Focusing on prices of HIV medicines in middle-income countries | Tenu Avafia & Katie KirkPublished on Thursday, 27 June 2013 11:33
By 2020, the majority of people living with HIV will be living in middle-income countries, such as South Africa, Brazil, Russia, Ecuador and Thailand. Yet at the same time as new, more effective medicines to treat HIV emerge, many of these countries, based on their average income levels, are increasingly being left out of special arrangements offered by pharmaceutical companies to low-income countries, such as price discounts or voluntary licenses to use their patents.
For instance, in 2011, using Global Fund grants, HIV medicine Darunavir was offered to Sub-Saharan African countries at US $1,095 per patient per year. Meanwhile, Nicaragua and Moldova (middle-income countries) had to buy that same medicine at $7,424 and $9,188 respectively.
This pricing challenge will test the 2011 commitment made by UN Member States, at a UN High-level Meeting on AIDS , to place 15 million people in need on antiretroviral treatment by 2015.
Eighteen middle-income countries and stakeholders met in Brasilia in June to confront these challenges. Whether discussing intellectual property, drug registration, procurement or supply-chain management, a critical –take-away was that increasing collaboration between countries in the global South represents a key opportunity to meet common objectives.
So individually or in collaboration, how can middle-income countries confront the challenge of sustaining treatment? Of course, the experiences vary between countries, but in general, middle-income countries want to foster increased competition among medicine suppliers to reduce the cost of treatment by:
- Incorporating flexibilities found in the Agreement on Trade-Related Aspects of Intellectual Property Protection (TRIPS) into national legislation, and using them to increase competition among drug suppliers
- Developing effective regulatory frameworks for evaluating drugs’ safety and efficacy
- Promoting local pharmaceutical manufacturing
- Increasing transparency during procurement of medicines
Talk to us: What can middle-income countries do to make sure HIV medicine is affordable and accessible to their affected populations?