medicines," explains Bernard Pécoul of Médicins sans Frontières (MSF). But there will soon be wider access to lifesaving AIDS medicines. Indian generic drug maker Cipla has announced it will supply a three-ingredient cocktail of AIDS drugs (stavudine, lamivudine and nevirapine) patented by Western firms at a daily treatment cost of less than one dollar. Cipla, which makes generic versions of drugs protected by patents in other countries, is offering the medicines to the charitable organisation MSF for $350 per year per patient, and to governments for $600. According to MSF, the same drug cocktail would cost $10,400 per patient annually in the US.
MSF called on Western pharmaceutical companies to match the Cipla price saying, "The offer by Indian generic manufacturer Cipla demonstrates that proprietary companies can immediately reduce their prices further."
Cipla's offer is aimed primarily at Africa, where AIDS drugs commonly used in the West are financially beyond the means of nearly all the 25.3 million Africans infected with the HIV virus. Four international drug companies recently negotiated discount deals of 60–90% with Senegal, Uganda and Rwanda under a United Nations initiative.
Cipla's move puts pressure on multinational drug firms to further reduce prices of their patented AIDS drugs. But industry analysts predict the majors will not be pushed into a price war. Industry analyst Martin Hal of HSBC Securities (London) said international drug firms could not produce or afford to offer the drugs at Cipla's price. GlaxoSmithKline spokesperson Phil Thomson called the Cipla pricing a "partial donation" and questioned whether Cipla could provide a reliable supply of the drug cocktail at this price.
Indian patent law permits its drug firms to manufacture drugs protected by patents elsewhere in the world, provided that the manufacturing process differs from the original patented synthesis. 'Composition of matter' patents — patents claiming protection for particular molecular structures and formulations — are not recognised in India.
Other developing countries also are reluctant to recognise patents. For example, South Africa has announced plans for importation or local manufacture of generic AIDS drugs. On 5 March, 42 pharmaceutical firms (including GlaxoSmithKline) will take the South African government to court, arguing that the government plan infringes their intellectual property rights.
Brazil offers another example. Its 1997 patent law requires products to be manufactured domestically. If they are not, then after three years a local company can win the legal right to produce another company's patented product. In 1994, the government urged local firms to start producing AIDS drugs. Brazil now makes eight of the 12 antiretroviral drugs used in AIDS treatments and plans to start producing the other four. Prices of these drugs have dropped more than 70%. Treatment typically costs a patient $4,500 annually. MSF notes, "The political commitment of the government of Brazil has successfully cut AIDS deaths in half, largely due to its ability to produce generic AIDS medicines."
Regarding the Cipla announcement, MSF has stated, "The immediate challenge is to convert this generic price offer into action. The international community must now provide political, practical, and financial support. Political support is needed for developing countries to overcome barriers posed by patents."
International relief organisation Oxfam has just launched the 'Cut the Cost Campaign' to encourage cheaper drug prices in developing countries. Oxfam director of policy Justin Forsyth said, "The WTO must change the rules that the drug industry is now using to cripple cheap, local competition which in turn is inflating the cost of new and patented medicines."