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Friday, 26 November, 1999, 11:26 GMT
Aids drugs & the developing world
Developing countries cannot afford Aids drugs
Treatments for Aids can be made available to the developing world through cheap, local production, but this is often barred by the West.

Why do developing countries want to produce drugs locally?

By manufacturing generic drugs within the developed world, it is possible to provide them to local people at much more affordable rates than if they are forced to pay the global price set by Western producers who hold the patent.

If the drugs are not provided cheaply from local production they are out of the price range of local people. Medical organisation Medecins Sans Frontieres (MSF) says doctors in Kenya advise Aids patients "to save up for their funeral" rather than drugs, as they are not affordable to them.

What is stopping them doing so?

The United States in particular has been accused of stopping the developing world from producing drugs generically, insisting they import American-made drugs at Western prices. Thailand, for instance, has faced trade sanctions on its own exports.

However, the Trade-Related Aspects of Intellectual Property Rights agreement (TRIPS) allows for so-called "compulsory licensing" in cases of public health emergencies or unfair pricing. This allows countries to produce drugs which are under patent.

How much cheaper are generic drugs?

Generally, they are around 70 to 90% per cent cheaper, according to MSF. In some cases they can be 200 to 300% cheaper than the branded equivalents made in the West.

Flucanozole, a drug which manages cryptococcal meningitis, an infection affecting one in five of Aids sufferers in Thailand, was supplied exclusively by US company Pfizer until 1998. Since local alternatives became available, the cost of a daily dosage of 400mg has fallen from US$14 to 5% of that price. This represents a saving per year of US$3m to the Thai government each year.

The US$0.75 a day price in Thailand compares to a US$20 a day cost for patients in Kenya.

Thailand's Government Pharmaceutical Organisation has supplied generic zidovudine - an antiretroviral drug - since 1993. The resulting competition has led to a fall in price of US$324 in 1992 to US$87 in 1995.

Are they as effective?

Yes. MSF says there is no evidence that generic drugs produced in the developing world are any less effective than branded versions manufactured in the West.

Nathan Ford, of the organisation's Campaign for Access to Essential Medicines, says: "MSF as a medical organisation is the first to ensure absolute quality guaranteed on these drugs."

The National Aids Trust points out that local regulation has an effect on the quality of drugs but adds that there is no reason in principle why locally-produced versions should be any less effective.

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15 Nov 99 | Health
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