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.