HIV patent pool hobbles as drug firms want India, China excluded

Efforts to bring together nine global drugmakers to pool their HIV patents in order to make available treatment to millions living with HIV/AIDS in the developing world seem to have faltered over a crucial issue — the inclusion of middle income countries such as India and China in the list of beneficiaries.

As reported by DNA Money on October 3, international humanitarian aid organisation Medecins Sans Frontieres (MSF) had launched a campaign calling on drugmakers such as GlaxoSmithKline, Johnson & Johnson, Gilead Sciences, Pfizer, Merck, Abbott, Bristol-Myers Squibb, Sequoia Pharma, and Boehringer-Ingelheim to join the patent pool of UNITAID, an international drug purchasing agency.

The idea was to create a mechanism whereby patents held by these companies could be pooled and made available to others for production, thus speeding up delivery of generic drugs for treatment of HIV/AIDS, as they could get produced well before the patent term expiry.

About 18 medicines were to be pooled, including atazanavir, abacavir, darunavir, lopinavir and nevirapine. In turn, the patent holders were to receive royalty from those using their patents.

The basic principle behind the pool was to include all developing countries, without discrimination. But now, according to people in the know, several drugmakers are opposing the inclusion of middle income countries such as India, China, Thailand, Philippines, Brazil, Chile, Argentina, Peru and South Africa, and want access to the pool limited only to the least developed countries.

According to a patent and healthcare expert tracking the pool, the UNITAID executive board, which is to meet next week, is planning to introduce an opt-out clause, which would give drugmakers the option of excluding middle income countries from the pool.
“If these clauses and demands are accepted, then patients in middle income countries will not be able to access cheap generic versions of patented HIV drugs,” says the patent and healthcare expert.

Says Leena Menghaney, project manager-India, MSF’s campaign for access to essential medicines, “If middle income countries are excluded, then the basic principle of the pool would stand defeated.”

“Middle income countries are where access to and scaling up of AIDS treatment has suffered as domestic generic production or importation of generics is seriously affected by the product patent regime,” says Menghaney.

Middle income countries introduced the product patent regime by 2005, while the deadline for the LDCs to introduce the regime is 2016. Thailand is one of the first middle income countries to have protested the exclusion, with Thai civil society groups sending a letter to the UNITAID executive board saying that bowing to the demands of the MNCs to decide which countries will benefit from the pool would amount to UNITAID turning its back on millions of people who are in desperate need of the medicines.

According to a report by the World Health Organisation, UNAIDS, and Unicef, over 4 million people in low and middle income countries were receiving antiretroviral therapy at the close of 2008. However, at least 5 million more still do not have access to treatment.