HIV/AIDS Drug Deal in Ukraine Promotes Multinationals, Ignores Cheaper Generics That Could Treat More People

Kyiv, May 24, 2002 — The international medical aid organization Doctors Without Borders/Médecins Sans Frontières (MSF), together with the non-governmental organization the All Ukrainian Network of People Living with HIV/AIDS, today criticized an agreement between four multinational pharmaceutical companies and the Ukrainian government to reduce prices of drugs to treat HIV/AIDS patients. MSF and the Ukrainian aids activists called upon the government to improve access to the most affordable HIV/AIDS drugs by swiftly registering generic versions and allowing them on the Ukrainian market.

The companies involved in the agreement (GlaxoSmithKline, BristolMeyersSquibb, Boehringer Ingelheim and Merck) agreed to provide a 70-87% discount on the price of specific HIV/AIDS medicines (antiretrovirals), which normally cost between US$5,000 to US$9,000 per patient per year.

However, generic drugs (copies of the original patented product) are offered at prices six times below the agreed discount levels of the multinational pharmaceutical companies. A combination of the drugs zidovudine, lamivudine, and nevirapine would cost US$1,700 under the recent agreement, whereas a similar combination by a generic manufacturer has been offered at US$300 per patient per year. "This will ensure access to treatment for almost 6 times as many patients as under this agreement," says Dr. Joost van der Meer, MSF country coordinator in Ukraine. "Although Ukraine made big improvements in the treatment of HIV/AIDS over the past years, we are disappointed by this deal and worried that in the end not enough people with HIV/AIDS are getting treatment.' The average monthly income per person in the Ukraine is approximately US$60.

The role of generic manufacturers has been recognized by UNAIDS and the WHO. However, in Ukraine the UN stepped away from supporting generic competition and representatives of generic companies have not been invited to take part in the negotiations. This recent agreement was made within the framework of the UN Accelerated Access Initiative (AAI), meant to improve access to treatment. MSF and the Ukrainian NGO call on the UN in Ukraine to take a real leadership role to ensure access to essential HIV medicines rather than brokering an inadequate deal. "Experience in other countries has shown that true market competition between generic companies and the other manufacturers has brought down prices for HIV/AIDS drugs much more than closed-door deals between governments and individual pharmaceutical companies," says van der Meer.

Ukraine has one of the fastest growing numbers of HIV infections worldwide. According to UN estimates, since 1995, 300,000 people (1% of the adult population) were infected with the virus, the highest rate in Europe and the former Soviet Union. MSF is involved in a program in southern Ukraine to prevent the transmission of HIV from mother to child, and is expanding its work to care and treatment for people with HIV/AIDS, including treatment of children with antiretroviral medicines. MSF works in partnership with the Ukrainian Ministry of Health and the All Ukrainian Network of People Living with HIV/AIDS.