Activists responded today to a Dominican generic pharmaceutical company¹s launch of generic versions of the anti-HIV drugs indinavir and AZT+3TC. The Dominican Republic and Haiti together account for 85% of the Caribbean¹s HIV cases. The Caribbean is the region of the world hardest hit by HIV after sub-Saharan Africa.
Local drug patent laws in the Dominican Republic have long been the target of intense pressure from the US Trade Representative (USTR) and the US pharmaceutical industry. AIDS activists warn that increased pressure or threat of trade sanctions from the US government in response to the production of these pharmaceuticals will effectively block the availability of lowest cost, life-extending medication in the Dominican Republic and the rest of the Caribbean.
"Generic competition can cut HIV drug prices dramatically. Use of WTO-legal safeguards like compulsory licensing and parallel importing are important strategies for increasing access to AIDS drugs in poor countries," said Asia Russell of the Health GAP Coalition. "If the US has its way, these strategies will never be fully exploited in the Dominican Republic or the rest of the Caribbean. Poor people with AIDS will be have to depend on the unreliable, unprolific force of drug company charity when they need drugs to extend their lives and are too poor to pay top dollar."
The Dominican government passed a new industrial property law in 2000, which contains provisions protecting the use of safeguards such as compulsory licensing of patented pharmaceuticals. The USTR, working in concert with US pharmaceutical industry, has placed the Dominican Republic on the USTR Special 301 Watch List every year since 1998. (Placement on this list is a harbinger of increased trade pressure.)
"Production from one local company in the Dominican Republic is a first step toward replicating what is happening among generic manufacturers in other parts of the world, where competition is exerting dramatic pressure on drug prices. If the US does not abandon its pressure campaign against the Dominican Republic, they will face the opposition of access activists from the US and around the world," said Julie Davids of Health GAP.
"The prices must come down even lower than what has been announced today by Rowe [the local generic manufacturer]‹and we believe they can," said Mark Milano of Health GAP. "Generic competition and countries¹ use of WTO-legal safeguards will help make that happen. If US pressure rules the day in the Dominican Republic, high prices will continue to keep drugs out of reach of poor people with AIDS in the Caribbean."
AIDS drugs have been available from multinational drug companies in the Dominican Republic, but at prices unaffordable to virtually all Dominicans with AIDS‹400% higher than the prices for generic versions launched today (US$260 per person per month for AZT+3TC and indinavir).
Activists claim that the US is using other settings in addition to bilateral pressure to obstruct access to affordable drugs‹in the Dominican Republic and other poor countries‹through negotiations on the Free Trade Area of the Americas (FTAA), the free trade pact for the Western Hemisphere, and through the WTO Council on the TRIPS agreement (Trade Related Aspects of Intellectual Property Rights). At the most recent TRIPS Council, many rich and poor countries asserted that current interpretations of WTO agreements on patent protection create drug access problems for poor countries. The US, however, stood almost alone in opposition to this view, insisting that patent monopolies for life extending drugs cause no access problems in poor countries.
According to activists, the current US position on FTAA would create drug patent protection even more stringent than currently required by World Trade Organization rules, and would undermine efforts to create sustainable access to affordable AIDS drugs in the Dominican Republic, Brazil, Argentina, and other Latin American countries with capacity for local generic drug production.
"The current US FTAA position would hobble efforts in Dominican Republic to get affordable life extending drugs to poor people with AIDS," said Sharonann Lynch of Health GAP and ACT UP New York. "The US must be stopped from using the FTAA to leverage increased patent protection on desperately needed treatments."