Former President Bill Clinton on Thursday is expected to announce a "landmark program" to secure antiretroviral drugs from generic drug manufacturers at discounted prices and to implement nationwide treatment plans in some African and Caribbean nations, the Wall Street Journal reports. The Clinton Foundation HIV/AIDS Initiative has secured a deal with India's Ranbaxy Laboratories, Cipla and Matrix Laboratories and South Africa's Aspen Pharmacare that will reduce the cost of the most commonly used three-drug regimen to 38 cents per patient per day, down from the already discounted price of 55 cents per patient per day for generic drugs; the lowest available price of the same three-drug regimen using brand-name antiretrovirals is $1.54 per patient per day, according to the Journal. In addition to reducing the cost of the three-drug regimen, the deal will reduce by half the cost of the antiretroviral drug nevirapine for people in developing nations. To secure the deal, the generic drug companies allowed Clinton advisers access to information about their accounting and manufacturing practices and worked with them to cut costs, a practice the foundation plans to use to reduce the price of diagnostic tests, which are still very expensive, according to the Journal.
Nationwide Treatment Plans Developed
The foundation -- under the leadership of long-time Clinton adviser Ira Magaziner -- has also helped Rwanda, Mozambique, Tanzania and several Caribbean nations to prepare detailed government-approved plans to roll out antiretroviral drug treatment programs nationwide as opposed to rolling them out gradually, the Journal reports. The plans seek to improve the overall health infrastructure of the countries by preparing budgets for hiring and training health care staff; building and renovating laboratories and clinics; improving drug storage and delivery channels; and developing patient-information systems, according to the Journal (Schoofs, Wall Street Journal, 10/23). Foundation members have also been advising the South African government as it prepares to roll out a national antiretroviral drug treatment plan (Kaiser Daily HIV/AIDS Report, 10/2). According to the Journal, gaining approval from the African and Caribbean governments for the nationwide treatment plans was "critical" in securing the pricing deals with the drug companies because the treatment plans can guarantee the drug makers a large number of patients over time -- up to 1.5 million patients by 2008 -- according to the Journal. Magaziner said that by promising a certain market for the drugs, he was able to lock in the lowest possible price for the drugs that would still give the companies a small profit, according to the Journal. Cipla Chair Yusuf Hamied said, "This is the first time a group has come forward with predictable volumes."
To pay for the cost of the drugs and for the improvements to the health systems in the developing nations, Clinton personally lobbied private donors and leaders of wealthy nations to secure funding for the initiative, according to the Journal. Ireland has committed $58.3 million over five years -- primarily for Mozambique's program. According to a senior Canadian government official, Canada has pledged "tens of millions" of dollars to the plan, but the details are still being finalized, the Journal reports. "Usually I just call the prime minister or the president and tell them what we're doing and ask them to have somebody look at it. And I always tell them that even though we're friends they don't have to do this for me -- don't do it unless they think it's a good thing. But I think it's the best thing going in the world in AIDS care," Clinton said. In addition, Rwanda, Mozambique and Tanzania have each secured partial funding from other sources, including the Global Fund to Fight AIDS, Tuberculosis and Malaria and the World Bank. Clinton has secured more than $1 million from private sources and has kept costs down in his foundation by working with a team of medical experts, business executives and consultants, nearly all of whom have either volunteered their time or who are financially supported by their own organizations. The funding will not be funneled through the Clinton Foundation, but will go directly to the governments of the countries involved in the programs, according to the Journal. However, it is ultimately unclear whether enough money will be raised to cover the cost of life-long antiretroviral therapy for millions of patients, the Journal reports.
Magaziner said that he first approached brand-name pharmaceutical companies to be involved in the deal because President Clinton "believes in intellectual property." However, none of the brand-name companies are currently involved in the program. Bristol-Myers Squibb
says it never received a proposal from the Clinton Foundation, and Merck
says it is currently in early-stage discussions, according to the Journal
. Western companies could try to block the deal by charging the generic companies with patent infringement. However, such an outcome is unlikely because similar moves have "damaged their images" in the past, according to the Journal
. Clinton's efforts "threaten to steal some thunder" from President Bush's five year, $15 billion global AIDS initiative, which Bush announced months after Clinton began working on his initiative, according to the Journal
. However, Clinton "vehemently denies" any partisan motivation in his program, the Journal
reports (Wall Street Journal
Back to other news for October 23, 2003
Reprinted with permission from kaisernetwork.org. You can view the entire Kaiser Daily HIV/AIDS Report, search the archives, or sign up for email delivery at www.kaisernetwork.org/dailyreports/hiv. The Kaiser Daily HIV/AIDS Report is published for kaisernetwork.org, a free service of the Kaiser Family Foundation, by The Advisory Board Company. © 2003 by The Advisory Board Company and Kaiser Family Foundation. All rights reserved.