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Lower tariffs to fight AIDS
By Thompson Ayodele,
August 4, 2008
THIS week, 25,000 people from around the
world have gathered in MexicoCity for the 17th
International AIDS Conference.
Many discussions will focus on how best
to deal with AIDS in thedeveloping world. Looking to the
West - where scientific advances have allowed those with
HIV/AIDS to live long, comfortable lives - many
attendees will argue that pharmaceutical patents are the
main barrier to getting medicines to the poor. That
argument misses the true obstacle -local policies.
Consider tariffs. In some African
countries, duties and taxes on medicines drive the costs
through the roof.
In my home country of Nigeria, there's a
5 percent tariff on Imported Pharmaceutical Ingredients
(APIs). And all generic medicines imported into Kenya,
Uganda and Tanzania are subject to a 10 percent tariff.
The rate is34 percent in Nigeria, 40 percent in Sierra
Leone and a whopping 50percent in Kenya.
Government regulations also add to the
price of drugs. It takes the South African government
more than three years to grant regulatory approval for
medicines already available in developed countries. This
not only delays access, it closes off a market - and so
drives up drug prices all over the world.
On top of that, drug companies already
sell their drugs to poor countriesat prices well below
cost. Often, they're free. Just this
year,GlaxoSmithKline, Merck and Pfizer donated $450
million worth of drugs toBurkina Faso.
Then there's the lack of investment in
infrastructure. In 2000, numerousAfrican leaders signed
the Abuja Declaration, a pact to combat malaria.The
agreement called for 15 percent of every country's
budget to bedirected toward improving health care - yet
most countries that signed itspend less than 10 percent.
That means low wages and low morale for
health-care workers - and, ultimately, a loss of medical
personnel. Recently, the National Association of Nigeria
Nurses and Midwifes said over 300,000 nurses are needed
to fill positions in the nation's hospitals and clinics.
Add to that the lack of roads and
electricity in many poor countries, andyou start to see
why focusing on drug patents misses the point. Many
developing countries don't have the roads to transport
drugs to patients, nor the electricity to keep
temperature-sensitive AIDS medications refrigerated.
Kevin De Cock, director of the World
Health Organization's Department ofHIV/AIDS, recently
noted that the main barrier to essential medicines "is
not the current price of drugs. The real obstacle is the
fragility of the health systems. You have health
infrastructure that is dilapidated and supply chains
that do not exist."
Despite understanding these fundamental
problems, the WHO has backed aglobal treaty aimed at
weakening pharmaceutical patents and putting drug
research under government control. The treaty, known as
the Agreement on Trade Related Aspects of Intellectual
Property Rights (TRIPS), lets developing nations issue
"compulsory licenses" to legally override pharmaceutical
patents.
This practice of compulsory licensing
isn't just a distraction from ethereal issues: It also
threatens the safety of many AIDS patients.
Just look at India. As a result of
poor-quality knock-offs that don't have to pass the same
safety tests as their brand-name counterparts, drug
resistance is on the rise. As a New Delhi-based
pharmacist recently remarked, "We lack quality
infrastructure to test the quality and purityof drugs."
This problem extends far beyond AIDS
drugs. In May, the science journal
PloS One published a study showing that 35
percent of all malaria drugs in Africa are of
substandard quality. Such low-grade drugs provide no
medical benefit to patients and pose a serious health
risk.
If this week's conference is to have an
impact on the growing AIDSpandemic, the participants
need to get their priorities straight.Improving medical
infrastructure and lowering tariffs should be theirchief
concern - not weakening drug patents.
Thompson Ayodele is the executive
director of Initiative for Public PolicyAnalysis, a
public-policy think tank based in Lagos,
Nigeria(ippanigeria.org).
Thompson Ayodele
DirectorInitiative for Public Policy
Analysis
P.O.Box 6434
Shomolu, Lagos,
Nigeria
Email:thompson@ippanigeria.orgBackup:
thompsondele@onebox.com
Website: www.ippanigeria.org*****Good
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