EU tackles illegal trade in developing countries` HIV drugs

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The European Commission yesterday announced a policy that should prevent the illegal trade of deeply discounted antiretrovirals meant for export to the world's poorest countries from being re-imported and sold at higher prices in the EC.

Under the EU plan, which is expected to be adopted by the end of year, pharmaceutical companies that manufacture drugs for the three major communicable diseases - HIV/AIDS, TB and malaria - can protect their profits in the developed world by registering their lower-priced products bound for developing countries on an EU-run price list, marking these products with a special logo, and possibly producing them in colours, sizes or shapes that would distinguish them from EU-bound drugs.

It is hoped that such measures will prevent these drugs from entering the EU. In order to be included on the list, drugs will have to be made available at a 'tiered price': either a discount of at least 80% off the average retail price in the 30 OECD countries (which includes the EU, US, Canada and Japan), or the cost of production plus 10%.

Glossary

malaria

A serious disease caused by a parasite that commonly infects a certain type of mosquito which feeds on humans. People who get malaria are typically very sick with high fevers, shaking chills, and flu-like illness. 

low income countries

The World Bank classifies countries according to their income: low, lower-middle, upper-middle and high. While the majority of the approximately 30 countries that are ranked as low income are in sub-Saharan Africa, many African countries including Kenya, Nigeria, South Africa and Zambia are in the middle-income brackets. 

EU Commissioner for Development and Humanitarian Aid, Poul Nielson, welcomed the proposal. "We need to substantially increase the supply of tiered-price products so that cheaper medicines reach the poorest patients," he said. "This measure should be seen as part of a wider plan to improve the health situation in developing countries."

The announcement of the policy comes within weeks of the discovery by Dutch officials that 3,600 packets of GSK's Combivir and 2,400 packets of Epivir worth approximately £1.5m at European retail prices had been diverted from African airports for resale in the Netherlands, Germany and the UK, as reported earlier this month on aidsmap.com. However, the Commission claims that is not a knee-jerk reaction but the result of a long term strategy "to ensure that poor countries benefit from access to essential medicines and builds on the work that has been going on for the past two years. Obviously the measures proposed today aim at preventing that cases such as the recent one involving GSK recur."

The policy is not without its critics, however. Oxfam point out that since it only covers three diseases and 72 countries (49 least developed countries, plus 23 other low-income countries most of which are in Africa or Asia), the policy does nothing to alleviate the problems of drug access in other countries and for other diseases.

The Commission acknowledges that the policy is somewhat limited in scope.

"We can't make manufacturers reduce their prices," a spokesman admitted yesterday. "But if the industry is encouraged to see the benefits of expanding their markets via the listing procedure, this will lead to manufacturers making use of it and increasing deliveries. This is a give-and-take exercise.

"We have to start somewhere,. If the system works, we are ready to consider adding other medicines. We can also extend the number of countries we include in the scheme."

Countries included in the EU scheme

Afghanistan, Angola, Armenia, Azerbaijan, Bangladesh, Benin, Bhutan, Burkina Faso, Burundi, Cambodia, Cameroon, Cape Verde, Central African Republic, Chad, China, Comoros, Congo, Democratic Republic of Congo, Republic of Djibouti, East Timor, Equatorial Guinea, Eritrea, Ethiopia, Gambia, Ghana, Guinea, Guinea Bissau, Haiti, Honduras, India, Indonesia, Ivory Coast, Kenya, Kiribati, Korea Democratic Republic of, Kyrgyz Republic of, Lao People's Democratic Republic, Lesotho, Liberia, Madagascar, Malawi, Maldives, Mali, Mauritania, Moldova, Mongolia, Mozambique, Myanmar, Nepal, Nicaragua, Niger, Nigeria, Pakistan, Rwanda, Samoa, Sao Tome and Principe, Senegal, Sierra Leone, Solomon Islands, Somalia, Sudan, Tajikistan, Tanzania, United Republic of, Togo, Turkmenistan, Tuvalu, Uganda, Vanuatu, Vietnam, Yemen, Zambia, Zimbabwe.