Dr Penninah Lutung is the AIDS Healthcare Foundation (AHF) Africa Bureau Chief.
Dr Penninah Lutung
This is seemingly the same script but a different cast; the profiteering and greed of big pharma know no boundaries. We have barely pulled out of the COVID-19 pandemic, during which big pharmaceutical companies once again insisted on putting profits before lives.
According to Action Aid, Moderna, BioNTech, and Pfizer were reaping astronomical and unconscionable profits due to their monopolies of mRNA COVID vaccines, with the three corporations having earned more than $26 billion in revenue in the first half of 2021.
This was despite the fact that taxpayers were the primary funders of COVID-19 vaccine research, development, and production – the world owns that intellectual property, not the drug companies that continue to profit from the pandemic. African countries have been pressurizing pharmaceutical companies to share their know-how and technology to increase local production and access to critical medicine in Africa and globally.
There must be a paradigm shift away from viewing sharing technology with Africa as charity or a threat to profitability. Africa should be treated as an equal partner in global health security that benefits everyone. With reasonable, non-predatory pricing and fair competition, Africa can still be an attractive market for pharmaceutical products.
Another large pharmaceutical company - Gilead Sciences is at it again, reaping billions from public coffers while at the same time risking the health and lives of the poor by continually hoarding patents that should be used for generic medicines.
Gilead Sciences is at the centre of a diabolical scheme of putting profits before people’s lives by deploying its power and clout to keep the costs of medicines high.
Gilead Sciences is one of the worst offenders of big pharma profiteering, and at the same time, it has priced several of its HIV and hepatitis C drugs out of reach for many people.
Gilead Sciences is also yet to license technology for the production of medicines to treat cryptococcal meningitis to generic manufacturers. Cryptococcal meningitis may not be top of mind in public awareness, but it kills thousands annually despite the availability of safe and effective treatment options.
People most at risk of getting the fungal infection of the brain are those living with HIV in sub-Saharan Africa, in areas that are not deemed financially viable for pharmaceutical corporations.
As one of the world’s top 15 largest biopharmaceutical firms, Gilead Sciences generated over $27 billion in revenue and paid its CEO over $19 million in 2021 alone. In addition to overpricing lifesaving drugs, it has refused to register some medications in lower-income countries and consistently blocks attempts to introduce cheaper, generic versions of its medicines.
Africa is not in the position to sustain the development of the public health sector while it's held in a pricing vise by Western pharmaceutical companies. For a continent that suffers greatly from HIV/AIDS, Africa’s response to the epidemic remains dependent on international donor funding because the debt burden is fanning mass cuts in health budgets and development spending.
The vicious debt burden is pushing countries in the Global South further into distress when it comes to funding public health. Presently, African countries invest less than three percent of their GDP in healthcare, as opposed to five percent as recommended by the African Union. For instance, in Kenya, up to 75% of funds for HIV, TB, and malaria programmes come from donors.
AIDS Healthcare Foundation (AHF) is now taking its grassroots campaign global to raise awareness about Gilead’s shameful practices and calling out its greedy profiteering practices. One of its most nefarious practices includes evergreening patents on existing HIV/AIDS drugs like Truvada – outright exploitation cloaked in the veil of innovation.
Through evergreening, drug companies ensure they maximise their benefits from patents which assure them of monopolistic power. While drug patents have a lifetime of two decades after the filing date, drug companies have devised tactics such as evergreening and thicketing to prolong a drug’s exclusivity.
Through evergreening, pharmaceutical companies make alterations to a drug, such as changing its chemical composition slightly or making an external tweak as minor as adding a stripe to a pill with the aim of preserving their patents. These patents ensure that prices remain high by reducing competition.
Gilead has harmed people living with HIV worldwide for over 20 years by securing continual patents and generating billions of dollars by creating a monopoly on some of the most effective and well-tolerated antiretroviral drugs to treat HIV. As a leading global HIV/AIDS organization with over 1.7 million patients in care across 45 countries, including over 900,000 in 13 African countries, it is our responsibility at AHF to take a stand and call out Gilead so that governments and decision-makers everywhere put collective pressure on it to prioritize lives over obscenely high profits.
But people living with HIV are not the only ones affected by Gilead’s greed. There is also a need for Gilead Sciences to open the license for the generic production of the hepatitis C drug Harvoni to all low- and middle-income countries, without exception. Some of the deals the pharmaceutical company has signed in the past under the pretext of increasing access to Harvoni hides a clear strategy to prevent fair generic competition.
For example, this highly effective hepatitis C drug costs $1,000 per pill, and a 12-week course of treatment has a retail price of over $90,000 in the U.S. A generic version of the same drug costs only $4 per pill in India, but according to Médecins Sans Frontières, Gilead has excluded 50 middle-income countries from access to the generic, discounted price. These excluded countries include Jamaica, Tunisia, the Philippines, Ukraine, and Venezuela, among others.
Gilead must be held accountable for arbitrarily placing a price on who lives and who dies by keeping the most effective, modern, and lifesaving medicines out of reach of millions of people in low and middle-income countries.
For their generosity, the public and lower-income countries are rewarded with astronomical drug prices. Our global advocacy campaign is meant to let everyone know about Gilead’s greedy tactics and make lifesaving medicines accessible to everyone, not just people in rich countries. It is high time that Gilead stops the greed.
* Dr. Penninah Lutung is the AIDS Healthcare Foundation (AHF) Africa Bureau Chief.
** The views expressed herein are not necessarily those of IOL.