Health Professional Students

AIDS Advocacy Network

Treat the People:Access to Essential AIDS

Medications

A Primer for Health Professional Students

The AIDS Advocacy Network:Drop the Debt, Treat the People,

Donate the Dollars

A network of health professional students dedicated to working together to stop the AIDS pandemic

Coordinated national and regional events throughout the year – in cooperation with other major organizations

www.amsa.org/global/aids

Background on the AIDS Pandemic

Worldwide, approx. 38 million infected

95% of people living with HIV reside in the developing world

Over 8,000 people die each day as a result of complications from AIDS

The epidemic is growing: in the last 2 years, the number of children infected has tripled from 1.3 Million to 3.2 Million.

Why are Essential AIDS Medications “Essential?”

Infections in prime economic and reproductive year

AIDS devastates not only individuals but families, communities, local economies

HAART treatment can reduce AIDS-related mortality

Less than 5% of those infected worldwide have access to these HAART

A treatment for AIDS is available…but not for everyone.

Barriers to Treatment

Lack of Funding Debt Service and

Effects of Structural Adjustment Programs

Health systems devastated by natural and man-made disasters

Access to Medications

Factors Affecting Access to AIDS Medications

Healthcare worker education Healthcare Infrastructure International trade policies Government importation policies User fees in primary care systems On-the ground costs of medicines Trade: Patents and trade regulations

keep AIDS medication prices high. We’ll talk about trade first…

Trade and Intellectual Property: Definitions and

History

Intellectual property and patents protect exclusive rights on such things as medications.

Promote R&D innovation because they will offer large monetary returns for such innovation.

Generic medication is “interchangeable” with original drug and produced without license from the originator.

Pills, Patents, and the Pandemic

Patents on AIDS drugs create monopoly conditions where prices are kept high because of lack of competition.

When generics are introduced, prices are reduced.

Because of lower prices, developing nations are beginning to be able to afford treatment for individuals living with HIV/AIDS.

Brazil: The Case for Generic Medications

In 1997, Brazil introduced a plan for universal treatment of HIV/AIDS.

Brazil decided to locally manufacture generic versions of patented medications.

The results:*50% decreased mortality from HIV*HIV incidence has leveled off since the introduction of the program*Government savings of $472 Million between 1997-1999, as a result of reduced hospitalizations and opportunistic infections.

US Government Use of Generics In Treatment Plans

President’s Emergency Plan for AIDS Relief (PEPFAR)Feb 20, 2004

•Expand prevention, treatment and care services bybuilding on existing programs; focus on prevention through abstinence•Identify new partners and build capacity for long-term success; •Amplify the worldwide response to HIV/AIDS by working through international partners, including the Global Fund to Fight AIDS, Tuberculosis and Malaria

http://www.globalhealth.gov/PEPFAR_factsheet_022304.shtml

Trade and Intellectual Property: Definitions and

History

So why doesn’t every country produce or import generic medications so they are able to afford to treat their populations?

One major reason is the enforcement of patents on AIDS medications.

Trade and Intellectual Property

The Players:• World Trade Organization (WTO)• PhARMA• World Health Organization (WHO)

http://www.ftaa-alca.org/alca_e.asphttp://www.who.int/en/ http://www.wto.org/

Trade Related Intellectual Property

Rights (TRIPS) In 1995, the WTO put TRIPS into effect. TRIPS regulates and enforces international

patents including those on drugs. TRIPS compliance deadlines:

*Already in effect for developed nations*2006 for middle-income nations such as Brazil and India (who currently produce many generic drugs)*2016 for least developed countries (LDCs)

TRIPS Continued

Does TRIPS compliance prevent access affordable generics?

Article 31 of TRIPS allows for “compulsory licensing”

“parallel importing”

http://www.wto.org/english/tratop_e/trips_e/trips_e.htm

TRIPS Plus

Why are developing nations not taking advantage of these tools?

US and other developed nations, encouraged by strong pharmaceutical lobbies, use bilateral pressure to force countries to become “TRIPS Plus” and eliminate some of the flexibility offered by the TRIPS agreement.

Example attempts to use generic medicines abroad: South Africa

BrazilThailand

The Doha Declaration

The Doha Declaration, adopted in Nov 2001, declares that “the TRIPS Agreement does not and should not prevent Members from taking measures to protect public health…in particular, to promote access to medicines for all.”

India Under Pressure to Stop Manufacturing Generic Drugs

US Trade Representative Wants India to Comply with TRIPS Plus

• According to the Doha Declaration, it is perfectly legal for India to manufacture generic ARV’s and still be compliant with TRIPS•The US Trade Representative is putting pressure on India to go beyond TRIPS and comply with TRIPS Plus•This would mean that India would not be able to produce new ARV’s generically due to the enforcement of “data exclusivity”

Where Does This Leave Us?

HIV is preventable…HIV/AIDS is treatable…

Yet 3 million people on our planet died of AIDS last year…

Eight thousand died yesterday…

15,000 more will become infected today…

World health organization statistics

What You Can Do: Today’s Action

Join AAN: Keep informed and active!Visit www.amsa.org/global/aids/

Visit www.fightglobalaids.org to find out more.

                                

Conclusion

Securing access to affordable AIDS medications is a crucial step in

stopping the global AIDS pandemic.

Our Future. Our Crisis.

Fight Global AIDS.

                                

http://www.accessmed-msf.org/index.asp