Twenty years ago, Hazel Tau, a young South African living with HIV, and her friends were unlikely to receive antiretroviral (ARV) treatment because it was totally unaffordable.
The South African price of just one of the three ARV drugs she needed, AZT, was 665% higher than the most expensive generic available elsewhere in the world.
Only about 20,000 South Africans with private health care were on ARVs at the time because of the price.
So Tau, an activist with the Treatment Action Campaign, agreed to be one of the public faces of an ARV price challenge – shrewdly filed as a complaint to the Competition Commission alleging that two pharmaceutical companies were charging excessive prices for front-line products. ARVs.
At the time, then-President Thabo Mbeki disputed that HIV caused AIDS and claimed that ARVs were poison. It was therefore useless to pressure the government to act on drug prices.
The targets were GlaxoSmithKline South Africa and Boehringer Ingelheim, with Tau and others claiming to have breached the country’s competition law by abusing their dominant position in the ARV price market.
Mapato Ramakgopa of the SA Competition Commission explained that the commission agreed with Tau and others, and had sought an order from the competition court to compel companies to grant voluntary licenses to allow generic manufacturers to manufacture genetic ARVs in exchange for a reasonable fee.
“It was found that the companies had abused their dominant position in the market and fortunately, before the case could be heard in court, the manufacturers settled the case and agreed to allow licenses for the generic and local manufacturers,” Ramakgopa said.
“It was a bittersweet experience because of all those who could not be saved,” Tau said, speaking at a memorial event on Thursday.
“I lost friends, family, colleagues. We have lost millions of breadwinners. But I will say that I was happy with the result.
Finally, she and others could look forward to a life with access to affordable treatment. But Tau’s fight for access to treatment continues today as she fights for cheaper cancer drugs.
“We know that in developed countries they have cheaper drugs that can help people with different types of cancer, but we still have to pay, so I don’t feel good about that,” Tau said. .
She also still fights the stigma faced by people living with HIV – and says it’s time for stand-alone HIV clinics – largely through special HIV funding – to be integrated into care settings. to spare those in need of HIV care. to be visible when they go for treatment.
“I blame us for having this HIV clinic. I wish HIV had been treated like other chronic diseases, normally without saying ‘it’s an HIV thing’ because the stigma started there,” Tau says.
Speaking on World AIDS Day, Tau said she pays tribute to the deceased and those newly infected and wants AIDS awareness campaigns to be active every day.
Access to affordable medicines
Access to affordable medicines continues to haunt people in the poorest countries, as shown by the COVID-19 pandemic when millions of people in low- and middle-income countries were unable to obtain vaccines because these had all been bought by rich countries.
The issue of intellectual property (IP) rights to essential medicines is as hot today as it was in the days of AIDS.
Fatima Hassan, director of the Health Justice Initiative (HJI), was one of the lawyers representing Tau and others — and more recently campaigned for wider access to COVID-19 vaccines and treatments.
“The reason we brought the case is because we saw the ‘Lazarus’ drugs. We’ve seen them work for people in the United States. We saw them working for people in Europe,” Hassan said.
“We have seen what Brazilian and Thai activists are doing to try to put in place mandatory measures for their governments to introduce generic therapies in their countries. But our government had none of that. He was in denial of science and he refused to implement a public sector program, which is why we had to focus on the price of abuse in the private sector.
Hassan says struggles today include fighting for access to expensive cancer treatments, exorbitant cystic fibrosis drugs and cabotegravir, an HIV prevention injection that has received regulatory approval for use in South Africa on Thursday but still too expensive for most.
“The pharmaceutical companies have these intellectual property monopolies, which means that we have to continually fight them on price because, in the absence of our government, taking the necessary executive action or issuing compulsory licenses, we will always have to rely on civil society or the Competition Commission to address abuse of dominance, market capture and excessive pricing,” Hassan said.
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