ThePharmaLetter; October 30, 2015. Availability of affordable generic medicines from India has been a game changer in the way millions of lives have been saved over the decades, and is of particular interest in the ongoing third India-Africa Summit, the most ambitious diplomatic outreach event in over two decades, reports The Pharma Letter’s India correspondent.
Though India’s trade with Africa has doubled to about $72 billion since 2007, it is nowhere near China’s $200 billion which makes the latter the continent’s largest trading partner.
Despite this, Gambia’s Health Minister Omar Sey pointed out the need to ensure a framework on healthcare between the two nations, stating that the framework for affordable healthcare in Africa “requires breadth, scope and depth.” Mr Sey called upon ‘India Inc’ to provide essential and life saving’s drugs to his countrymen, and also urged for investments to enable it to provide suitable and affordable healthcare facilities to the people of Gambia.
Addressing the India Africa Business Forum meeting in New Delhi, Mr Sey said essential and “life saving drugs, including necessary pharmaceutical equipment and articles are in utter shortage in the entire African continent and especially so in Gambia. Therefore, I seek the help of Indian pharmaceuticals and health industry to reach out to Africa to equip it with these facilities.”
Indian officials are holding bilateral talks with all 40 African leaders. The Indian government has already announced credit at concessional rates of $10 billion over five years, in addition to about $7.4 billion that India has already pledged since 2008. A grant assistance of $600 million has also been announced, which will include an India-Africa Development Fund of $100 million and an India-Africa Health Fund of $10 million.
Continue to play a role
India’s expertise in healthcare and affordable medicines is set to offer new hope to fight many diseases in Africa. Stressing the need for India to continue to be the pharmacy of the world, Medecins Sans Frontieres (MSF) has urged the African governments and India to work together to maintain trade in affordable generic medicines.
In the case of multi-drug-resistant tuberculosis (MDR-TB), where treatment for one patient can cost several thousand of dollars, MSF has said the cost of newer drugs to treat MDR-TB could be slashed by up to 95% if generic versions could be produced in India, as with HIV drugs.
Gilles Van Cutsem, Medical Coordinator for MSF, South Africa noted that the nation could scale up HIV treatment in its healthcare programs “because Indian generic medicines made treatment more affordable. We shudder at the threats that India faces from the US government, other developed countries and multinational drug companies. Any shift in India’s policy would dramatically undermine access to affordable medicines that we need in India, across Africa and beyond.”
He added that “millions of people in Africa are alive today because of affordable medicines made in India,” referring to the possible shift in India’s stand over patent regime in the pharmaceutical sector, that could potentially make generic drugs, like the anti retroviral drugs that India exports to Africa for 80% of its AIDS treatment, much more expensive.
It is estimated that there are around 22.5 million HIV-positive people in sub-Saharan Africa. Reports indicate that because of cheap Indian drugs, the proportion of AIDS patients being treated rose from 2% in 2003 to 37% in 2009.
HIV aid from India
India has played a crucial role in South Africa’s battle against AIDS. In 2001, when AIDS had become the leading cause of death in sub-Saharan Africa, Indian company Cipla rolled out a generic version of antiretrovirals (ARVs) for $1 a day.
Mihir Rajesaheb Gaikwad, general physician, said access to medicines is a critical element for universal health coverage. Citing a report from the World Health Organization, he said prices of HIV treatments tend to vary greatly between middle income countries, and often depend on many factors like patents and licensing agreements.
The WHO analysis found significant variation in the prices of ARVs between countries for first-line and some second-line treatments, but all countries paid very high prices for third-line drugs. This is where countries like India can show the way, he said, adding that the issue of affordable medicine imports from India is a matter of great concern for African nations.
Dr Gaikwad added that the US pharma lobby has been urging India to limit the production of affordable generics to only what is required for Indian consumers under a `voluntary licensing scheme’ and not produce drugs for third country patients. He said that India needed to resist growing pressure from the US government and Western drug multinationals to stop exporting cheap generics to Africa.
Healthcare activists have pointed out that drug production, by Cipla in Kampala, has been the main reason that 15 million people in the developing world are alive today, and that other diseases like hepatitis, tuberculosis, and malaria also need affordable generic medicines from India. The India-Africa summit has provided an opportunity to address many of these issues.
Major help and investment needed
Officials pointed out that, last year, the Indian community in the Gambia had provided 865,000 dialysis machines to the country’s government to boost preparatory readiness against the Ebola virus. Officials said though the gesture was aimed at supporting the government in its efforts to prevent the spread of the disease in the country, it was highly appreciated.
Mr Sey assured that it had helped in keeping the highly contagious disease at bay. The Indian community had supported the Gambia government in its bid to prevent the spread of Ebola. Apart from the president of the Republic, the World Health Organization, he said the Indian community had stepped in with a helping hand. He added that it was time for the nation to help out again with life-saving drugs.
Stating that few things were now needed to ensure better healthcare facilities, Mr Sey outlined that universal health coverage, strengthening of primary health centers, utilization of healthcare funds, public health education, vaccination, basic primary healthcare services and availability of essential drugs were paramount to the nation. He added that help was needed from India in all these sectors.
Vice President Inonge Wina also called on Indian investors to venture into pharmaceuticals, manufacturing and agricultural investment, among other sectors. She said: “I wish to reiterate the government’s commitment in providing an enabling business environment that supports private sector participation.”
Hirut Zemen from the Ethiopian foreign ministry urged for investments from India, especially in the creation of super speciality hospitals. He also alluded to the recent marketing and distribution tie up between Cipla and India’s largest vaccine exporter, Serum Institute of India, for the South African market.
Cipla’s South African subsidiary, Cipla Medpro is to partner with the vaccine maker and ensure affordable and accessible vaccines for South Africans. The agreement would be instrumental in addressing the national vaccine shortage.