Fluconazole: Pfizer Asked to Lower Africa Price

On March 13 the Nobel prize winning medical organization Doctors Without Borders/Medicins Sans Frontiers (MSF) demanded that Pfizer, Inc. greatly reduce the price of fluconazole in poor countries, in a communication delivered to the company in 18 countries (Pfizer is headquartered in New York). Doctors Without Borders supported South Africa's AIDS-activist Treatment Action Campaign (TAC), which on the same day organized a delegation of union leaders, church leaders, and others representing millions of South Africans asking that Pfizer either lower the price, or grant a voluntary license allowing TAC to import the drug or manufacture it locally, with a 5% royalty to Pfizer.

According to MSF, fluconazole costs almost 15 times as much in South Africa, where it is patent protected, than in Thailand, where it is not (in U.S. currency, $17.84 in Africa for an adult's daily maintenance dose, which must be taken indefinitely, vs. only $1.20 at the generic price in Thailand). The African price is more than twice the average daily wage of employed South Africans.

The consequence is that few Africans are treated for cryptococcal meningitis, and as a result their life expectancy is less than one month. Patients who are treated can live for years with a greatly improved quality of life. Many Africans could be treated if they could obtain the drug at the generic price.

According to TAC, Pfizer in South Africa agreed to respond within one week as to how TAC's letter was being handled -- although it could not act on the issue itself within a week, as the decision would have to be made in the United States.

Letter from Archbishop

The Most Reverend Njongonkulu Winston Hugh Ndungane, Anglican Archbishop of Cape Town, wrote the following to the chairman and CEO of Pfizer, Inc.:

"Dear Mr. Steere,

"In the face of evidence to the effect that it is possible to manufacture and sell Fluconazole at a price affordable to a significant number of South Africans, we urge you, in the interest of justice, to make this a reality.

"We do understand that Pfizer is neither a charitable nor a humanitarian organization and that you have a responsibility to your shareholders. We assume, however, that Pfizer's market share in our country warrants an interest in our economic and social stability -- both of which are acutely threatened by our AIDS pandemic.

"Many so called 'First World' institutions and corporations are busy taking out patents on every new intellectual idea and discovery in every field. The poor are continually being excluded from benefits of these discoveries and will continue to be so until some sense of global responsibility is introduced. Creativity is needed to bridge the huge gap between human need, scientific effort and market returns.

"Both rich and poor need to direct their attention towards a common plan of action regarding mobilization of science and technology for poor country problems. One recent suggestion is the creation of a vaccine fund which would guarantee future markets for epidemic vaccines.

"Besides the bottom line issues, we strongly urge you to consider these humanitarian and moral aspects.

"Grace and Peace,"

ISSN # 1052-4207

Copyright 2000 by John S. James. Permission granted for noncommercial reproduction, provided that our address and phone number are included if more than short quotations are used.

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