World AIDS Day, Geneva, 1 December 2000 — The international medical aid agency Médecins Sans Frontières (MSF) calls on multinational drug companies to deliver on their promise to drastically reduce AIDS drug prices. On May 11th 2000, The Wall Street Journal reported that UNAIDS and five drug companies1 were offering “to slash the prices of HIV drugs for people living in poor countries.” According to the article, exact prices were supposed to be settled upon in the weeks to come. More than six months later, there is still little progress on the promised discount (see Report Card, below).
As a first step, MSF calls on the five multinational drug companies to immediately reduce the price of their AIDS drugs in poor countries by 95 per cent. In practise, this means that Glaxo Wellcome should make its drug AZT/3TC available for US$1.00 a day against its current $19.60, Bristol-Myers Squibb should charge $0.49 a day for d4T against the present $9.80, and Merck $0.65 for efavirenz, which now costs $13.20. Major discounts for poor countries should be similar to those already in place for vaccines and contraceptives. The polio vaccine, for example, is sold to UN agencies for $0.09 while it costs $10.93 in the US.2
“95 per cent of people living with HIV/AIDS dwell in poor countries and cannot afford medicines that could prolong and improve the quality of their lives. We challenge the drug companies to deliver on their promises and publicly respond to this demand by the first week of 2001”, says Dr. Bernard Pécoul, director of MSF’s Access to Essential Medicines Campaign.
Countries that have not waited for large multinationals to lower prices have already brought down the cost of antiretroviral drugs dramatically, as MSF research2 shows. Brazil is the most striking example of how local generic drug production can reduce prices. Due to the introduction of less expensive generics, as many as 1000 HIV/AIDS patients are being treated in Brazil for the price of treating only 228 in Uganda.
The Brazilian approach has been to import the best quality generic raw materials and locally manufacture finished products. Countries such as Burkina Faso, Cambodia, Guatemala, South Africa and Uganda have been speaking both to Brazilian and Indian generic manufacturers that can sell the products at true discounted prices. Brazil has also been discussing technology transfer with other developing countries, so that they can begin producing their own quality medicines.
The UNAIDS company initiative requires countries to negotiate with each of the multinational companies for each of the drugs they produce. This system diverts precious human resources from national AIDS programmes, whereas real across-the-board price reductions would benefit people immediately.
Médecins Sans Frontières has HIV/AIDS programmes in more than 20 countries. Traditionally, MSF has focused on reducing the stigma of people with HIV/AIDS, as well as on prevention and pain alleviation. More recently, the organisation has expanded its approach to encompass preventing transmission from mother to child, and preventing and treating opportunistic infections in HIV-infected people. Small-scale antiretroviral programs are being or will be launched in Thailand, Guatemala, El Salvador, Cameroon, South Africa, and Cambodia.
Six-month Report Card – UNAIDS five company Accelerated Access Programme
Number of countries that have negotiated price reductions to date
Number of people with HIV in sub-Saharan Africa
Number of patients that will benefit once this programme in Senegal is implemented (according to UNAIDS)
Number of patients that Brazil has put on antiretroviral therapy by using affordable generic medicines
More than 90,000
Amount that prices of generic antiretrovirals have fallen because of introduction of generics in Brazil (1996-2000)
Amount of money Brazil has saved on hospitalisations and treatments for opportunistic infections avoided by successful use of antiretroviral therapy (1997 – 1999)
Annual cost of triple combination in the US
$10 000 –15 000
Annual cost of triple combination offered by a generic Indian manufacturer (quality meeting international standards)
1Boehringer Ingelheim, Bristol-Myers Squibb, Glaxo Wellcome, Merck & Co., Inc., and F. Hoffmann-La Roche.
2HIV/AIDS medicines pricing report. Setting objectives: is there a political will? MSF, July 6th 2000.