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Improving Access to Medicines in African, Caribbean and Pacific countries
Lynette MaboteProgrammes LeadAIDS and Rights Alliance for Southern Africa (ARASA)
117 partners working in 18 countries in South •and East Africa to promote a rights-based response to HIV and TB
03/2017 AIDS & Rights Alliance for Southern Africa
Who are we?
PLHIV (21%) AIDS service organisations and others (22%)
LGBTI (17%) Legal aid providers / Human rights (15%)
Youth, children & other inadequately served populations (inc. people with disabilities) (11%)
People who use drugs / Harm reduction (6%) Sex workers (6%)
Prisons (2%)
ARASA partners per constituency (12/ 2016)
Some of the URGENT issues:
Policy incoherence among human rights obligations, intellectual •property and international trade and investment regimes.
Access gap of Lower Middle Income Countries (LMICs) •= Millions of people in CPA countries still in need of treatment, but unable to afford it. E.g. Slow responses to neglected diseases such as Tuberculosis, recent Ebola and Zika virus experience
Global health funding for urgent tropical, non-communicable and •communicable disease concentrated on “disease Hotspots” in these regions, leading to weak health systems
TRIPS and the Doha Declaration disrupting the high cost of essential •medicine through flexibilitites
Dramatic reduction in the price for generic first-line treatment compared to originator drug
www.msfaccess.org/sites/default/files/HIV_report_Untangling-the-web-18thed_ENG_2016.pdf
The effects of generic drugs affecting the originator price
The HIV Challenge today
3.3 million children living with HIV •today and only 32% receive antiretroviral therapy (ARV).
Need for innovation: e.g. “ More •Fixed-dose combinations that are easy to use”37 million need
treatment
17 million are on treatment
Global Impact of Tuberculosis
www.stoptb.org/assets/documents/resources/factsheets/Stop%20TB%20infographic%20Missing%203%20Million.pdf
Spotlight on West and Central Africa
http://www.msf.org/sites/msf.org/files/2016_04_hiv_report_eng.pdf
Spotlight on West and Central Africa
Facing a Triple burden of resistance
Tuberculosis:TB remains the leading killer of people with HIV, causing one in three•AIDS-related deathsTwo new drugs to treat tuberculosis—the first in over 50 years, were •conditionally approved for use in 2016Only 2% of the 150,000 people who need them have access•
Antiretrovirals & TB medicines:The cost of 2nd and 3rd line treatment often many times more •expensive
Antimicrobial resistance (AMR) is an “intractable global problem” we need a sustainable solution to fight AMR
Resistance to Antibiotics, need for 2nd& 3rd generation ARVs, MDR- and XDR-TB
Growing Non-Communicable Disease (NCD) burden
Lower Middle Income Countries (LMICs) bear nearly 80% of the burden•from NCDs like cardiovascular disease, diabetes, cancer and chronic respiratory diseases
More than two thirds of all cancer deaths occur in Caribbean, Pacific •and Africa (CPA) regions
Costs of some treatments can be prohibitive, especially for •cancer
USD 40 000 for a year’s treatment of Trastuzumab for breast •cancer;USD 31 000, for colorectal cancer;•USD 75,100 for metastatic melanoma; most aggressive form of •cancer (skin cancer)
A recent study found that cost of cancer care was set to rise at •up to 10.5% annually until 2020
What changed to make treatment more
affordable?
03/2017 AIDS & Rights Alliance for Southern Africa
Doha Declaration adopted by WTO Member states in 2001:
“We agree that the TRIPS Agreement does not and should not prevent members from taking measures
to protect public health.
“Affirm that the Agreement can and should be interpreted and implemented in a manner
supportive of WTO members' right to protect public health and, in particular, to promote
access to medicines for all.”
Impact of TRIPs since 2001
Changed environment post TRIPS-era•Compulsory licensing•
Thailand => EFV price 1400 Baht (45$) to 615 Baht (19$) a bottle. Brazil => EFV 77% price drop => increase of patients from 23.300 to 75.000
Some Least Developing Countries (LDC’s) have used “government •use” powers to procure genericsSome LDC’s excluded product patents when patented in their •context
India – strict patentability criteria: 15 Patent-grant oppositions •related to AIDS medicines by Indian civil societyNewer products patented in developing countries•
Prices will not come down automatically•IP barriers to FDC development•
Deliberate action taken to counter the consequences of global pharmaceutical patenting
17 years on…Urgent Responses to the failure of the
patent-drive Access
system…
03/2017 AIDS & Rights Alliance for Southern Africa
On 1 July 2016, the 32nd session of the Human Rights Council (HRC) adopted a far-reaching resolution on access to medicines which provides the Human Rights Council a strong mandate to examine the relationship between international trade agreements, intellectual property rights obligations and their implications on access to medicines - through the prism of human
rights. [A/HRC/32/L.23/Rev.1]
“We recognize that intellectual property protection is important for the development of new medicines. We also recognize the concerns about its effects on prices.”
Human Rights Council Resolution on Access to Medicines, 2016 [i]
03/2017 AIDS & Rights Alliance for Southern Africa
Concerned also that the increasing incidence of non-communicable diseases constitutes a heavy burden on society…
Recognizing the urgent need to improve accessibility to safe, affordable, efficacious and quality medicines and technologies to, diagnose and to treat non-communicable diseases, to strengthen viable financing options, and to promote the use of affordable medicines, incl. generics, as well as improved access to preventive, curative, palliative and rehabilitative services, particularly at the community level [Emphasis added]
Human Rights Council Resolution on Access to Medicines, 2016 [ii]
03/2017 AIDS & Rights Alliance for Southern Africa
Reiterates the call upon States to collaborate on models and •approaches that support the de-linkage of the cost of new research and development from the prices of medicines, vaccines and diagnostics for diseases that predominantly affect developing countries, including emerging and neglected tropical diseases…to ensure sustained accessibility, affordability and availability and to ensure access to treatment for all those in need;
Calls upon States to promote access to medicines for all, •including through the use, to the full, of the provisions of the Agreement on Trade-Related Aspects of Intellectual Property Rights which provide flexibility for that purpose…
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Role of Members of Parliament & Recommendations to this Joint-Assembly
As African civil society, we call on this House to:
Support the Human Rights Council and other U.N bodies in promoting a 1.rights-based access to medicines, vaccines and diagnostics agenda for diseases that predominantly affect developing countries
Show fierce commitment such as the Global TB Caucus and the Barcelona 2.Statement; which is calling on the End to Tuberculosis
Championing the Call to Action for “ending deaths as a result of 3.expensive medicines” at international, regional and domestic level
through; Developing a Consensus statement to be signed by Members of Parliament,
globally on Intellectual Property and Access to Medicines, calling for the de- linkage of the cost of new research and development from the prices of medicines, vaccines and diagnostics for diseases that predominantly affect developing countries
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Thank you for listening
Lynette MaboteRegional Programmes Lead, AIDS and Rights Alliance for
Southern Africa Tel: +27 21 447 2379Fax:+27 21 447 1972
Email: [email protected]:LynetteMaboteTwitter:@_ARASAcomms
Photo courtesy of Treatment Action Campaign
