Opinion article |

Canada’s role in ‘getting to zero’ on HIV

Author: Stephen Cornish, Executive Director, Médecins Sans Frontières/Doctors Without Borders (MSF) Canada

This year’s World AIDS Day has an ambitious theme: “Getting to zero.” This means: Zero new HIV infections, zero discrimination and zero AIDS-related deaths.

Significant progress has been made. AIDS is no longer an automatic death sentence. More than eight million people living with HIV in developing countries are currently on antiretroviral drugs (ARVs), which allow them to live healthy and productive lives. Scientific evidence stemming from research done in Canada by Dr Julio Montaner and his team at the B.C. Centre for Excellence in HIV/AIDS shows that, by getting people on treatment earlier, you can reduce the spread of HIV. And, on paper at least, the political commitment is there: the international community has committed to scaling up HIV treatment to millions more who are still in need.

Success in “getting to zero” could be within our reach if countries, including Canada, fulfil their pledges to do more. But progress is continually threatened by inconsistent government policies. Canada, for example, has pledged almost $1.3 billion to support the Global Fund for AIDS, Tuberculosis and Malaria; yet, on the other hand, Canada is also entering into trade talks that threaten the availability of affordable generic medications for HIV and other diseases.

Affordable ARVs are the cornerstone of the world’s response to AIDS. Thanks to generic competition from India, the price of HIV drugs has dropped by a staggering 99 per cent in the past decade. More than 80 per cent of all HIV medicines bought by donors come from Indian generics, and Médecins Sans Frontières / Doctors Without Borders (MSF) also sources from India most of the ARVs it uses to treat 220,000 people across the developing world.

Yet inconsistent government policies make it harder to succeed in the fight against AIDS and threaten this lifeline of generic medications. We at MSF are particularly concerned about the Trans-Pacific Partnership agreement (TPP), a U.S.-led regional agreement under negotiation that currently involves Canada, the United States and nine other countries, including developing countries such as Peru and Vietnam. Canada is a latecomer to the TPP but will participate at the next round of negotiations in December.

The TPP talks are being conducted in secret, but leaked drafts of the text show that the U.S. is demanding aggressive provisions that would stifle the production of less-expensive generic drugs. The U.S. is pushing for longer and harsher rules that will keep generic competitors out of the market and keep prices high. The U.S. also wants to make it easier for pharmaceutical companies to get new patents on variations of old drugs even if these bring no additional therapeutic benefit for patients.

These policies threaten the affordability of and access to medicines for AIDS and other diseases. This can mean the difference between life and death for people in the developing world.

This trade pact also has implications for Canada’s own foreign aid and development policies. The Global Fund’s ability to scale up treatment to the almost seven million people who need it is critically dependent on a sustainable flow of affordable generic drugs, for example. By signing up to the provisions being proposed in the TPP today, Canada would be undermining the very global health programs that we support. It would be reneging on previous promises to ensure that trade does not trump public health.

The importance of protecting access to generic medicines is not a new issue for Canada. The country pioneered a bill in 2004 — Canada’s Access to Medicines Regime (CAMR) — that aimed to ensure we did our part to help developing countries access affordable medicines even when patents stood in the way of generic production. Yet eight years later, only one license has been issued under CAMR, and only one Canadian drug manufacturer has shipped generic HIV drugs to a developing country. CAMR is virtually unusable unless the political will to reform it is found. This week saw a massive setback when the revised CAMR bill C-398 failed to pass. Without this reform, it is unlikely that Canada will ever be able to make another shipment of life-saving generic drugs to the world’s poorest.

Now, it is more important than ever for Canada to actively ensure the commercial negotiations it participates in do not trade away health. Getting to zero means drugs need to be kept affordable, and Canada must play its part.

This article originally appeared on the Ottawa Citizen