HEALTH-INDIA: Group Helps Keep Up Fight Vs Expensive Drugs

Inter Press Service - May 7, 2001
T V Padma

NEW DELHI, May 7 (IPS) - Fearing that new drugs will be out of reach of most Indians once the rules on intellectual property rights come into force in 2005, activists have kickstarted a national campaign to raise awareness on citizens' rights to affordable drugs.

The campaign, launched by a Mumbai-based NGO Lawyers Collective, is initially focusing on anti-AIDS drugs, but plans to cover all other drugs in its nationwide effort to raise awareness of citizens' right to demand affordable medicines.

Lawyers Collective which held a public meeting a fortnight ago in Mumbai, and another in Delhi on May 1, plans to extend such meetings to all other cities. Other non-government organisations, medical professionals providing care and support to HIV-infected persons and networks of HIV- positive people have joined the campaign.

Organisers of the campaign received a shot in the arm when South Africa last month won a major court case against 39 pharmaceutical companies that withdrew their suit to prevent that country from importing cheap generic anti-HIV drugs that differ only slightly from the original patented drug molecules.

The companies had initially charged South Africa with infringement of patent laws.

The case raised seminal questions on the issue of health care in developing countries, and their access and ability to buy affordable generic versions of medicines patented by multinational pharmaceutical companies.

Astronomical prices of anti-AIDS drugs, kept deliberately high by multinational companies (MNCs), make them out of the reach of many in poor African and Asian countries that are bearing the brunt of the epidemic. The companies cite the high cost of in-house research and development that goes into making a new drug as justification of the high prices.

The MNCs' strident protests against firms such as India's Cipla that is offering a cocktail of three essential anti-AIDS drugs at a fraction of the cost charged by transnationals ended in a whimper last month when the drug companies decided not to press their suit against South Africa.

The climb-down followed a realisation that their belligerence was turning into a major public relations disaster.

Compared to the cost of the triple drug therapy (stavudine, lamivudine and nevirapine) offered by multinationals at 10,000-15,000 dollars per person per year in the west, Cipla offered it for as low as 350 dollars per patient per year to Nobel Prize-winning French NGO Medecins Sans Frontieres and 1,000 dollars to other countries.

Last week, it signed an agreement with Nigeria, offering the drug at 300 dollars. Other major Indian firms that are offering a similar price slash are Hetero Drugs Ltd at 347 dollars and Aurobindo at 295 dollars.

The three drugs are among a group of drugs called anti- retrovirals that prevent replication of the HIV virus and its spread.

According to official estimates, India has 3.5 million HIV- positive people, and many more are at risk of contracting the infection.

"We need to pressurise policy makers and parliamentarians to ensure that the citizens' rights to affordable medicines are not compromised in the upcoming national patent law, especially once TRIPS comes into force," Akshay Khanna, from Lawyers Collective said.

Currently, India has a process patent system that recognises the manufacturing process only and permits firms to make drugs through new routes.

However, once TRIPS (Trade Related Intellectual Property Rights) comes into force from 2005, India will have to adopt a product patent system that will prohibit firms from manufacturing the basic patented drug in any form and through any route.

A new draft national patent law to make it more TRIPS- compatible is currently under scrutiny by a special parliamentary committee. Legal experts, NGOs and even some health ministry officials have strongly recommended changes in the draft law to ensure that India does not suffer once TRIPS comes into force four years from now.

The option of producing cheaper generic drugs closes down once the product patent system falls into place, warns Vandana Shiva, director of The Research Foundation for Science, Technology and Ecology, based in Delhi, who is leading a national campaign against imposition of TRIPS by the West on developing countries.

"Once TRIPS comes into force, not only will companies like Cipla not be able to manufacture generic drugs and export them to countries like South Africa, but they will also not be able to provide low-cost drugs to millions of Indians who require affordable drugs," Shiva said.

"If TRIPS is a disaster, then the draft law before the parliamentary committee is another disaster," B K Keayla, convenor of the National Working Group on Patents and member of the committee, told the public gathering.

Doctors treating HIV patients pointed out that India could well follow the example of Brazil that started providing the triple drug therapy free of cost, and South Africa that declared AIDS as a national emergency and asserted on its right to buy cheaper drugs for HIV treatment.

"Like India, Brazil is a developing country, has a fragile public health infrastructure, and many of its uneducated people cannot follow the complicated drug regimen of pills needed to be taken by AIDS patients," Delhi-based Dr Bitra George who treats HIV positive persons at a care home, pointed out.

Since 1998, Brazil has provided anti-AIDS drugs free, built a well-run network of AIDS clinics and started making copies of well-known brands, causing their prices to fall by 79 per cent.

Brazil's strategy has helped stabilise the epidemic, cut the transmission rates, and halved the death rate due to AIDS.

Availability of treatment is a powerful incentive for people to access voluntary test centres, and treatment will limit the spread of AIDS due to lower viral load in the infected persons, George said.

Experts at the gathering in Delhi stressed that it was up to the Indian government to include clauses to protect the country's interests in its national patent law.

Indian health minister Dr C P Thakur had, at a Non Aligned Movement (NAM) meeting in Johannesburg in the last week of March, stated that poor countries must have access to affordable anti-AIDS drugs.

Thakur also suggested creating a global fund to help poor countries access the costly anti-AIDS drugs.

Experts point out that the Indian patent law should incorporate clauses to safeguard the country's interests and also lower costs of new drugs once TRIPS comes into force.

These include differential pricing or the clause allowing lower prices for drugs in poor countries; and declaration of AIDS as a national emergency. The latter would allow issue of compulsory licenses to local manufacturers to replicate patented anti-AIDS drugs cheaply.

Unless citizens groups put pressure on the government and Parliament not to cave in to international lobby to follow the TRIPS agreement in the strictest sense, it may be too late for Indians to exercise their right to affordable medicines, warns Lawyers Collective.
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