Charlene Smith
South Africa has declined an offer by the Thailand government of free technology for the manufacture of 300 generic drugs that will cut prices for HIV medicines up to tenfold.
Thailand has pledged not to rest until every African country has generic drugs for HIV and has vowed to “ring South Africa with countries producing cheap drugs if it refuses to help its people”.
So says Dr Kirsana Kraisintu, the director of research and development for the Thailand Government Pharmaceutical Organisation. Attempts to obtain comment from the South African Department of Health were unsuccessful.
Zimbabwe will be the first country to begin manufacturing the generic equivalent of Fluconazole, a broad spectrum anti-fungal for use against thrush, to be followed in February by Ghana. Within weeks after that the first generic drugs are due to come offline in Cameroon, followed by Uganda and Nigeria.
The generic equivalent of Fluconazole sells at US13c a tablet almost a tenth of the pharmaceutical price.
Kraisintu, who has just returned from Zimbabwe, says she personally goes to each country to assess production capacity and capabilities. “Zimbabwe and Ghana have very good manufacturing capacity.”
She said that once the five countries had successfully manufactured Fluconazole, they would go on to produce anti-retrovirals such as DDI, AZT and 3TC.
Thailand first began researching the potential of manufacturing generic drugs for HIV-related ailments in 1992. In the past three years it has manufactured more than 300 different generic drugs at between a fifth and a tenth of the list price of multinational pharmaceutical companies.
Generic equivalents are manufactured for anti-retrovirals including Combovir, AZT, 3TC, nevirapine and Stavudine. Equivalents for Rifampicin, an essential medicine for the treatment of tuberculosis, and Ketonazole, used for treating fungal infections of the lungs and oesophagus, are also produced.
The Thai effort, which is directed toward some of Africa’s most populous countries, is likely to produce a revolution in drug accessibility and pricing. Although the prices of patented HIV drugs have dropped significantly over the past year, UNAids has warned that they still remain unaffordable for most Africans.
Kraisintu says Zackie Achmat of South Africa’s Treatment Action Campaign approached the Thai government to supply generic drugs to South Africa, “but as a government agency we cannot supply NGOs. We can only do this on a government-to-government basis. We transfer this technology free for humanitarian reasons. We charge nothing, there are no licensing fees.”
Kraisintu said South Africa has two problems. “One is that many anti-retrovirals, such as AZT, are patented in South Africa but not all drugs are patented there [South Africa]. Nonetheless there are ways of getting around some agreements.
“But, too, there is a lack of political will in South Africa. I am willing to transfer technology if South Africa gives the green light. They have a very good manufacturing infrastructure and if they made the request, they could begin rolling out generic drugs within six months.”
Kraisintu said: “We intend supplying drugs and providing manufacturing capacity to every country that surrounds South Africa, whether it is Zimbabwe, Namibia, Lesotho, Swaziland to ensure that one way or another the South African people can access medication. There will be 100-million HIV-infected people in the world by 2004.”