Govt pledges Rp 200b for HIV/AIDS campaign

Yogita Tahilramani, The Jakarta Post, Jakarta

Indonesia launched a national movement on Tuesday to fight the deadly spread of HIV/AIDS in the country with officials pledging some Rp 200 billion annually for the campaign and a concerted effort to reduce the cost of high-priced, imported life saving drugs.

Minister of Health Achmad Sujudi, during the launch of the campaign, said that the government had come to a consensus on efforts to mitigate the effects of Human Immunodeficiency Virus/Acquired Immunodeficiency Syndrome, which included the crucial measure of importing badly needed ingredients for AIDS cocktails.

Achmad conceded that ensuring access to affordable medicine in the war against the epidemic ultimately fell to national governments.

He said that in the control and prevention of the epidemic, which official figures say has claimed some 2,880 lives in Indonesia, the government could eventually register generic medicine producers and when possible, issue compulsory licenses when necessary to negotiate prices based on comparative price data.

"Life-saving drug treatments for HIV/AIDS are unaffordable for developing countries like ours. It costs at least US$10,000 a year per patient," Achmad said on the sidelines of a national consultation meeting on the control and prevention of HIV/AIDS.

The need for such medicine may be even more pressing since activists suggest that the official estimates are merely the tip of the iceberg.

HIV/AIDS-related illnesses often go undetected, with some estimates of those infected put at over 80,000.

"We plan, in the long run, to import the extremely costly ingredients of AIDS cocktails from labs in India or Thailand, then make the cocktails in Indonesia and sell them at a more affordable price," Achmad said.

"This is possible. It just takes will."

Costly cocktail ingredients include Nelfinavir, made by Roche and Efavirenz, as well as Merck.

Also included in the government's campaign is a commitment to allocate some Rp 200 billion annually.

Mechanisms to coordinate the movement would be established by, among other methods, scheduling an annual Special Session on HIV/AIDS in the Cabinet.

During Tuesday's meeting, discussions touched on the critical issue of life-saving drugs, which are grossly unaffordable due to exorbitant prices that result from patents or exclusive marketing rights.

As a consequence, intellectual property protection ironically threatens people's health. Big pharmaceutical companies like Pfizer, Bristol-Myers Squibb and Glaxo-Smith-Kline had earlier stated that such high prices were necessary since their research and development depended on those high prices.

A classic example is that of fluconazole, a primary drug in the treatment of cryptococcal meningitis, a disorder which reportedly affects around one in ten people who have AIDS, and without treatment, life expectancy is less than a month.

Pfizer for instance, has had a market monopoly for fluconazole for at least 12 years, according to recent reports from the Medecins sans Frontieres (MSF), a French-based nonprofit health organization.

This patent will reportedly not expire before 2004 in the U.S. and even later in some countries. The terrible part is that Pfizer sells fluconazole in less-developed or developing countries at the same rates as those in more-developed countries.

If prices of medicines puts them out of reach of people in need, Tuesday's meeting concluded that governments need to be encouraged to produce or import generic versions. Should South Africa, for instance, import generic fluconazole from Thailand, the cost of one year's maintenance treatment would reportedly fall from US$2,970 to US$104, MSF had earlier stated.

MSF added that an adequate response to the burden of infectious diseases would never be possible through limited donations from multinational pharmaceutical companies, and urged governments to issue compulsory licenses should it become necessary.