Novartis a global healthcare company based in Switzerland recently signed a Memorandum of Understanding (MOU) with the Ministry of Health to supply the country with, among others, cancer drugs. The Independent’s Flavia Nassaka spoke to Dr. Nathan Mulure, Cluster Head Norvatis Social Business for East and Southern Africa during the Joint International Conference on Cancer and Palliative Care in Kampala.
Norvatis earlier this month signed an MOU with the Ministry of Health to supply drugs for Non-Communicable Diseases (NCDs). What are the details of this MOU?
We signed an MOU with the Ministry in June to introduce what we call Access Programme in Uganda. The programme comprises 15 molecules that treat hypertension, cancer, asthma and diabetes. We are offering these drugs at a cost of one dollar per treatment per month. They will be supplied through either National Medical Stores or Joint Medical Stores.
Apart from that, we are helping the ministry and faith-based hospitals to carry out capacity building activities like screening, creating awareness, and training healthcare providers in these disease areas. We based our decision on the fact that many people are sick and don’t know and even those who are aware of their status can’t afford treatment.
What specific drugs are we looking at and when do we get the first deliveries?
The first supplies will be delivered in December. We have not yet known what quantities the country will need for sure but I have asked NMS to do some quantification. For breast cancer we are offering Letrozole, Tamoxifen and Anastrozole, Amlodipine, Ramiprilab, for high blood pressure Valsartan, Hydrochlorothiazide and Bisoprolol, for diabetes Metformin and Glimepiride, and Salbutamol for asthma and Amoxicillin for pneumonia.
Currently, the big story in Uganda is fake drugs especially for cancer. What guarantee do you give us that we will only get quality?
The name ‘Norvatis’ means ‘new skills’. We have been in the business of pharmaceuticals for a long time and we are assuring people of high quality. Our drugs are manufactured in Europe and U.S. and they are FDA – Food and Drug Administration approved. In Uganda, our drugs have gone through NDA – National Drug Authority approvals. You need to know that counterfeits come about if drugs are very expensive and in trying to find alternatives for cheaper ones, people end up making ineffective products and sometimes harmful products. Counterfeits are criminal and shouldn’t be allowed to thrive in the market.
Research shows over 90% of prescriptions in Africa are of generic drugs than brand –name drugs. Does this pose any danger?
Norvatis has a very big generic division called Sandoz and is the second largest manufacturer of generics in the world. What is key really with generics is to ensure that there’s quality. Manufacturers should ensure that their generics are as good as the original products. When this is done then there is no danger at all.
Many companies, aid agencies and even government mainly focus on infectious diseases like HIV. Why are you focusing on NCDs?
More and more we are seeing that with many interventions going into infectious diseases, they are going down. For instance malaria deaths have generally reduced by 50% in the last ten years and for HIV we are seeing people living longer. But, as they live longer also other diseases set in. Actually the more you live the more you get prone to NCDs which is a reason we should start focusing seriously on these diseases. People are surviving malaria and HIV but are ending up with hypertension.
How do you rate Uganda’s potential as a healthcare market?
While it’s smaller compared to countries in the U.S. and Europe, the pharmaceutical sector for East Africa where Uganda belongs is very vibrant first because the region has a high population of about 100 million people now. Also it being in the tropics means there are many diseases that are communicable and non-communicable which means the market is there. What should be of concern now is sustainable supply and drug quality.
What strategies do you have in place to ensure that your drugs get market here with Uganda being a country that largely relies on medical donation?
We might see the demand of these drugs increasing in Africa with NCDs being on an increase. With our approach of Novartis Access we are aiming to achieve sufficient numbers to allow sustainability of the program.
Ours is not a donor funded program, but one designed to be self-sustaining. We believe that affordability will increase access and improve patient outcomes. Some of the drugs in the access program are beyond reach of many people when sourced from the private markets. In short we are opening the space for many patients to be able to afford such treatment that is otherwise beyond reach.
You introduced Coartem to this market and you are conducting a trial for another anti-malarial compound. Is Uganda one of the countries you are targeting?
We will soon launch a trial center in Tororo. It’s a new class of drug called KAF156 and is very different from existing ACTs. This has been developed by Novartis and Medicines for Malaria Venture (MMV) imidazolopiperazines, a new class of antimalarials. The first trial center is operational in Mali. KAF156 has potential to be a game-changer in malaria elimination, rapidly clearing malaria infection, including resistant strains, and blocking parasite transmission – making it a possible future first line therapy for the prevention and treatment of malaria. KAF156 is fast-acting and potent across multiple stages of the parasite’s lifecycle, rapidly clearing both P. falciparum and P. vivax parasites from the blood and the liver.
The initial trials were done in Asia and Australia. This is phase two where we’re focusing on Uganda, Kenya and Mali. In total we will establish 17 sites across in 9 countries in Africa and a total of 500 participants. The trial has already started in Mali.
Lastly, how are pharmaceuticals like Norvatis tackling drug resistance?
Resistance is of big concern; especially for antibiotics and anti-malarials. That’s why we developed combination therapy for malaria. Initially there was monotherapy like chloroquine, quinine, and the rest but we realised if that trend continued we were going to lose a lot of drugs along the way. So we decided to combine and have two drugs in one pill so that if a parasite develops resistance to one the other would knock it out. That’s why our drug coartem has been in the market for over 16 years now and is still effective because its combination therapy.