Letter from 65 NGOs to Leaders of the Branded Pharmaceutical Industry on the Pricing of Antiretrovirals in Non-OECD Countries

30 June 2003

Jean-Pierre Garnier
Chief Executive Officer
Glaxo Wellcome House
Berkeley Ave
Greenford, Middlesex
UB6 ONN, England

Miles D. White
Chairman of the Board and Chief Executive Officer
Abbott Laboratories
100 Abbott Park Road
Abbott Park, IL 60064-6400

Peter R. Dolan
Chairman and Chief Executive Officer
Bristol Myers Squibb Company
345 Park Avenue, New York, NY 10154-0037

Franz B. Humer
Chief Executive Officer
F. Hoffman-La Roche Ltd.
Group Headquarters
Grenzacherstrasse 124
CH-4070 Basel

John C. Martin, PhD
President and Chief Executive Officer
333 Lakeside Drive
Foster City, CA 94404

Raymond V. Gilmartin
Chairman, President and Chief Executive Officer
Merck & Co., Inc.
One Merck Drive
P.O. Box 100
Whitehouse Station, NJ 08889-0100

Rolf Krebs
Chairman of the Board
Boehringer Ingelheim GmbH
55216 Ingelheim am Rhein

Henry A. McKinnell, Ph.D.
Chief Executive Officer
Pfizer, Inc.
235 East 42nd Street
New York, NY 10017

Dear Sirs:

The World Health Organization estimates that there are 6 million people living with HIV/AIDS in the developing world and the former Soviet Union in acute need of antiretroviral therapy, yet only approximately 300,000 people are currently receiving treatment in these countries, with a majority of these people in one country, Brazil.

Although generic competition has been a critical factor in reducing the prices of antiretroviral drugs, most of the originator companies have responded by making significant price reductions for the developing world. However, the criteria and terms of these discounts vary from company to company. Some of these price reductions are limited to sub-Saharan Africa or the world's least developed countries (according to United Nations classification), while others depend on a formula that combines a nation's human development index score and its prevalence of HIV infection. Even if a country is eligible for a discount, the pharmaceutical manufacturers may put restrictions on the kinds of institutions that can take advantage of these prices. Furthermore, the terms and conditions of shipment, particularly the inclusion of transportation and customs costs, vary from company to company as well.

We are writing to ask for discounts and other concessionary offers to be extended to all countries, except those that are members of the Organization for Economic Co-Operation And Development (i.e. Australia, Austria, Belgium, Canada, Czech Republic, Denmark, Finland, France, Germany, Greece, Hungary, Iceland, Ireland, Italy, Japan, Korea, Luxembourg, Mexico, Netherlands, New Zealand, Norway, Poland, Portugal, Slovakia, Spain, Sweden, Switzerland, Turkey, United Kingdom, United States) and the exploration of further reductions in the prices of these life-saving medications to as close as possible to marginal cost of production. We are also asking that these price reductions be made available to all public and private institutions, including private clinics, pharmacies and employers that are committed to distributing these medications on a not-for-profit basis. Furthermore, standard international procurement procedures should be established for all discount and concessionary offers to allow rational drug supply management at the country level. Finally, all discounts and concessionary offers cannot be tied to the renouncement of countries' rights to parallel importing or compulsory licensing of generic medications as allowed under current trade regulations.

We would like to meet with you as soon as possible to discuss these requests. A more systematic, transparent approach to differential pricing would be an important step in facilitating wider access to antiretroviral therapy. With one price for all non-OECD countries, broad and uniform eligibility criteria for discounts and concessionary offers and standard international procurement procedures, it will be far easier for all countries and treatment initiatives, and importantly people living with HIV/AIDS, to obtain these drugs at a reasonable cost.

Yours truly,

  1. Darío Abarca, Coalición de PVVS de Ecuador, Ecuador

  2. Zackie Achmat, Treatment Action Campaign, South Africa

  3. Olayide Akanni, Journalists Against AIDS( JAAIDS), Nigeria

  4. Cyriaque Ako, Ivorian Network of PLWHA, Ivory Coast

  5. Pablo Anamaria C., Colectivo por la Vida, Peru

  6. Dato Ananiashvili, Georgian Plus Group, Georgia

  7. Chukwuemeka Anyamele, Center for the Right to Health, Nigeria

  8. Israel Asamoah, Ghana AIDS Treatment Access Group (GATAG), Ghana

  9. Snehansu Bhaduri, En-Joy/INP+, West Bengal, India

  10. Juan J. Carabajal, Agencia de Cooperación y Consulta en Desarrollo Social para América Latina, Argentina

  11. Cesar Castellanos, Dominican Network of PLWHA, Dominican Republic

  12. Enrique Chavez, Coordinadora Peruana de PVVS, Peru

  13. Polly Clayden, I-Base, United Kingdom

  14. Michaela Clayton, AIDS Law Unit, Legal Assistance Centre, Namibia

  15. Olive Edwards, Jamaican Network of Seropositives, Jamaica

  16. Sharon Ekambaram, AIDS Consortium, South Africa

  17. Jaime Fabrés, Grupo de Trabajo sobre Tratamientos del VIH (gTt), Spain

  18. Beverley Figaji, Walvis Bay Multi-Purpose Centre, Namibia

  19. Stuart A. Flavell, The Global Network of People Living with HIV/AIDS, Netherlands

  20. Eric Fleutelot, SIDACTION : Ensemble Contre le Sida, France

  21. Greg Gray, Asia-Pacific Network of People Living with AIDS, Thailand

  22. Mauro Guarinieri, European AIDS Treatment Group

  23. Derrick Hackett, Jamaica

  24. Mark Harrington, Treatment Action Group, USA

  25. Aruna J. Hewapathirane, Asia-Pacific Network of People Living with AIDS, Sri Lanka

  26. Masaki Inaba, Africa Japan Forum, Japan

  27. John S. James, AIDS Treatment News, USA

  28. Bruce Kilmister, Body Positive Inc., New Zealand

  29. Chan Chee Khoon, Citizens' Health Initiative, Malaysia

  30. James Kamau, Kenya Coalition for Access to Essential Medicines, Kenya

  31. Iris Irene Kavege, Espoir Vie, Togo

  32. Sandris Klavins, AGIHAS (PLWHA Support group), Latvia

  33. Svilen Kolev Konov, 'Plus and Minus' Foundation, Bulgaria

  34. Periasamy Kousalya, Positive Women Network of South India (PWN+), India

  35. Larry Kramer, USA

  36. Saban Laryea, Lynx Africare Network (LAN), Ghana

  37. Suzanne Lau-Gooey, Positive Women Victoria, Australia

  38. C.D. Carlos García de León, AVE de México/LACCASO, Mexico

  39. Konstantin Lezhentsev, International Harm Reduction Development Program of the Open Society Institute, Hungary

  40. Edward Low, Asia-Pacific Network of People Living with AIDS, Malaysia

  41. Kasia Malinowska-Sempruch, Iternational Harm Reduction Development Program of the Open Society Institute, USA

  42. Ambroise Mamona, Reseau National des Positifs(RENAP+) du Congo-Brazzaville, Congo Brazzaville

  43. Kevin Moody, Health Action International

  44. Idah Mukuka, Centre for Infectious Disease Research, Zambia

  45. Guillermo Murillo, Asociación Agua Buena, Costa Rica

  46. Grace Shileanga Muro, Pathfinder International, Tanzania

  47. Vladimir Musatov, Humanitarian Action/Botkin Hospital, Russia

  48. Kim Nichols, African Services Committee, USA

  49. Ana Oliveira, Gay Men's Health Crisis, USA

  50. Mr. Rama Pandian, Tamil Nadu Network of Positive People, India

  51. Sunil Pant, Nepal

  52. Rodrigo Pascal, Vivo Positivo, Chile

  53. Germán Humberto Rincón Perfetti, Lideres en Acción, Colombia

  54. Dr. E. Mohamed Rafique, Indian Business Coalition on AIDS, India

  55. Dr. Sai Subhasree Raghavan, Solidarity and Action Against the HIV Infection in India (SAATHII)

  56. Joe Selvaretnam, Malaysia

  57. Richard Stern, Agua Buena Human Rights Association, Costa Rica

  58. Lucia-Maria Stirbu, UNOPA (National Union of the Organisatios of the HIV/AIDS Affected People), Romania

  59. Raminta Stuikyte, Central and Eastern European Harm Reduction Network, Lithuania

  60. Paisan Suwannawong, Thai AIDS Treatment Action Group (TTAG), Thailand

  61. Tracy Swan, USA

  62. Pervaiz Tufail, Pakistan

  63. Vjatseslav Vassiljev, ESPO society (PLWHA), Estonia

  64. Dr. Venkatesan Chakrapani, Solidarity and Action Against the HIV Infection in India (SAATHII)

  65. Rachel Yassky, The Starfish Project, Center for Special Studies, New York Presbyterian Hospital, USA

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