HEALTH: Generic Drugs Only Answer to Bird Flu in Asia

By IPS Correspondents Reprint | | Print |

Bob Burton

CANBERRA, Oct 26 2005 (IPS) - Despite concerns raised by leading medical researchers, an Asia Pacific Economic Cooperation (APEC) meeting next week on a potential avian influenza pandemic is unlikely to discuss the need to accelerate production by generic manufacturers of crucial anti-viral drugs.

In a lead article in the Medical Journal of Australia, published on the Internet on Wednesday, Dr. Buddhima Lokuge, Dr. Peter Drahos and Warwick Neville argue that while the drug company Roche, which holds the patent on the more popular of the two drugs being stockpiled, has expanded production capacity in the U.S., ”it is clear that this is not sufficient for many countries.”

”Most of the countries in our region that are potential sources of a pandemic strain are also the ones that can least afford to pursue a national stockpiling strategy at monopoly prices and many – such as Laos, Vietnam and Cambodia – do not have domestic manufacturing capacity,” Lokuge and his colleagues wrote.

While the potentially deadly H5N1 avian influenza virus – which can infect people in close proximity to infected birds – is spreading in Asia, the worst-case pandemic scenario is if a new strain of the virus emerges which can be transmitted between people.

Both Roche’s Tamiflu and Glaxo SmithKline’s Relenza can reduce the fatality rate from avian influenza and its transmission. It is estimated that the use of anti-viral drugs will be crucial for at least the first six months of a pandemic, while a vaccine is developed, tested and distributed for broad scale use.

Rather than leave decisions about the volume and pricing of the drugs to the market, Lokuge argues that at the APEC meeting in Brisbane next Monday and Tuesday on a possible pandemic, the Australian government should promote generic production and exports within the Asian region.

To clear the way for generics manufacturers, governments must invoke provisions under intellectual property agreements to override patents held by major drug companies. Generic companies in Thailand and India have begun developing generic versions, but possible legal hurdles could be encountered.

”It is a good time to discuss the issue of generic manufacturing of these drugs in our region, in particular, because in so many of the APEC countries avian influenza is endemic. At present approximately only one percent of anti-viral drugs have been sold to the Asian region,” Lokuge told IPS.

”If generic producers in the region India, China, Indonesia and Thailand were able to start working on efficient manufacturing they could not only drive the price down, they could significantly increase the volumes available,” he said.

While aware of Lokuge and his colleagues’ article, a department of Foreign Affairs and Trade official, who requested anonymity, told a background briefing on the APEC meeting that ”I’m not aware that that’s (compulsory licencing to facilitate generic manufacturing) on the agenda.”

Asked if the Australian government may provide some of its stockpiled anti-viral drugs to countries that have none, the official, while indicating that it was a matter for the Department of Health, was vague. ”Yes, I mean that issue may well be discussed in this meeting,” he said. ”The availability of anti-virals … one would assume would be an issue in an appropriate response.”

In their paper, Lokuge and his colleagues argue that stockpiling anti-viral drugs at prices charged by the patent holding drug companies for 20 percent of the population would cost countries such as Australia, Canada and the U.S. approximately only one percent of their annual health budget.

However, according to their calculations, an equivalent stockpile would take 28 percent of the health budget of China, 54 percent of Cambodia’s, 67 percent of Indonesia’s, 75 percent of Vietnam’s and 173 percent of Laos’.

”At the current prices it is unlikely that many countries will be able to afford it. Falling back on the charity option hasn’t usually worked in the past, it is more a symbolic thing such as Australia providing a stockpile to Indonesia of only 50,000 courses when it has a population of 211million,” Lokuge told IPS.

”Australia, as a key power in the region, has the opportunity – and responsibility – to create a climate of political confidence around the use of compulsory licencing as a tool of public health policy,” the researchers argue.

While key officials involved in next week’s meeting seem unaware of the importance of expediting generic production, in mid-September the Australian Minister for Health, Tony Abbott, warned that ”there are no additional anti-virals anywhere in the world.”

While the Australian government has already established a stockpile, Abbot acknowledged it would only be sufficient to cover one million essential service workers for approximately six weeks.

On Wednesday, at the Pacific Islands Forum in Papua New Guinea, Australian Prime Minister John Howard announced a limited 1.5 million U.S. dollar programme per year for the next four years to help all the Pacific nations prepare for an avian influenza pandemic.

The Leader of the Greens, Senator Bob Brown, has criticised Howard with being more pre- occupied with promoting draconian anti-terrorism legislation rather than ensuring a strong domestic and regional approach to preventing a pandemic.

”A pandemic would put terrorism right off the front pages,” Brown said. In the wake of the 2002 Bali nightclub bombings, the Australian government launched a major advertising and awareness campaign on terrorism, including mailing a magnetic fridge magnet to every household in the country, before introducing its first round of anti-terrorism legislation.

In contrast, it has done little to promote awareness of what people should do if a pandemic does occur. ”By now, school, workplaces, medical centres, hospitals and homes as well as emergency services should have been comprehensively informed to minimise ignorant fear and maximise real protection from a pandemic,” Brown said in a statement.