South Africa, Colombia and other countries battle drugmakers over access to TB and HIV drugs | Associated Press

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CAPE TOWN, South Africa (AP) — South Africa, Colombia and other countries that have lost out in the global race for coronavirus vaccines are taking a more combative approach toward drugmakers and pushing back against policies that deny cheap treatment to millions of people with tuberculosis and HIV.

Experts see it as a change in how these countries deal with pharmaceutical giants and say it could trigger more efforts to make life-saving drugs more widely available.

In the context of the COVID-19 pandemic, rich countries purchased most of the world’s vaccines early, leaving few vaccines for poor countries and creating a disparity that the World Health Organization has called “a catastrophic moral failure”.

Today, poorer countries are trying to become more self-reliant “because they realized after COVID that they couldn’t rely on anyone else,” said Brook Baker, who studies access issues. treatments at Northeastern University.

One target is a drug, bedaquiline, used to treat people with drug-resistant versions of tuberculosis. The pills are particularly important for South Africa, where tuberculosis killed more than 50,000 people in 2021, making it the country’s leading cause of death.

In recent months, activists have protested Johnson & Johnson’s efforts to protect its patent on the drug. In March, tuberculosis patients petitioned the Indian government, demanding cheaper generic drugs; the government finally agreed that J&J’s patent could be broken. Belarus and Ukraine then wrote to J&J, also asking it to abandon its patents, but without much response.

In July, J&J’s patent on the drug expired in South Africa, but the company had it extended until 2027, angering activists who accused it of profiteering.

The South African government then began investigate the company’s pricing policy. The country paid about 5,400 rand ($282) per treatment, more than twice as much as poor countries that obtained the drug through a global effort called the Stop TB partnership.

In September, about a week after the South African investigation began, J&J announced that it would abandon its patent in more than 130 countries, thus allowing generic manufacturers to copy the drug.

“This addresses any misconceptions that access to our medicines is limited,” the company said.

Christophe Perrin, a tuberculosis expert at Doctors Without Borders, called J&J’s turnaround a “big surprise” because aggressive patent protection was usually the “cornerstone” of pharmaceutical companies’ strategy.

Meanwhile, in Colombia, the government said last month it would issue a compulsory license for Dolutegravir, drug against HIV without the permission of the drug’s patent holder, Viiv Healthcare. The move came after more than 120 groups called on the Colombian government to expand access to the WHO-recommended drug.

“This is Colombia taking the reins after the extreme inequity of COVID and challenging a major pharmaceutical company to guarantee affordable AIDS treatment for its population,” said Peter Maybarduk of the advocacy group Public Citizen in Washington. He noted that Brazilian activists are pushing their government to take a similar step.

Yet some experts say there is still much to do before poorer countries can produce their own medicines and vaccines.

When the coronavirus pandemic hit, Africa was producing less than 1% of all vaccines manufactured globally, but was using more than half of the world’s supplies, according to Petro Terblanche, chief executive of Afrigen Biologics. The company is part of a WHO-backed effort produce a COVID vaccine using the same mRNA technology as those made by Pfizer and Moderna.

Terblanche estimates that about 14 million people died of AIDS in Africa between the late 1990s and the 2000s, when countries could not obtain the necessary drugs.

At the time, President Nelson Mandela’s government in South Africa finally suspended patents to allow wider access to AIDS drugs. This prompted more than 30 drugmakers to take the matter to court in 1998, in a case dubbed “Mandela v. Big Pharma.”

Doctors Without Borders described the episode as “a public relations disaster” for the pharmaceutical companies, which dropped the lawsuits in 2001.

Terblanche said Africa’s past experience with the HIV epidemic has been instructive.

“It is not acceptable for a listed company to hold intellectual property that prevents saving lives and so we will see more countries fighting back,” she said.

Challenging pharmaceutical companies is just one part of ensuring Africa has equal access to treatments and vaccines, Terblanche said. Stronger health systems are essential.

“If we can’t get (vaccines and medicines) to the people who need them, they’re not useful,” she said.

Yet some experts have pointed out that South Africa’s intellectual property laws have still not been sufficiently amended and make it too easy for pharmaceutical companies to acquire patents and expand their monopolies.

While many other developing countries allow legal challenges to a patent or patent extension, South Africa has no clear law that allows it to do so, Lynette Keneilwe Mabote said. Eyde, a health care activist who consults for the nonprofit Treatment Action Group.

South Africa’s Department of Health did not respond to a request for comment regarding drug procurement and patents.

Andy Gray, who advises the South African government on essential medicines, said J&J’s recent decision not to enforce its patent may have more to do with limited future revenues from the drug than bowing to market pressure. activists.

“As bedaquiline will never be sold in large quantities in high-income countries, this is the kind of product they would like to get rid of at some point and perhaps earn a royalty,” said Gray, a master of lectures in pharmacology at the University. of KwaZulu-Natal.

In his annual report on tuberculosis Published earlier this month, the World Health Organization said more than 10 million people fell ill last year and 1.3 million died. After COVID-19, tuberculosis is the deadliest infectious disease in the world and is now the leading cause of death among people living with HIV. The WHO noted that only 2 in 5 people with drug-resistant TB are treated.

Zolelwa Sifumba, a South African doctor, was diagnosed with drug-resistant tuberculosis in 2012 while she was a medical student and endured 18 months of treatment taking about 20 tablets each day in addition to daily injections, making her left her in “tremendous pain” and caused some hearing loss. Bedaquiline was only rolled out as standard treatment in South Africa in 2018.

“I wanted to stop (treatment) every day,” she said. Since his recovery, Sifumba has campaigned for better treatment for tuberculosis, saying it makes no sense to charge poor countries high prices for essential medicines.

“TB is everywhere, but the burden is in low- and middle-income countries,” she said. “If low-income countries can’t get it (the drug), then what’s the point? Who are you making it for?”

Cheng reported from London.

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