Canada's plan to supply cheap antiretroviral
drugs to poor countries has failed. Everyone —
doctors, politicians, analysts, activists — knows
it. And they all agree the well-intentioned program
needs a major reality check.
"We have failed lamentably," said
Stephen Lewis, UN Special Envoy for HIV/AIDS in Africa,
at the recent International AIDS Conference in Toronto.
"Exhibit A is not a single pill has flowed through the
system and got to the people who need it," added Health
Minister Tony Clement at the same event. A review of
the plan was scheduled to take place in 2007, but Mr
Clement deemed that timeframe "unacceptable." "I have
ordered an immediate top-to-bottom review of the legislation,"
he announced.
A
GENERIC CRISIS
The problem with the plan is that it just assumes generic
drug-makers will supply medications out of the goodness
of their own hearts, according to Richard Elliott, director
of policy and research at the Canadian HIV/AIDS Legal
Network, an advocacy group. "They are commercial enterprises,"
he told the Ottawa Citizen. "For it to be economically
worth their time and effort, they need economies of
scale." So far only one Canadian generic drug firm,
Apotex, has taken them up. The company has produced
a generic triple antiretroviral which they hope to sell
to Doctors Without Borders for about 38 cents a pill.
The transaction is currently being held up by licensing
red tape.
There are other holdups too. To
prevent the drugs ending up on the black market, generics
have to change the look of the pills, which is more
complicated than it sounds. "You have to show the new
coating still dissolves properly in the stomach and
that the chemical compound of the drug doesn't change,"
explained David Windross, spokesman for generic drugmaker
Novopharm, in an interview with the Toronto Star. "It
just adds another layer of research." And that narrows
the profit margin even more. Most analysts think the
only way to break the gridlock is for Canada to offer
the generic companies financial incentives to undertake
this work. Tony Clement says the government will consider
it.
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Canada's
AIDS relief plan
What is it?
Canada's Access to Medicines Regime came into
effect on May 14, 2005. It's a law that allows
generic pharmaceutical companies to supply, under
very strict conditions, still-patented drugs at
a very low price to third world countries. Though
it also deals with TB, malaria and other diseases,
its main focus is HIV/AIDS.
How it works
In order for a nation to receive cheap generic
drugs under the Regime, it has to be on Canada's
list of eligible countries and must have "little
or no capacity to manufacture drugs and medical
devices." The Regime also allows some NGOs to
act as the drug buyers, provided they use the
medicines in an eligible country. The generic
company must approach the patent-holders to obtain
a licence to produce their drug.
Safeguards
There are a few rules to prevent cheap generic
drugs from ending up on the black markets of the
developed world:
- Pills must be a different
colour than the brand name version.
- All tablets produced under
the Regime rules must be stamped "XCL."
- Medications must include
a tracking number and packaging must clearly
read "Not for sale in Canada."
For more information check out
the Regime's website: http://camr-rcam.hc-sc.gc.ca
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