“We have never been against patents. We have been against monopoly.”
— Dr. Yusuf Hamied, CEO, Cipla
Dear Sirs:
We are writing as a coalition of AIDS treatment advocates, educators, and service providers to request that GlaxoSmithKline immediately withdraw from participation in threatened legal action regarding the importation of generic antiretroviral medications in Ghana and South Africa.
Specifically we refer to your threats of legal action against Cipla for selling Duovir, its generic form of Combivir, in Ghana (Wall Street Journal, 1 December 2000), and in Uganda (Glaxo-Wellcome letter to Cipla, 20 November 2000), and the announcement by the Pharmaceutical Manufacturers Association of South Africa of its intent to bring suit against the South African government on March 5 (Reuters, 15 January 2001).
As you are no doubt well aware, two-thirds of the world’s 34 million HIV infected people live in Africa, the world’s poorest continent. UNAIDS estimates that 4.2 million (20%) of South Africa’s population of 39.7 million, 820,000 (8.3%) of Uganda’s 21 million people, and 340,000 (3.6%) of Ghana’s 19 million people are infected with HIV. The per capita income in South Africa is $3,160 per year (although most of the HIV infected population earns far less than that, if they are lucky enough to be employed at all), while the per capita income in Ghana is just $390 per year, and $320 in Uganda.
We believe that threatening lawsuits to prevent people in poor countries — already staggering under the weight of the AIDS pandemic, excessive debt to western banks, poverty, and underdevelopment — from accessing life-saving antiretroviral medications is simply unacceptable from a moral and humanitarian point of view.
GlaxoSmithKline has several other options before it which would enable it to help increase, rather than decrease, access to antiretroviral medications among infected people in developing countries:
- Immediately implement, without regard to negotiations with host countries, steep discounts in the prices of antiretroviral drugs to affordable levels.
- Match the generic offering price (for example, with Cipla, the retail price — not their best price — appears to be $1.72/day for Duovir — just twenty-eight cents lower than Glaxo’s own announced discount to $2.00/day for Combivir in Rwanda, Senegal, and Uganda).
- Provide antiretroviral drugs in donation programs, which may presumably confer some tax benefits for your company.
- If you choose not to undertake the expense of providing discount antiretroviral drugs to poor countries where they are most desperately needed, permit generic manufacturers to manufacture and distribute them in your stead.
None of these steps would affect your markets in rich countries, which are where your profits come from. According to your own spokesman, quoted in the Wall Street Journal, Africa represents less than one percent of GlaxoSmithKline’s revenues or profits. We doubt that you are earning significant profits in Ghana, in Uganda or in South Africa on overpriced medications which few can afford.
We appreciate Glaxo’s efforts to develop new treatments for HIV, and we recognize that you have invested significant resources in the development, testing, approval, distribution, and marketing of antiretroviral medications. However, what use are these discoveries for the 95% of the world’s HIV infected population which cannot afford them at current prices? Can you really maintain that 30 million people must die because they cannot afford your drugs? We recognize that it is not up to industry alone to resolve the issues of health care infrastructure, political leadership, and social mobilization which responding to the AIDS pandemic necessitates.
However, it is also important for drug companies not to stand in the way of saving the lives of people for whom the price of drugs is often the main, and sometimes the only, obstacle to treatment.
Since Glaxo, along with four other global pharmaceutical companies, announced in May 2000 their intent to provide steep discounts on anti-HIV medications to developing countries, many press releases have been issued, but how many discounted pills have reached anyone in Africa or elsewhere in the developing world? How many lives have been saved?
Over two million people around the world have died of AIDS since that announcement, and now you, along with 39 other companies, are going to court in order to stop the South African government, with the world’s worst epidemic, from obtaining life-saving therapies by means established as legal under the TRIPs clause of the World Trade Organization treaty. The TRIPs clause allows the granting of a compulsory license in cases where there is a national emergency. How could you deny that AIDS constitutes a national emergency in countries such as Ghana and South Africa?
We appeal to you to immediately cease and desist from using the court systems in Ghana, Uganda, South Africa, and elsewhere in the developing world to prevent HIV infected people from accessing life saving antiretroviral medications.
Yours truly,
[several pages of signatures]