India offers cheap AIDS drugs

February 7, 2001
Web posted at: 6:32 PM EST (2332 GMT)

NEW DELHI, India -- An Indian drug company has offered to sell an AIDS cocktail at a fraction of the market price to an international aid agency to distribute to patients for free.

The decision by Mumbai-based Cipla Ltd could revolutionize the treatment of HIV patients in developing countries, where the virus is most rampant.

But it could also raise resistance from Western drug manufacturers holding the patents.

Cipla will sell the three-drug, anti-retroviral cocktail to Doctors Without Borders, a Paris-based medical aid agency, at $350 per patient per year as long as they agree to distribute the drug for free, said Dr. Yusuf Hamied, Cipla's chairman.

Similar drug cocktails often cost between $10,000 and $15,000 per patient annually in the United States and Europe.

"This is my contribution to fighting AIDS," Hamied told The Associated Press on Wednesday.

He said the inspiration for his decision came from the Jan. 26 earthquake in western Gujarat state -- where more than 17,000 people have been confirmed dead -- and the outpouring of relief for the 1 million people left homeless.

"AIDS is going to be a bigger holocaust in India than the earthquake," Hamied said.

Three-tiered price structure

Doctors Without Borders welcomed the offer. "For us, it's excellent news," said Annick Hamel, who runs the group's Campaign for Access to Essential Medicine, which would oversee the project.

The group, which won the Nobel peace prize in 1999, was studying the proposal and was to meet Cipla representatives in Mumbai next week, she said from Paris.

The agency operates 40 AIDS projects worldwide, about half of them in sub-Saharan Africa, home to 70 percent of the world's 36 million AIDS cases.

Hamied said the key to the program is a three-tiered pricing scheme under which wholesalers would pay $1,200 for drugs to treat one patient for a year, governments would pay $ 600 and Doctors Without Borders would pay $350.

"We're not making money but we are not going to lose money either," Hamied said. "With the average of the three prices, we should break even."

The cocktail consists of two 40-milligram tablets of stavudine, two 150-milligram tablets of lamivudine and two 200-milligram tablets of nevirapine.

Hamied said Cipla was able to manufacture the drugs so cheaply because his company makes the raw materials and production costs in India are low.

Patent problems likely

One stumbling block may be the patents on the drugs held by Western pharmaceutical companies and whether the governments of poor countries would be willing to waive local patent laws by issuing compulsory licenses and possibly angering the big drug companies.

Bristol-Myers Squibb holds the patent on stavudine under the brand name Zerit; GlaxoSmithKline of Britain developed lamivudine, also known as Heptovir; and Boehringer Ingelheim of Germany holds the rights to nevirapine under the name Viramune.

A spokesman for GlaxoSmithKline in London, Phil Thompson, said the company was not consulted about Cipla's offer and was waiting to see the details.

"It would appear that the offer is partially one of donation. As a consequence of that, questions have to be raised about the sustainability of the offer," he said.

A spokesman for Boehringer Ingelheim in Berlin refused to say if the company would take legal action against Cipla but said "intellectual property rights should be protected" by any proposals to treat AIDS victims.

Hamied said Cipla cannot be sued in India and that it was up to Doctors Without Borders to work out the legalities of importing the drugs into the countries where they work.

"Any government that wants to buy and distribute the drug is welcome," Hamied said. Doctors Without Borders "can take it anywhere they want, but they must give it away for free."

Doctors Without Borders has campaigned for two years to persuade Western pharmaceutical companies to cut drug prices.