Cheap drugs beyond reach of HIV carriers

Cheap drugs beyond reach of HIV carriers

Debbie A. Lubis, The Jakarta Post, Jakarta

People living with HIV/AIDS in Indonesia are having difficulty
gaining access to imported live-saving antiretroviral drugs
because of the exorbitant price of patented drugs and a limited
supply of the generic version.

Health experts said a package of antiretroviral drugs
available in drugstores across the country, which were supplied
by large pharmaceutical companies in Europe and the U.S., costs
HIV sufferers Rp 8 million ($US900) to Rp 10 million.

A package is equivalent to a one-month treatment.

Meanwhile, cheaper generic versions of the drug, mostly
imported from India, are available only at the HIV/AIDS study
center at the University of Indonesia and Cipto Mangunkusumo
General Hospital.

The cost of the one-month treatment package of the generic
drug is Rp 750,000.

Samsuridjal Djauzi, an immunologist at the study center, said
on Tuesday that no other parties in the country were importing
the generic antiretroviral drugs except for the study center,
which had started importing them last year.

"It all came from our own initiative. At that time, we felt
sorry for poor people with HIV/AIDS who could not afford patented
drugs. Then our doctors pooled their money together to bring in
the generic drugs from India," said Samsuridjal, who is also
president of Dharmais Cancer Hospital.

Because of limited funds, the center can only provide drugs
for 200 HIV carriers, which is far below meeting the demand.
Every month, he said, 10 new HIV carriers are put on a waiting
list to receive generic drugs from the center.

Despite the scarcity of affordable antiretroviral drugs, the
government has not yet made any real moves toward helping low-
income people living with HIV/AIDS.

Nevertheless, sources said that the government had planned to
appoint a state pharmaceutical company, PT Indo Farma, to import
generic versions of the drug.

Although Indonesia has no plan to produce its own life-saving
drugs any time soon, the trade-related aspects of the
Intellectual Property Rights (TRIPS) agreement has given new
flexibility to allow countries to override patents for the sake
of public health.

Mawarwati, the secretary-general of the National Agency of
Food and Drug Control (BPOM), said that based on such
flexibility, Indonesia would be able to have access to
antiretroviral drugs at affordable prices.

"We can produce the drugs here, but we have to import the raw
materials. We can import them from sources that offer cheap
prices with the same quality as patented ones," she said.

Meanwhile, the study center manager, Kurniawan Rachmadi, said
Indonesia would be liable to be sued in the courts for infringing
the companies' patents, unless it declares an HIV/AIDS crisis.

"The declaration allows us to override patents if we state
that the epidemic has reached an extreme state of urgency to
allow access to the drugs," he said.

Rachmadi was pessimistic that the country could declare a
crisis any time soon as the government was careless in collecting
data.

"Their numbers do not represent the real figures," he told the
Post.

According to an official estimate, Indonesia has 120,000
people living with HIV/AIDS.

Antiretroviral drugs do not cure AIDS but prolong the life
expectancy of sufferers, Samsuridjal said.

"It prevents the virus from replicating and improves the
patient's immunity," he said.

He said there were many kinds of antiretroviral drugs and
should be consumed in three combinations because taking only one
kind would create a resistance to the virus.

He advised people with HIV/AIDS not to stop taking the drugs.

"It is similar to diabetes patients who take medicine for
their entire life. Antiretroviral therapy requires discipline and
continuity," he said.