By the end of this day, another 1,300 children will be dead as part of the daily toll of HIV and AIDS-related illnesses. Yet for just a few cents a day, this appalling cost in young lives could be slashed. The respected UK Medical Research Council (MRC) has just reported about a field study in Zambia that demonstrated conclusively that a cheap antibiotic has been dramatically effective with almost half the sick children treated.
So compelling have been the MRC’s findings that the World Health Organization and UNICEF are changing their drug advice to back the use of the antibiotic, called co-trimoxazole, for the more than million children, mostly in Africa, who are suffering from HIV and AIDS. This is a medical initiative which, given effective distribution and administration, would seem destined to succeed because unlike so many other treatments for the diseases which ravage many poor Third World countries, this one is eminently affordable.
Co-trimoxazole is cheap because it is a widely copied 35-year-old out-of-patent generic drug developed by Wellcome and Hoffman-La Roche under the brand name “Septrin” and “Bactrim.” Though there have been serious concerns about sometimes fatal side effects, the drug by whatever name it is called is estimated to have an annual market of over $5 billion.
Among the leading generic manufacturers are Indian, Thai and Brazilian pharmaceutical companies. Such firms are of course the source of many other lifesaving drugs needed by the Third World. As a result of their presence in the market, the cost of anti-retrovirals — which are the key lifesaving drugs in HIV/AIDS treatment — has plunged by as much as 90 percent in recent years.
The mainstream pharmaceutical industry which developed these products in the first place has been widely condemned for its reluctance to allow generic manufacturers to effectively flout their existing patents. Last year and again this year in South Africa and Thailand, the international HIV/ AIDS conferences saw ugly attacks upon the display stands of the big drug companies.
The big pharmaceutical giants are of course easy targets as the villain of the story. It is unfair. Though they doubtless exaggerate research and development costs significantly and spend large fortunes marketing new products, it is a genuinely long and costly process developing and winning approval for new drugs. In contrast, all the generic manufacturers have to do before going into production is to prove that their product is exactly the same as the original. Because they are businessmen, they can then undercut the branded product by only as much as is necessary and still make an outstanding profit. And generic makers are not above creating their own high-cost branded drugs by, for instance, combining a number of treatments into a single preparation which they then patent.
The question for all prosperous pharmaceutical firms everywhere is: Where does the market leave off and common humanity kick in?
