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Beneficial HIV/AIDS drug deal on the horizon

Jo-Anne Smetherham. 08 December 2003. Cape Times. Republished courtesy of Independent Newspapers (Pty) Ltd.
HIV/AIDS drugs are costing South Africa no more than drugs for serious asthma, complicated diabetes or hypertension. And prices will plummet even further, to around R100 monthly, if the government takes advantage of a deal negotiated recently by former United States president Bill Clinton.

The Bill Clinton Foundation announced the deal for cheap anti-retrovirals in late October. The low prices were made possible by an agreement that the drugs would be mass manufactured for supply to countries in Africa and the Caribbean. The price of the HIV/AIDS drugs was around R10 000 monthly about four years ago. In the state sector the cost is now R600 monthly.

"We're in freefall," said Western Cape health deputy director general Fareed Abdullah last week of the HIV/AIDS drug prices. "Whether it's R100 or R600 we're paying, it's a fraction of what the drugs used to cost."

The drug companies that signed the Clinton Foundation deal are the South African generic manufacturer Aspen Pharmacare, Indian generic companies Ranbaxy and Cipla and the Indian raw materials supplier Matrix Laboratories Limited.

Linda Philips, group chief operating officer of Aspen Pharmacare, said on Sunday the company had been in discussions with the government for two years about a possible generic anti-retroviral supply. Aspen was "certainly hoping" to supply much of the government's requirement for HIV/AIDS drugs, she said, although it was likely that government might well strike deals with all three generic manufacturing companies to minimise its risk. All three companies would use raw materials from the Matrix Laboratories and sell the drugs at the same prices, she said.

"The Clinton Foundation has been negotiating an acceptable price and we've all been involved in those discussions," Philips said.

Health department spokesperson Jo-Anne Collinge said last week that a special team was being set up, by Health Minister Manto Tshabalala-Msimang, to guide the process of buying anti-retrovirals. This team would include representatives from the departments of finance and trade and industry, Collinge said. The team was likely to issue a public invitation to all pharmaceutical suppliers to submit information before making decisions. The goal would be to ensure reliable supplies of drugs at the lowest possible prices.

The South African health minister is able to import generic drugs if they are cheaper than the drugs on sale in this country. This process, called "parallel importation", is made possible by the Medicines and Related Substances Control Amendment Act of 1997.

Aspen Pharmacare has one generic anti-retroviral, called Stavudine, which is already available to the public sector. Several more Aspen generics are awaiting approval from the Medicines Control Council.

The Western Cape health department, which has several pilot anti-retroviral programmes, aims to provide the drugs to more than four-fifths of people needing them in the province within five years. There are 650 people currently taking the drugs in programmes set up by Médicins Sans Frontieres in Khayelitsha - but around 5 000 more desperately need the drugs now. Some of these people will die soon without the treatment.

Said Médicins Sans Frontieres spokesperson Marta Darder said: "The need is just so enormous."
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