New 20 Year Patents Threaten to End AIDS Drugs for Developing Countries

Doctors Without Borders has warned that efforts to treat AIDS patients with antiretroviral drugs in developing countries could be threatened under new World Trade Organization rules granting 20-year patents to new drugs. The WTO agreement goes into effect Jan. 1, 2005, for most nations. Only the least developed countries can delay implementing the agreement until 2016.

The potential effect of the agreement on India's generic drug industry -- which produces most of the generic, fixed-dose combination antiretroviral drugs DWB now uses -- troubles Dr. Rowan Gillies, DWB's international president. "We're not ideologically attached to generics, but we've found it's what works best. At the moment, only generics can provide a treatment regimen of just two pills a day. That's essential for compliance and good results," said Gillies. DWB now treats 23,000 HIV patients in 27 countries in Asia, Africa, Latin America, and Eastern Europe -- double the patients it treated last year.

"We're gravely concerned that our sources of affordable medicines will dry up," said Gillies. "Not only are patents going to be granted on all new medicines, some existing medicines that we rely on will be reviewed for possible patent protection as well," he said.

The two-year survival rate for patients in DWB's Malawi program is 85 percent, said Dr. Arnaud Leannin of DWB's AIDS program there. But growing numbers of patients are now failing first-line treatment, said Pietro di Mattei, medical coordinator of DWB's Mozambique AIDS program. Switching to second-line therapy raises the per-patient cost from $250 a year to $700-$3,000. Second-line drugs adapted to resource-poor settings are needed, he said.

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