Geneva, March 28, 2006 — As the World Health Organization (WHO) and UNAIDS release a long-awaited report on their 3x5 AIDS treatment initiative, and call for universal access to AIDS drugs, the medical humanitarian organization Doctors Without Borders/Médecins Sans Frontières (MSF) is expressing concern that not enough is being done to make sure that the drugs needed to expand and sustain treatment are accessible to those who need them.
WHO and donors alike are ignoring the looming threat to access to affordable essential medicines that form one of the key barriers to global treatment scale-up, MSF said. Growing numbers of people that have been on AIDS treatment for several years will increasingly need access to newer, second-generation medicines that remain priced out of reach or are not available at all.
"We won't be able to keep our patients alive beyond the first few years unless there are some dramatic price reductions for second-line drugs," said Dr. Karim Laouabdia, director of MSF's Campaign for Access to Essential Medicines. "Patients will inevitably need second-line drugs after a few years on treatment, because resistance develops, even when every single pill is taken according to the treatment plan."
At the same time, World Trade Organization (WTO) rules on patents are threatening to dry up sources of low-cost generic versions, including some of the first-generation drugs. Without a reliable supply of low cost AIDS drugs, national governments and treatment providers will be faced with an uphill battle, and patients risk having vital treatment interrupted or priced out of their reach.
"It was generic competition and the absence of patents on first generation AIDS drugs in key producing countries that forced prices to drop drastically over the early part of the decade, helping expand treatment," said Ellen 't Hoen, director for policy and advocacy at MSF's Campaign for Access to Essential Medicines. "But we are loosing ground again. What we're witnessing now are patent regimes that threaten to block access to both first- and second-line drugs. It's a cruel case of déjà -vu, to which the WHO seems to be blind," she added.
Indian manufacturers are the source of 84 percent of antiretrovirals MSF uses in its AIDS treatment projects across the globe. Last year, India changed its patent law to comply with the WTO TRIPS Agreement, and three weeks ago, India granted its first ever patent on a drug. MSF is deeply concerned that this will set a precedent, threatening access to other essential medicines including antiretrovirals, patents to some of which are being considered by the Indian patent office right now.
Pharmaceutical companies are faster in filing patents in developing countries than in delivering the drugs. As an example, Abbott Laboratories only sells in the US a new version of a WHO recommended second-line AIDS drug (lopinavir/ritonavir) that is particularly well-suited for use in developing countries because it does not need require refrigeration. MSF placed an order for the drug with the company's headquarters in Chicago, but so far, Abbott has refused to proceed with filling the order, and there are no alternative sources for this product today.
MSF warns that if there is no concerted effort by the UN and the international community to make sure there is a steady supply of low-cost AIDS drugs, attaining the goal of universal access will remain impossible.
