Zimbabwe overrides patent protection on HIV/AIDS drugs

by Kanaga Raja

GENEVA: The government of Zimbabwe on 27 May declared a national emergency for six months over the HIV/AIDS pandemic and has decided to override patent protection to enable the procurement and sale of HIV/AIDS drugs in their generic names.

The decision has been acclaimed and warmly welcomed by the international NGO Medecins Sans Frontieres (MSF).

The government's action will enable it to override patent protection on HIV/AIDS drugs that is currently in force in the country and would allow Zimbabweans to use generic antiretroviral drugs instead, which will dramatically reduce the price of treatment for patients.

The Doha Declaration on the TRIPS Agreement and Public Health adopted at the 4th WTO Ministerial Conference last November reinforces the right of WTO member countries to take all measures necessary to protect public health, including overriding pharmaceutical patents.

Zimbabwe's move allows a swift action without the need to engage in lengthy negotiations with the patent holder. This is the model other countries should follow, asserts MSF.

According to MSF, AIDS is threatening the very future of the country. More than 2,000 people die of AIDS every week and the average life expectancy in Zimbabwe has fallen to less than 41 years, compared to 70 years before the epidemic.

"The government has decided to override patent protection on antiretrovirals and use generics - this means that the price of the first-line AIDS cocktails recommended by the World Health Organization will plummet from $1,168 to $412," said Carmen Perez Casas, pharmacist coordinator at the MSF Access Campaign.

"Although prices are just one barrier to overcome to increase access to antiretrovirals, this measure will allow available resources to treat more than twice as many patients," she adds.

The price of $1,168 quoted by MSF is for triple combination with AZT/3TC+nevirapine per patient per year.

Before Zimbabwe decided to declare the emergency decree, the lowest prices available in the country were those offered by the proprietary companies. The lowest price of $412 amounts to the cost of internationally available generic versions of these medicines.

Among the antiretrovirals under patent or where patent is pending in Zimbabwe are: GlaxoSmithKline's zidovudine (AZT), lamivudine (3TC), abacavir (ABC), AZT/3TC, and AZT/3TC/ABC, and Boehringer-Ingelheim's nevirapine.

Zimbabwe's decision to actually declare that it will override patents, to increase access to needed medicines whose prices are too high as a result of patent protection, marks the first time that a government has gone beyond using the threat of compulsory licensing as a negotiating tool.

Zimbabwe had come under criticism for being slow to react to the rampant AIDS crisis, but the government has now taken several steps that should allow it to begin scaling up treatment.

For instance, Zimbabwe this year successfully applied for and will receive a Global Fund grant of $5.3 million to strengthen and extend disease prevention and care for HIV/AIDS, tuberculosis and malaria.

"Zimbabwe doesn't manufacture antiretrovirals, so it will need to import them from other countries which produce cheaper generics," said Ellen 't Hoen from MSF.

"Exporting generics is still permissible for these countries under international trade regulations - but this will change as the TRIPS Agreement [Agreement on Trade-Related Aspects of Intellectual Property Rights] is fully implemented in all WTO members. Unless the TRIPS Council finds a swift and workable solution to this question of production for export, measures such as those taken by Zimbabwe to deal with health care needs may become impossible," she adds.

MSF and Zimbabwean health authorities have been preparing a project to support implementation of prevention of mother-to-child transmission of HIV/AIDS protocols in Bulawayo.

This will eventually be expanded to include treatment with antiretroviral drugs. MSF points out that the Zimbabwe government's emergency decree can only facilitate this and similar undertakings in Zimbabwe. (SUNS5129)

From TWE No. 281 (16-31 May 2002)