HIV : more than half of patients now have access to treatment

Never before have so many people had not received treatment for HIV. On the 36.7 million patients living with the human immunodeficiency virus (HIV), 19.5 million had access to antiretroviral therapy by 2016, reports the world health Organization (WHO), on Friday. This is the first year that more than half of the patients affected by this disease benefit from drugs ad hoc. Nothing in 2016, 2.4 million additional people could be brought under treatment, reports Unaids. In Africa, the continent most affected, the distribution of treatments for hiv-positive people has increased, but the rate of follow-up different depending on if it is the Africa of the West (35%) or to the East and South of the continent (60%).

This trend is explained by an increase in the number of diagnoses, with an improvement of the support of the health systems. But also by agreements, such as those passed in 2015 between Unaids and Roche to lower the price of the diagnostics in the developing countries, where the prevalence of the virus is strong especially in Africa. More broadly, the strategy of the pharmaceutical laboratories leaders in HIV has boosted the availability of treatment. In recent years, they have spent many agreements with the ” génériqueurs “, giving them access to the patents of their drugs.

BMS, one of the main leaders in this field, has begun to grant licenses, as of 2006, for atazanavir in India and South Africa. New agreements have been reached then for the developing countries. Then the drug has been licensed in the Medicine Patent Pool in 2013, a public health organization supported by the United Nations, to be broadcast in 110 countries, of which a large part of the developing world. A policy also adopted by ViiV, a joint venture of GSK, Pfizer and Shionogi. For countries with low GDP, and in particular in sub-saharan Africa, ViiV has made partnerships with “génériqueurs” and the organization Medicines Patent Pool for its dolutegravir in 121 countries in total, in July 2015.

Calls for tender are carried out by the States, which can potentially lower the prices proposed by the “génériqueurs” competition. Thus, Kenya became the first african country to be in June 2017. The dolutegravir will be, in a first time, available to people who are unable to cope with the side effects of another treatment. The cost of a box of 30 pills goes to 4 dollars, compared to 25 to 50 dollars before. Africa sees the dolutegravir arrive on the market, three years after Europe and the green light from the european medicines Agency in January 2014.

Gilead, which has carried out the same types of partnerships, estimates that in 2011, two million patients in the countries of the south were to be treated with patented drugs Gilead, against ten million in 2016.

“Learning the lessons of the past”

“We tried to learn the lessons of the past. Patents are necessary, they fund the research, but they should not be a barrier to access to medicines in low-income countries”, explains to La Tribune Michel Joly, president of the Gilead France.

The latter refers to a snub historic for the pharmaceutical industry, which occurred in the 1990s. Under the presidency of Nelson Mandela, South Africa had “broken” the patent of the drug companies to allow “génériqueurs” to manufacture anti-HIV therapies, so that they are marketed less expensive. The pharmaceutical industry had launched a lawsuit against the State, accusing it of undermining the exclusivity on their drugs, and then had to give it up.

The laboratories now prefer to try to control the market by agreeing to allow generic drug manufacturers to dispose of their patents. Because if they try to maintain the exclusivity of their drugs in developing countries, these could be function of compulsory licenses, a right given to the State to use the patent without the agreement of the laboratory holder in the event of a health emergency. This allows the manufacture of generic cheaper than the original molecule, considering its vital importance to public health. In addition, with these agreements with the ” génériqueurs “, a laboratory as Gilead avoids the infringement by asking its partners, ” génériqueurs “, “to produce tablets in a color and a different shape”.

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