Competition between drug companies and generic producers has been far more effective in ensuring cheaper anti-AIDS drugs than negotiations with drug companies.

This is despite a massive humanitarian initiative launched two years at the 13th world AIDS conference by the Joint UN Programme on HIV/AIDS (UNAIDS) and five of the world’€™s biggest pharmaceutical companies aimed at ensuring that developing countries had access to cheaper drugs.

Evidence presented yesterday (mon) at the 14^th World AIDS Conference in Barcelona by a number of economists and Medicins sans Frontieres (MSF) showed that it was only when Brazil and Thailand started to manufacture their own generic versions of anti-retroviral drugs that drug companies responded by offering substantial discounts.

MSF’€™s Carmen Perez Casas said that Senegal had only secured a 3% reduction in the cost of three AIDS drugs by negotiating directly with drug companies as suggested by UNAIDS. However, Thailand was able to secure the same drugs at a 46% reduction by opting for generic versions.

Drug company Roche only reduced its prices for certain anti-retrovirals in Brazil after the Brazilian government threatened to override its patents on certain anti-retroviral drugs. However, Roche did not offer the same discounted price to African countries.

“So Roche has no clear policy of discounts based on the level of development of countries. It responded to the fact that Brazil could manufacture its own generics,” said Perez Casas.

Thailand’€™s K Kraisintu said that before her government set up the Government Pharmaceutical Organisation (GPO) to manufacture generic drugs, anti-retroviral therapy cost $600 a month, whereas the average Thai salary was $120.

“Thailand was the first country to make generic anti-retroviral drugs, and we managed to reduce the price of triple therapy drugs to $53 a month,” she said.

As the GPO was not constrained by drug patents, it could combine drugs made by three different companies into a single tablet, thus making it easier for HIV positive patients to take their treatment.

“The cheapest anti-retroviral regimen now costs $32 a month,” said Kraisintu. “We would have spent $276-million on treatment for Thailand’€™s 50 000 patients but instead we have spent $16,6-million.”

Dr Jamie Love of a US-based consumer organisation said officials from African countries had told him that they were afraid to opt for generic drugs as they feared that “aid was tied to brand-name drugs”, and that agreements concluded with drug companies precluded them from getting cheaper drugs from generic manufacturers.

However, UNAIDS negotiations on humanitarian grounds had failed to deliver cheaper drugs and it was now time for the body to engage with generic manufacturers.