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November 30, 2006
Clinton’s Foundation Brokers AIDS Deal
By ANAND GIRIDHARADAS
The New York Times
MUMBAI, Nov. 30 — The cost of treating children infected with H.I.V. and AIDS is poised to plummet next year, under a deal announced today between two Indian drugmakers and former President Bill Clinton’s foundation.
Cipla and Ranbaxy Laboratories agreed to make 19 different anti-retroviral drugs designed for children available at an average price of 16 cents a day, or $60 a year, which is about 45 percent lower than the lowest current price, the Clinton Foundation said in a statement.
Because not everyone has access to the current lowest price, the plan will actually translate into a four- to six-fold cost reduction for many children, said Stephen Lewis, the United Nations special envoy for H.I.V. and AIDS in Africa.
The prices will be available to 62 developing countries and will lead to the treatment of an additional 100,000 people in 2007, the statement said.
A $35 million grant from Unitaid, a drug-buying consortium formed in September by France, Brazil, Chile, Norway and the United Kingdom, will be combined with $15 million from the Clinton Foundation to assure the Indian drugmakers a volume of sales high enough to justify the lower prices.
“What you’re doing with this announcement is keeping hundreds of thousands, indeed millions, of children alive who would otherwise die,” Lewis said in a telephone interview from London. “That’s the simple truth of it.”
“This is historic,” Lewis added, “because it’s doing for children what was always available for adults.”
There are 2.3 million children worldwide with H.I.V., with 2 million in Africa alone, according to United Nations figures, and just 10 percent of them are receiving treatment. The vast majority of infected children get the virus from their mothers during pregnancy or breast-feeding, and 700,000 more will get the virus this year at present rates. There is an 80 percent chance of an infected child’s dying before the age of 5; half a million children are expected to die next year.
Even as governments and aid organizations have worked to broaden access to AIDS drugs among adults in the developing world, children in the same places have been left behind because they need special versions of drugs with varied gradations of dosage and delivery method for different ages and weights.
Pills that dissolve in water are preferred, for example, while the liquid formulations used for pediatric AIDS drugs in the West are difficult to administer and thus not viable for large-scale rollouts in places like Africa, China and India.
There is little interest among global drugmakers in catering to the pediatric market. Western pharmaceutical companies generate most of their profits on AIDS drugs by treating adults in the West, where mother-to-child transmission of the virus has been effectively eliminated by medicines still not widely accessible in poorer countries.
Without a strong market for pediatric AIDS treatments, doctors in the developing world are frequently left to smash adult pills into child-sized doses, guessing the proper amount based on weight and age.
In an interview in New Delhi earlier this year, Mr. Clinton argued that generic drugmakers like Cipla, Ranbaxy and others could provide developing countries with medicines for which there is minimal demand in the West.
“The important thing they do is to step into the breach,” he said, that is “created by the fact that most of the research money is in wealthy countries and most of the ability to do breakthrough drugs is in developed countries, and most of the need for these drugs is in poor countries.”
“If a company develops a new advance in AIDS, TB, malaria, you need large numbers right away, and all the people who need it are in poor places,” he said. “If you don’t have Cipla, Ranbaxy, Hetero, Aspen in South Africa and other people to step into the breach, how are we going to do that?”
Jon Liden, a spokesman for the Global Fund to Fight AIDS, Tuberculosis and Malaria, based in Geneva, said the deal announced today would allow grants already made by the foundation to treat substantially more people in 2007.
“It’s a hugely positive step,” he said, “because one of the really difficult areas in rolling out treatment has been to have a steady and huge supply of pediatric dosages and packaging.”
Aid organizations have been warning that the contribution of generic companies will be short-lived. Ellen ‘t Hoen of Médecins Sans Frontières, the Paris-based organization also known as Doctors Without Borders, warned today that Western pressure on countries like India to tighten patent rules will complicate price reductions.
Indian drug companies were able to produce the special pediatric drugs because they mixed together a customized combination of chemicals invented by Western companies but never patented under India’s once-lax intellectual-property protections. Yet India has recently changed its patent rules, under its World Trade Organization commitments, so as to protect Western innovations.
“What President Clinton did today is fantastic,” Hoen said. “He will not be able to do it in a few years time.”
In another Asian country combating AIDS, there was an omen this week that patents will spur ever greater tensions between AIDS activists and drugmakers.
Health officials in Thailand announced on Wednesday that they would break a patent on the AIDS drug Efavirenz and make generic copies.
Efavirenz is a second-line AIDS treatment, made for those immune to the first generation of AIDS drugs, and it is substantially more expensive than first-line drugs.
It was the first time Thailand has broken a patent since it adopted tough patent protections 27 years ago.
As with pediatric drugs, the cost of second-line treatments has yet to fall as precipitously as first-line therapies have. Within the last decade, the latter drugs have dropped from up to $15,000 a person a year to as little as $130.
David Wilson, an official with Doctors Without Borders in Thailand, lauded the move. “Thailand is demonstrating,” he said in an e-mailed statement, “that the lives of patients have to come before the patents of drug companies.”
Copyright 2006 The New York Times Company
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November 30, 2006
Clinton’s Foundation Brokers AIDS Deal
By ANAND GIRIDHARADAS
The New York Times
MUMBAI, Nov. 30 — The cost of treating children infected with H.I.V. and AIDS is poised to plummet next year, under a deal announced today between two Indian drugmakers and former President Bill Clinton’s foundation.
Cipla and Ranbaxy Laboratories agreed to make 19 different anti-retroviral drugs designed for children available at an average price of 16 cents a day, or $60 a year, which is about 45 percent lower than the lowest current price, the Clinton Foundation said in a statement.
Because not everyone has access to the current lowest price, the plan will actually translate into a four- to six-fold cost reduction for many children, said Stephen Lewis, the United Nations special envoy for H.I.V. and AIDS in Africa.
The prices will be available to 62 developing countries and will lead to the treatment of an additional 100,000 people in 2007, the statement said.
A $35 million grant from Unitaid, a drug-buying consortium formed in September by France, Brazil, Chile, Norway and the United Kingdom, will be combined with $15 million from the Clinton Foundation to assure the Indian drugmakers a volume of sales high enough to justify the lower prices.
“What you’re doing with this announcement is keeping hundreds of thousands, indeed millions, of children alive who would otherwise die,” Lewis said in a telephone interview from London. “That’s the simple truth of it.”
“This is historic,” Lewis added, “because it’s doing for children what was always available for adults.”
There are 2.3 million children worldwide with H.I.V., with 2 million in Africa alone, according to United Nations figures, and just 10 percent of them are receiving treatment. The vast majority of infected children get the virus from their mothers during pregnancy or breast-feeding, and 700,000 more will get the virus this year at present rates. There is an 80 percent chance of an infected child’s dying before the age of 5; half a million children are expected to die next year.
Even as governments and aid organizations have worked to broaden access to AIDS drugs among adults in the developing world, children in the same places have been left behind because they need special versions of drugs with varied gradations of dosage and delivery method for different ages and weights.
Pills that dissolve in water are preferred, for example, while the liquid formulations used for pediatric AIDS drugs in the West are difficult to administer and thus not viable for large-scale rollouts in places like Africa, China and India.
There is little interest among global drugmakers in catering to the pediatric market. Western pharmaceutical companies generate most of their profits on AIDS drugs by treating adults in the West, where mother-to-child transmission of the virus has been effectively eliminated by medicines still not widely accessible in poorer countries.
Without a strong market for pediatric AIDS treatments, doctors in the developing world are frequently left to smash adult pills into child-sized doses, guessing the proper amount based on weight and age.
In an interview in New Delhi earlier this year, Mr. Clinton argued that generic drugmakers like Cipla, Ranbaxy and others could provide developing countries with medicines for which there is minimal demand in the West.
“The important thing they do is to step into the breach,” he said, that is “created by the fact that most of the research money is in wealthy countries and most of the ability to do breakthrough drugs is in developed countries, and most of the need for these drugs is in poor countries.”
“If a company develops a new advance in AIDS, TB, malaria, you need large numbers right away, and all the people who need it are in poor places,” he said. “If you don’t have Cipla, Ranbaxy, Hetero, Aspen in South Africa and other people to step into the breach, how are we going to do that?”
Jon Liden, a spokesman for the Global Fund to Fight AIDS, Tuberculosis and Malaria, based in Geneva, said the deal announced today would allow grants already made by the foundation to treat substantially more people in 2007.
“It’s a hugely positive step,” he said, “because one of the really difficult areas in rolling out treatment has been to have a steady and huge supply of pediatric dosages and packaging.”
Aid organizations have been warning that the contribution of generic companies will be short-lived. Ellen ‘t Hoen of Médecins Sans Frontières, the Paris-based organization also known as Doctors Without Borders, warned today that Western pressure on countries like India to tighten patent rules will complicate price reductions.
Indian drug companies were able to produce the special pediatric drugs because they mixed together a customized combination of chemicals invented by Western companies but never patented under India’s once-lax intellectual-property protections. Yet India has recently changed its patent rules, under its World Trade Organization commitments, so as to protect Western innovations.
“What President Clinton did today is fantastic,” Hoen said. “He will not be able to do it in a few years time.”
In another Asian country combating AIDS, there was an omen this week that patents will spur ever greater tensions between AIDS activists and drugmakers.
Health officials in Thailand announced on Wednesday that they would break a patent on the AIDS drug Efavirenz and make generic copies.
Efavirenz is a second-line AIDS treatment, made for those immune to the first generation of AIDS drugs, and it is substantially more expensive than first-line drugs.
It was the first time Thailand has broken a patent since it adopted tough patent protections 27 years ago.
As with pediatric drugs, the cost of second-line treatments has yet to fall as precipitously as first-line therapies have. Within the last decade, the latter drugs have dropped from up to $15,000 a person a year to as little as $130.
David Wilson, an official with Doctors Without Borders in Thailand, lauded the move. “Thailand is demonstrating,” he said in an e-mailed statement, “that the lives of patients have to come before the patents of drug companies.”
Copyright 2006 The New York Times Company
