February 08, 2006

AIDS Drug Treatment Access: Walking the Walk

Bashing pharmaceutical companies: no self-respecting international AIDS conference can do seemingly without it. It happened at the 2002 International AIDS conference in Barcelona. It happened at the previous conference in Durban two years before that. The 2004 International AIDS conference in Bangkok saw the kiosk of Gilead Sciences, a California-based producer of the anti-retroviral drug Viread (or tenofovir), being thoroughly trashed by activists.

This year’s international Conference on Retroviruses and Opportunistic Infections (CROI) in Denver is no exception. And it is Gilead Science being taken to task again, not by AIDS activists this time, but by the Nobel Prize-winning humanitarian organization Doctors without Borders, better known outside the United States as Medicins sans Frontieres (MSF). According to MSF-USA, Gilead unveiled its ‘global access program’ for developing countries to great fanfare over three years ago, promising to eventually reduce its prices for tenofovir to 97 countries. They looked like the good guys. But in the meantime, tenofovir has actually only been registered in 6 developing countries: the Bahamas, Gambia, Kenya, Rwanda, Uganda, and Zambia.

According to MSF, the company has not bothered to request marketing clearance or gone through other regulatory procedures to make its drugs available in most developing countries – the typical behavior of a drug company faced with unprofitable markets. (Gilead’s HIV/AIDS products made . $1.39 billion last year, up 47% from 2004, presumably in the better-off regions of the world.) Unfortunately, Gilead is the sole producer of this efficacious, low-side effect antiretroviral drug. No generic equivalent is currently being made. So if MSF’s side of the story is correct, many AIDS patients in low-income countries will just have to wait until Gilead sees a market advantage in registering its product and lowering its prices. Since ‘waiting for treatment access’ in low-income countries is often a polite way of talking about death, this is a serious accusation.
- Stuart Rennie

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