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Big pharma problem for HIV/AIDS

By Henry Zakumumpa

Thousands of Ugandan lives at stake after generic HIV/AIDS drugs deadline extension snub

The lives of thousands of Ugandans enrolled on HIV treatment hang in the balance after an application by poor countries to extend the deadline for manufacture of generic AIDS drugs was rejected by the World Trade Organization (WTO) under a treaty known as Trade Related Aspects of Intellectual Property (TRIPS).

Over 90% of HIV drugs in Uganda are generic drugs manufactured mostly in India, according to Denis Kibira, a pharmacist and Medicines Advisor at HEPS-Uganda, a coalition of health and social development rights organisations.

Generic drugs are copies of drugs manufactured by brand names. Quality Chemicals, a Ugandan pharmaceutical company also manufactures generic drugs.

Globally, generic drugs-which go for only about a tenth of the cost of brand drugs-were a major enabling factor for the accelerating access to HIV treatment to the over six million people currently on treatment.

More than 1.6 million Ugandans live with HIV, with an estimated 300,000 currently enrolled on antiretroviral treatment in Uganda.

“The ability to access cheap medicines on the market will be curtailed and the fight against HIV/AIDS in Uganda may be lost if expansive trade laws are adopted without improving the incomes of Ugandans,” says Joshua Wamboga from TASO, an NGO that trains handlers of AIDS patients.

The initial deadline for the manufacture of generic HIV drugs was set to end in 2016 but an application by Haiti in November last year, on behalf of all poor countries, to extend it indefinitely, was rejected by the World Trade Organization which is dominated by rich industrialized countries where most patents for HIV drugs are held by large western multilateral giants such as Norvatis and Pfizer.

The World Trade Organization (WTO) insists it would only  allow the extension of the ban on generic drugs  for 5-7 years, which poor countries are opposed to arguing that they cannot build  pharmaceutical capacity for manufacturing original drugs within that period.

“This is unacceptable as the TRIPS Agreement states that upon a duly motivated request, the TRIPS council shall grant an extension. LDCs, to which Uganda is categorised, are justified in seeking an unlimited extension for so long as they are so classified because the suggested 5-7years will not give us adequate time to overcome capacity constraints to develop a viable and competitive technological base,” says Moses Mulumba, a director at the Center for Health, Human Rights and Development (CEHURD).

Civil society organisations working in the area of intellectual property rights and access to medicines in Uganda argue that the WTO is beholden to western interests. They have issued a letter to the WTO Council chair and Developed country Missions in Uganda to express their disapproval of the manner in which negotiations for the request to extend the time within which Least Developed Countries (LDCs) can enforce Trade Related Aspects of Intellectual Property (TRIPS) is being handled.

‘’It is infuriating to note that over the past few months, WTO has been chairing informal meetings between developed countries and least developed countries where LDCs have been pressed to agree to a shorter term of 5 – 7.5 years’’ says Primah Kwagala a lawyer with CEHURD.

About a quarter of the Ugandan population lives under the poverty line according to the Uganda Bureau of Statistics, and the majority cannot afford to buy brand drugs manufactured by western pharmaceutical companies to treat AIDS, malaria, and Tuberculosis-the three most important diseases in the developing world. With over 90% of Ugandans dependant on Indian generic drugs, outlawing these drugs would jeopardise millions of lives.

An extension of 5-7 years is not a long enough period to nurture the local pharmaceutical industry and for companies such as Quality Chemicals to develop original drugs to meet the local demand for medicines in Uganda. Millions of lives depend on the decision to extend this deadline and the WTO should exercise restraint by balancing the interests of western pharmaceutical giants with the public health and development needs of poor countries.

The writer is a PhD candidate at the School of Public Health Makerere University

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