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American pharmaceutical giant fails to supply life-threatening HIV-related drugs

By Ashok Ramsarup :: Claims have been made that a leading American pharmaceutical company failed to honour an agreement to supply certain life-threatening HIV-related drugs. This has been revealed by the international medical humanitarian organisation  – Doctors Without Borders/Médecins Sans Frontières (MSF). MSF has accused the Californian-based Pharmaceutical Corporation Gilead Sciences of failing to deliver on promises to make an important drug available to people suffering from a life-threatening HIV-related infection”.

According to MSF, Gilead announced its ‘access initiative’ promising lower prices for liposomal amphotericin B (L-AmB) in 116 developing countries a year ago.  To date, the drug largely remains inaccessible, said in a statement. The affected countries include South Africa, India, Bangladesh,  Bolivia, Ethiopia and Thailand.

The pharmaceutical corporation has registered the drug in only six of the 116 countries, and even where it is registered, the drug is unavailable at an affordable price, for MSF and others.

The drug in question is, LAmB, which is highly effective when used in combination with other medicines to treat cryptococcal meningitis, which is the second biggest killer of people living with HIV, after tuberculosis. Cryptococcal meningitis is an infection of the brain, which if left untreated, results in an agonising death for people living with HIV.

MSF said the World Health Organization (WHO)recommended the drug as the preferred treatment over a sub-optimal, more toxic treatment (AmB deoxycholate), indicating it had safety benefits and fewer side effects associated with L-AmB.

WHO has been adamant and recognised the high prices and a lack of registration of L-AmB drug that is creating major barriers to people accessing this drug in developing countries.

MSF stated that although Gilead publicised their pledge to reduce the price of the drug to a ‘no-profit’ price of US $16.25/ R233.21 per vial in September last year, LAmB continues to be priced out of reach in many developing countries. For example, in South Africa, the drug is priced as high as $200/R2 870.27per vial (at least $4,200/R60 275.67 per full treatment course). In India, it is priced at $45/R645.81 per vial (nearly $1,000/R14 351.35 per full treatment course). National programmes and treatment providers are still unable to purchase the drug at the pharmaceutical corporation’s promised price.

But, instead, MSF said Gilead continued to earn billions of dollars each year from global HIV drug sales. It has been claimed that the corporation reported $14.6 billion in sales from global HIV drugs in 2018 alone.

MSF Access Campaign Pharmacist  Jessica Burry said: the organisation are outraged that Gilead’s announcement to provide this lifesaving drug at a supposed ‘no profit’ price and expedite its registration appears to have been nothing more than a public relations stunt.  Burry said the corporation was after profits and it failed to make good on their promise to do more to help ensure the survival of people living with HIV affected by this deadly disease.

 “It’s deplorable that they keep dragging their feet at the expense of people’s lives. We urge Gilead must urgently honour their commitment to make L-AmB available to everyone who needs it, and immediately register the drug in high HIV-burden countries.” Burry added.

MSF Medical Coordinator in India – Dr Amit Harshana – said it was shocking news to see that people living with HIV in India today continue to suffer from cryptococcal meningitis just as they did during the height of the global AIDS epidemic nearly two decades ago, even though effective prevention and treatment for the infection exists.

Peoples Health Organisation President Dr Ishwar Gilada has reacted to the debacle, stating that though MSF was right, his experience has been that among all multi-national pharma giants, Gilead is liberal and taken a humanitarian approach more than once.  However, Dr Gilada said nevertheless, Gilead should walk the extra mile and make liposomal amphotericin B available through voluntary licensing, the way it had done for the drug to cure Hepatitis C.

The HIV specialist says that in India the Indian Generic pharma comes in the picture, where he put it firmly that at the current time only India can do that, as it has done for antiretrovirals and anti-HCV drugs to name a few.

Dr Gilada says taking the Hippocratic oath, afforded him to be the doctor is to directly improve the health and wellbeing of patients and to develop professional and personal relationships with patients. He was recently elected as the Governing Council Member to represent Asia and the Pacific at the International AIDS Society in Geneva.

Statistics show that Cryptococcal meningitis kills more than 180,000 people annually. 75% of infected people reside in sub-Saharan Africa. MSF treats the infection in all its HIV programmes, including in the Democratic Republic of Congo, India, Malawi, Myanmar, Mozambique and South Africa.  

The pharmaceutical giant could not be reached for comment.

Ashok Ramsarup is award-winning senior journalist of South Africa 🇿🇦 

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