Protecting first-world pharmaceutical markets is key to ensuring that drug companies remain committed to providing low-cost antiretrovirals for resource-limited settings, a key official at the World Health Organization (WHO) has warned.
According to an article in the November 12th edition of the British Medical Journal, Dr Jim Yong Kim, departing WHO director of HIV/AIDS, warned that “rational measures” are needed to avoid shortages of low-cost HIV drugs for resource-limited countries.
At the G8 summit in July this year a commitment was made “to provide as close as possible to universal treatment for AIDS by 2010”, however Dr Kim warned that “a crisis in terms of supply” would be reached “very, very soon” because of the rapid expansion of HIV treatment programmes.
The BMJ highlights Dr Kim’s comments on the important role research-based pharmaceutical companies have played in expanding access to cheap antiretrovirals. Thanks to the big drug companies’ efforts, as many as half a million people now have access to anti-HIV drugs, Dr Kim said. However, he added that he doubted if big pharmaceuticals could meet the 2010 treatment target. “They’re taking a loss on each regimen they sell, they tell us”, he told the BMJ, adding, “something has to be done.”
That something, said Dr Kim, is the protection of the big pharmaceuticals’ markets in rich countries, which would provide an incentive for them to continue to develop new anti-HIV drugs. Simultaneously, the drug companies would create a “humanitarian corridor”. This would involve countries with the capability to produce low cost generic antiretrovirals – such as China – supplying them at low cost to Africa.
Returning from a fact-finding trip to China, Dr Kim expressed confidence that Chinese manufacturers could make generic versions of all the antiretrovirals used in first and second-line HIV therapy at a cost of approximately $150 per person per year. Generic manufacturers would not be able to make versions of fusion inhibitors.
The cost of generic first-line treatment could go as low as $100 per person per year once the Chinese scaled up their production capacity to meet global demand, Dr Kim said. However, to achieve this it was essential that the humanitarian corridor was established in the next 18 months.
Dr Kim’s views are not universal. Harvey Bale, director general of the International Federation of Pharmaceutical Manufacturers and Association is also quoted by the BMJ. “It’s simply premature to make a forecast for 2010”, he said, and added that although research-based pharmaceuticals were not making any money on their cut-price antiretrovirals they could “still cut their losses” if they increased the volume of low-cost manufacture.