Saturday, May 5, 2007

Brazil and Generic AIDS drugs

The BBC reports that Brazil will be bypassing Merck’s patent on Efavirenz.
Brazil will be getting a generic version of the drug from India. This is a really mixed bag. Brazil is suffering from the AIDS pandemic. It is also struggling with endemic poverty and can’t afford the $1.55 per pill charged for Efavirenz. Merck did offer $1.30 per pill which was nowhere near the $0.65 per pill that Merck offered Thailand. Brazil’s president Luiz Ignacio Lula da Silva was not happy with Merck’s offer. So now Brazil will get the drug from India at $0.45 pill.

Our Government sprang into action by what, coming up with equitable solution? No, not this administration, the US added Brazil to a list of copyright violators. So Brazil just got blackballed by the Feds because it tried to get the best deal for it’s people.

This is not all black and white though. Merck developed this drug in the hope of seeing a return. The cost of getting a drug through FDA approval is not insignificant. Merck’s investment was quite large. Drug companies are reluctant to develop medications for disease cures in the first place because they can make more money elsewhere. Thus we find ourselves in a world were we have multiple drugs to help middle age men better perform sexually but very few drugs to treat Sexual Transmitted Diseases. It is a situation dripping with irony.

It would all be darkly humorous if AIDS was not such a killer. Make no mistake, outside of Western Europe and the “developed world” AIDS has long broken out of the gay male ghetto it resides in those aforementioned areas. In Africa in Asia in Russia and in Central Europe AIDS is decimating whole generations of young heterosexual adults. There are villages in Africa where every adult is gone and children are raising children. This is a medical and moral crisis.

So should we make an exception for AIDS drugs? If so why not an exception for TB? Tuberculosis is making one hell of a comeback. It is again killing and maiming thousands and thousand in the less developed world. This is not your great-grandfathers TB, it’s drug resistant and spreading fast. New medications are needed and quickly But who will develop them? Who is going to spend the millions of dollars and the decade of testing to get FDA approval? Who is going to do this if some company in Thailand or India is just going to make a generic copy a few weeks after release? Going deeper should health care and drug manufacture even be a for profit endeavor in the first place? Is there any guarantee that we will not still be getting more pills for “erectile dysfunction” than malaria if the government was in charge of drug research? Lots of questions and no answers yet.
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