[Ip-health] Bloomberg: AIDS Sufferers Seen Hurt in Pacific Trade Pact Limits

Asia Russell asia at healthgap.org
Wed Aug 8 06:06:34 PDT 2012

Bloomberg News
AIDS Sufferers Seen Hurt in Pacific Trade Pact Limits


Edward Low, an AIDS activist in Malaysia who is HIV-positive, says
treatments to fight the disease in his country cost about $90 a month,
down from $1,000 a decade ago before generic drugs became widely

Now he’s worried that a trade deal being negotiated by nine
Pacific-region nations including the U.S. may curtail access to those
cheap drugs in favor of patented pharmaceuticals, raising costs to
survive HIV/AIDS in developing nations.

“This agreement is good for the rich countries,” Low, 45, said during
an interview in Washington. “It’s not good for the poor countries.”

Protecting the patents of drug makers including Abbott Laboratories
(ABT), Bristol-Myers Squibb Co. (BMY) and GlaxoSmithKline Plc (GSK) as
part of the Trans-Pacific Partnership has drawn criticism from groups
such as Doctors Without Borders and Public Citizen. The proposed
accord has also spurred calls from U.S. lawmakers for greater
transparency about the negotiations, while technology companies
including Microsoft Corp. (MSFT) and Symantec Corp. (SYMC) are urging
fewer restrictions on cross-border data flows.

While the advocacy groups claim the U.S. position in the talks favors
patented medicines, not just those for HIV/AIDS, administration
officials say affordability and innovation aren’t mutually exclusive

Twin Goals
The U.S. cited two goals in the talks: “Preserving the intellectual
property protections that spur innovation in the pharmaceutical
industry in a way that also drives access to medicines in the
developing world,” Carol Guthrie, a spokeswoman for the U.S. Trade
Representative’s office, said in an e-mail.

Demetrios Marantis, a deputy USTR, is scheduled to speak about the
trade pact at an event in Washington today.

The multilateral talks, the main accord being pursued by President
Barack Obama’s administration, would create an economic zone with
$20.5 trillion in output, according to a Canadian estimate. Talks that
began with Australia, Brunei, Chile, Malaysia, New Zealand, Peru,
Singapore, the U.S. and Vietnam may expand after the parties invited
Canada and Mexico.

A final agreement probably will encompass traditional issues including
agriculture and intellectual property, as well investment and
protections for businesses that compete against state-owned
enterprises, according to the trade office.

HIV Populations
The number of people living with HIV in the nine nations varies from a
low of 49 in Brunei, or about 0.01 percent of its population last
year, to 1.2 million, or 0.39 percent of the U.S. population in 2010,
according to reports submitted by the countries to the UNAIDS
Secretariat in Geneva.

U.S. negotiators in September proposed eliminating duties on medicines
and setting a deadline for drug companies to bring their products to
market by giving them access to nations in the pact and creating a
“pathway” for generics. The strategy is aimed at promoting access to
medicines while protecting intellectual property for the products.

“An effective, transparent and predictable intellectual property
system is necessary for both manufacturers of innovative medicines and
manufacturers of generic medicines,” according to a U.S. briefing

HIV patients take a daily regimen of at least three antiretroviral
medications -- such as Bristol-Myers’ Sustiva, Glaxo’s Ziagen and
Abbott’s Kaletra -- from two or more different drug classes to manage
the virus, according to the U.S. Department of Health and Human

Generic Costs
Generic versions of the drugs, widely used in developing countries,
cost as little as 19 percent of the patented version, according to
Doctors Without Borders.

Under a 1995 multilateral agreement, which sets minimum
intellectual-property standards, patents are protected for at least 20
years. U.S. Trade Representative Ron Kirk has said the U.S. and the
partner nations will implement the agreement in a way that supports
public health.

Advocacy and development groups that have seen documents in the
negotiations said the U.S. position offers too many protections to
existing patent holders, such as letting manufacturers extend their
patents by modifying existing brand- name products. The U.S. Trade
Representative’s office hasn’t confirmed the authenticity of those

Broader patent protections deter production of generics, and treatment
costs rise as patients switch regimens after developing resistance to
their original medications, according to Burcu Kilic, legal counsel
for Public Citizen’s Global Access to Medicines program in Washington.

Lower Prices
“We need the generic companies to enter the market” to bring down the
price for HIV/AIDS drugs, she said in a phone interview.

Karl Uhlendorf, a spokesman for the Pharmaceutical Research and
Manufacturers of America, the Washington-based industry group for
patent holders including Bristol-Myers, Pfizer Inc. (PFE), Abbott and
Merck & Co. (MRK), said in an e-mail that intellectual- property
protection isn’t a barrier to patient access to medicines.

“The negotiations should sustain the high standards on
intellectual-property rights that are a hallmark of U.S. law,” Senator
Claire McCaskill, a Missouri Democrat, said in an Aug. 6 letter to
Obama, echoing statements by Democrats from Massachusetts and
Washington state.

Intellectual-property revenue is “one of America’s big strengths in
the world economy” and patent protections provide incentives for
future medicines, said Edward Gresser, a policy adviser at USTR during
President Bill Clinton’s administration.

Illness Specific
“You really need to look illness by illness” to determine if there’s
an issue with access to medicines, he said in a phone interview.
“There’s vastly more income being provided to low- income cases” of
HIV/AIDS than 10 years ago, he said.

“Trade policy alone cannot solve the challenges relating to access to
medicines,” the agency said in its report dealing with pharmaceuticals
in the Pacific talks. Poor drug distribution networks and
infrastructure systems in developing countries also limit access to
HIV treatments, it said.

The next round of talks is set for Sept. 6-15 in Leesburg, Virginia.
The public, industry, health and development experts and federal
agencies can attend, as they have in the past, according to the trade
representative’s office.

Groups that work with HIV/AIDS patients say it’s important that
negotiators get the balance right between access and innovation.

“It’s a matter of life or death,” Low said.

To contact the reporter on this story: Brian Wingfield in Washington
at bwingfield3 at bloomberg.net

To contact the editor responsible for this story: Steve Geimann at
sgeimann at bloomberg.net

Asia Russell
Health GAP (Global Access Project)
email: asia at healthgap.org
tel: +256 776 574 729 (Uganda)
     +256 703 574 729 (Uganda)
     +1 267 475 2645 (US)
skype: asia_ilse

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