Kenya: NGOs seek to import generic drugs from India

by Judith Achieng

Nairobi, 22 Feb 2001 (IPS) -- Kenyan non-governmental organisations (NGOs) are seeking to import generic drugs from India, following delays by the pharmaceutical industry to cut the price of anti-retroviral drugs for people living with AIDS.

“We have seen too much suffering and wonder what happened to the offer, which was announced with fanfare (last year),” charges Christopher Ouma, a Kenyan medical doctor with the British charity, Action Aid.

The 12 NGOs have challenged the pharmaceutical companies to match the offer made by Mumbai-based Cipla Ltd.; make their prices public, and ensure the drugs reach the needy as quickly as possible.

Last week, Cipla, a leading generic manufacturer, offered to sell a triple therapy combination of anti-retroviral drugs at an equivalent of $350 per patient per year. Cipla was responding to a call by Medicines sans Frontieres (MSF) and other organisations that have been fighting for cheaper AIDS drugs to sub-Saharan Africa.

This offer means that the target price of $200 a year for the drugs - outlined by MSF at the World AIDS Conference in Durban, South Africa, last year - is within reach.

Cipla’s announcement has been greeted with relief in many African countries, where anti-retroviral drugs cost up to $15,000 per patient per year, which is beyond the reach of the majority.

In May last year, a number of global pharmaceutical giants, including Merck & Co, Bristol-Myers Squibb Co., Roche, GlaxoSmithkline PLC, and Booehringer-Ingelheim, offered to reduce the prices of AIDS drugs to sub-Saharan Africa by 85%.

The cost of the drugs has been ranging between $10,000 and 15,000 per patient per year.

So far, only Boehringer-Ingelheim has lowered the cost of its Nevirapine by 80%, bringing it closer to the Cipla offer. The rest of the companies are still involved in negotiations with the Kenyan government.

Without donor support, the price of treatment, even with the 85% reduction, would still be well out of reach for an average Kenyan earning $270 a year, in a country where the per capita spending on health is only $3, says MSF.

The NGOs, led by MSF, have criticised the “lack of transparency” in price negotiations between the Kenya government and the pharmaceutical industry. Negotiations between major pharmaceutical players, the Kenya government and UNAIDS started in January this year.

The NGOs are urging president Daniel Arap Moi’s government to take advantage of Kenya’s laws, which still allow for the importation of generic drugs, and make them available to AIDS patients.

Kenya has 2.1 million of East Africa’s 4.2 million HIV-infected persons, 500 of whom succumb to the disease every day. “We think the negotiations are a technique in time wasting. We wonder who is deadlier in sub-Saharan Africa - AIDS or businessmen with briefcases full of patent applications,” Ouma told journalists in Nairobi this week.

Unable to wait any longer for the price reductions promised by the pharmaceutical industry, one of the NGOs, which takes care of some 70 HIV-infected children, has announced that it will place an immediate order for the drugs from India. “I am sick and tired of doing funerals.  We conduct two to three funerals a month,” Fr. D’Agostino, founder of the Nyumbani children’s home in Nairobi, told journalists.

The home spends 250,000 shillings (about $3,000) each month on the drugs, more than twice what it spends on food and accommodation for the children under its care. But the home will be taking Cipla’s offer at the risk of facing legal suit from the pharmaceutical industry, like in the case of South Africa.

About 42 pharmaceutical companies take the South African government to court next month for violating patent rules, by among other things, promoting the use of generics to fight AIDS, and its opportunistic infections.

The suit follows a decision by the South African government to pass legislation intended to implement a number of mechanisms to reduce the price of medicines in South Africa, such as permitting parallel importation, enforcing generic substitution and setting up of a price committee to mandate single exit prices.

The pharmaceutical industry objected to many of the new provisions and in February 1998 filed a suit to block the legislation from coming into force, claiming that it contravenes the rules set by the World Trade Organisation (WTO) on patent protection.

“It really is the darkest side of capitalism. Pharmaceutical companies holding the people of sub-Saharan Africa at ransom, people are dying because the cost of drugs cannot be reduced,” said Fr. D’Agostino.

The industry threatened similar action in other African countries, if they go ahead and import the generic drugs offered by Cipla. In a letter to Cipla, GlaxoWelcome head of patents G.G Brereton, was quoted as warning against the sale of the generic versions of Lamivudine and Zidovudine combination therapy to Uganda and Ghana, and said it was “an infringement of the company’s exclusive patent rights”.

“I look forward to your assurance that you will cease all infringing activity in Uganda and respect the above-mentioned patent rights,” he wrote.

Cipla was responding to a call by MSF and other organisations, which have been fighting for cheaper AIDS drugs.

MSF, which won the 1999 Nobel peace prize for its global work in rushing emergency medical assistance, was the first to attack world trade rules on drug patents, which it says, raise prices and restrict access to vital medicines.

“While I strongly support Cipla’s move to supply cheaper generic drugs for treating those suffering from AIDS or HIV infection in Africa, I also say that there are major dangers in such good intentions,” said Otula Owuor, editor of the Nairobi-based African Medical News, a monthly newspaper, are concerned about India’s record as a “poor drug exporter to Africa.”

“The sale of sub-standard drugs in Africa is an issue that can not be ignored by any honest group or individuals keen on supplying relatively safe and effective drugs that are relatively cheap or affordable,” he noted article. “When it comes to HIV/AIDS, the Indian government may have to step [up] its laws to help curb counterfeits although the vast country has over 16,000 drug firms,” he added.