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Q&A: South Africa's AIDS treatment battle

A landmark court case between the South African government and the world's leading drugs companies has been withdrawn after the pharmaceutical industry abandoned its battle against a law that allowed for the use of cheaper, generic versions of patented AIDS drugs.

Q: What is the argument about?

A: The drugs companies say that the court action is not about price, but about protecting patents. The industry says that, "the case is nothing to do with blocking access to medicines, or price fixing. It's about patents. Patents do not block medicines. They stimulate research and development."

Q: What is the Medicines and Related Substances Control Act?

A: It was passed in 1997 by Nelson Mandela, the former South African President, which gives the government power to ignore patent protection on any pharmaceutical product where the health minister “considers it appropriate.”

Q: And that is bad?

A: For drug companies it is. Mirryena Deeb, the chief executive of the Pharmaceutical Manufacturers' Association of South Africa, has said: "If this type of legislation was applied to any other type of industry infringing their commercial rights it would be regarded as a form of nationalisation and they would pack up and go."

Q: How serious is the AIDS epidemic in Africa?

A: Africa accounts for 70 per cent -- 24.5 million people -- of the worldwide HIV-AIDS population. More than four million people in S. Africa HIV or AIDS sufferers. According to the Red Cross, AIDS will kill more people in sub-Saharan Africa over the next decade then have died in all the wars of the 20th Century combined.

Q: What are the main AIDS and anti-HIV drug treatments available?

A: The current treatment involves a cocktail of three anti-viral drugs that does not cure the disease, but they do keep it at bay. The first drugs developed to combat HIV were AZT (also called zidovudine or Retrovir), ddI (didanosine or Videx) and ddC (zalcitabine or Hivid).

Q: How much do they cost?

A: Patented drugs cost around £7,000 to £10,000 per patient per year ($10,500 to $15,000), while cheaper generic drugs, from Brazil or Thailand for example, cost £150 ($200) per patient per year.

Q: Why is the cost so high?

A: Due to the expense of discovering, testing and marketing (to bring a new drug to market typically costs £300-£500 million -- $450-$750 million).

Q: What could they cost?

A: South Africa says drugs such as the antibiotic Ciprofloxican costs its public health sector 52 pence (76 cents) per pill and the country's private health care providers more than £3 ($4.5) a tablet. If the new law is implemented, a generic of the drug could be imported from India for just four pence (six cents) per pill.

Q: Are the generic drugs as safe as their patented counterparts?

A: Properly produced, generics should be safe and effective, because they should be chemically identical to the originals. However, the Third World is flooded with fake drugs which look like the real thing but are completely ineffective.

Q: What is the importance of this case to other developing countries?

A: Other developing countries may now follow South Africa's lead, such as Brazil, India, Ghana, Uganda and Kenya.

Q: What, if at all, is the risk to the drugs industry?

A: The companies say the act puts the future of the pharmaceutical industry at risk, threatening the profits that allows it to create and test new drugs. While the industry has offered donations of AIDS and HIV drugs to South Africa, it says it is not prepared to allow a government to pass legislation that undermines the principle of patents.

AIDS drugs case adjourned
April 18, 2001
Harvard drafts plan to get AIDS drugs to Africa
April 4, 2001
South Africa in AIDS drug fight
March 9, 2001

South African Government
Oxfam International
HIV/AIDS Treatment
Medicines and Related Substances Control Amendment Act (S. Africa)

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4:30pm ET, 4/16

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