When I started working in sub-Saharan Africa in the mid-1990s, HIV/Aids was cutting a seemingly unstoppable swath through families, communities, workplaces. At the time, HIV medicines cost more than $10,000 per person per year. The world seemed to accept the unacceptable fact that life-saving drugs were priced out of reach for millions of people in poor countries. The doctors I worked with were not prepared to accept this inequality, and together with brave patients and activists around the globe, we sought to change it.
The availability of affordable, quality generic medicines made in India was a critical factor in helping turn the tide in the fight against HIV/Aids. Fierce competition among producers in India, where there were no patents on medicines until 2005, caused the price of HIV medicines to plummet by 99 per cent to roughly $100 today for a year’s treatment.
For my organisation Médecins Sans Frontières, more than 80 per cent of the HIV medicines we use across the globe are manufactured in India. And we are not alone – big international aid donors also get a similar proportion of HIV drugs in India. It is known as the “pharmacy of the developing world”.
This is why yesterday’s decision in India’s Supreme Court is so critical. The stakes could not have been higher. While the case centred around a cancer drug, the implications reached far beyond cancer and far beyond India. The judges’ landmark decision will help secure the supply of affordable medicines for millions of the world’s poorest people in the future.
If Novartis had won the case, patents would have been granted in India as broadly as they are in wealthy countries and on new formulations of medicines already in use. People living with HIV would have soon felt the pinch. Even though first-generation HIV drugs are affordable today, people with HIV need to be switched to newer and improved medicines over time. With Novartis’s loss in the courts, India can keep the door open more widely for the production of affordable medicines.
Thanks to yesterday’s decision we have won the latest battle. But until a better model for drug development is agreed – a model that ensures innovation is rewarded but that prices are affordable for the people who need the medicines – the struggle will continue.
Dr Unni Karunakara is the international president of MSF