Ugandan activists call for early action on patent barriers for generic HIV drugs

Human rights organisations warn that action must start now to protect the lives of thousands of Ugandans on HIV treatment, who stand to suffer if generic drugs are outlawed in 2016.

Human rights organisations warn that action must start now to protect the lives of thousands of Ugandans on HIV treatment, who stand to suffer if generic drugs are outlawed in 2016.

Following a recent decision on patents by the World Trade Organization, cheaper generic HIV drugs are still available in poor countries. But in three years time it will be a different story when the deadline for enforcing drug patents owned by multi-national companies runs out and the Trade Related Aspects of Intellectual Property Rights (TRIPS) law comes into force.

According to Denis Kibira, medicines advisor for the non-governmental organisation HEPS-Uganda, over 90% of all HIV drugs in Uganda are generics manufactured in India. Generic drugs are identical copies of brand drugs manufactured by western pharmaceutical companies. Activists are already advocating for an unconditional extension to the drug patent deadline to ensure continued access to these life-saving drugs.

HIV drugs must be affordable

Joshua Wamboga from The AIDS Support Organization, where over 100,000 people are enrolled on HIV treatment, said: “The ability to access cheap medicines on the market will be curtailed and the fight against HIV in Uganda may be lost if expansive trade laws are adopted without improving the incomes of Ugandans.”

According to the Ugandan Ministry of Health, there are over 330,000 antiretroviral users in the country. PEPFAR, the leading funder of HIV treatment in Uganda has indicated that cheap Indian generic drugs have been a major factor in scaling up access to over six million* people on treatment in Africa.

In July, Medicins San Frontiers reported the price of first line and second line antiretrovirals had fallen due to competition among generic drug manufacturers, further making antiretrovirals affordable by poor countries.

Putting lives at risk

The demand for antiretrovirals in Uganda will increase given the national prevalence of HIV has risen from 6.4% in 2005 to 7.3% in 2012, according to the Ugandan health ministry. Outlawing generic antiretrovirals would jeopardise the lives of those already on treatment and be a crippling impediment to scaling up for those who become eligible for treatment.

The World Health Organization’s new HIV treatment guidelines issued on 30 June, recommend antiretroviral therapy now be initiated earlier before people’s CD4 counts get too low. So the demand for generic HIV pharmaceuticals is set to increase even further based on these recommendations.

Professor Brook Baker of the US-based organisation Health GAP, in a joint statement with Uganda’s Centre for Health, Human Rights and Development (CEHURD), calls for least developed countries to start early in their quest for an unconditional extension to the grace period given by the World Trade Organization for manufacture and sale of generic antiretrovirals, before it elapses in 2016.

Uganda’s pharmaceutical industry

Quality Chemicals is currently the only Ugandan pharmaceutical company manufacturing generic HIV drugs in a joint venture with Cipla of India and Ugandan industrialists.

Moses Mulumba, director at CEHURD, said: “Uganda has major technological and infrastructural deficiencies for its indigenous pharmaceutical industry to be able to develop its own original antiretrovirals. This would require millions of dollars in investment and highly qualified researchers.”

Although he advised that Uganda could overcome these challenges through technology transfer arrangements with countries such as Brazil, China and India.

* UNAIDS report, May 2013