On the occasion of the 24th conference of the International AIDS Society, AIDS 2022, held in Montreal, Canada, between July 29 and August 2, I have reviewed some data that continue to challenge my conscience.
According to WHO data (for 2021), every year 650,000 people die from HIV/AIDS in the world (510,000-860,000). Likewise, each year 1.5 million people are infected. The same source points out that 38.4 million people live with HIV/AIDS, and draws attention to the fact that 25%, some 7.7 million people, are not receiving the treatment they need (1).
It is true that, over the last few years, the number of people who die from HIV / AIDS has decreased, as has the number of people who become infected each year. But there are still many, too many. Above all because the suffering and death that this disease continues to cause could be drastically reduced if medicines were sold at cost price and if governments invested more in their dissemination and administration...
Let's look at a recent example: injectable Cabotegravir (Apretude) is a drug used for pre-exposure prophylaxis (PrEP) of HIV/AIDS, and has been authorized by the FDA in December 2021. The price per person per year (6 injections ), set by ViiV Healthcare (a company related to GSK), taking advantage of the patent monopoly, is $22,200 in the US (2). In some low-income countries, the company would accept lower prices, through an agreement with the Medicines Patent Pool that would allow companies to manufacture generics, under certain conditions and restrictions (voluntary license). However, it is feared that those prices would still be well above manufacturing costs. On the other hand, generic companies will take several years to manufacture the drug if technology transfer is not actively facilitated (3).
David Ripin, executive vice president of the Clinton Health Access Initiative, has estimated manufacturing costs for Cabotegravir injectable at $15.64 per person per year (4). If the US and the EU set prices close to cost, they could offer pre-exposure prophylaxis to all people who require it. In this way, with much less than half of what these countries would spend on the drug at an abusive price, injectable Cabotegravir could be financed for all the people who need it throughout the world.
The same goes for medications to treat the disease. As an example, we cite a study by Joel Sim and Andrew Hill (5) showing how the price of dolutegravir in the US was $20,130. The median price in high-income countries was $9,164 per person per year, while the drug cost was $42 per person per year.
If in the EU and the US, at current prices ($9,164 pppy), $18,328 million were currently spent to treat 2 million people living with HIV, instead, at cost, these treatments would have amounted to only $84 million . With the rest of what we spend each year in high-income countries, we could offer treatment to 38 million people around the world, with drugs at cost price. Indeed, $1,596 million would be needed, and $16,500 million would be left over, which could be used to strengthen health systems in all countries.
In other words, with much less than the money we currently spend in high-income countries on medicines for the prevention and treatment of HIV/AIDS, we could offer prophylaxis and treatment to all the people in need around the world. Let us remember that in the world 25% of people with HIV / AIDS are currently without treatment, which, in addition to their suffering and that of their loved ones, causes the prolongation of the pandemic.
It is immoral that the top executives of pharmaceutical companies set abusive prices, above cost, for these drugs. It is irresponsible for governments to tolerate these abusive prices, when by setting cost prices (also reimbursing the amounts spent on research, and adding an incentive similar to that of the non-pharmaceutical industry), pain and death could be avoided to thousands of people, ending a disease that has already caused more than 40 million deaths and continues to be a public health threat.
If governments understood that health is a human right and not a business for the profit of a few, they would change the rules of the game, prohibit drug patents, finance research in a transparent way, make the immediate transfer of technology and knowledge mandatory (of any scientific advance related to health), and would set prices for medicines in relation to cost of production, preventing the abuse of monopolies and speculation.
Isn't it terrible to be aware that this year more than 600,000 people will die from AIDS, whose death could have been prevented with a fair price for medicines?
(1)
https://www.who.int/news-room/fact-sheets/detail/hiv-aids
(two)
https://www.statnews.com/pharmalot/2022/07/28/viiv-gsk-hiv-aids-patents-licensing/
(3)
https://www.doctorswithoutborders.org/latest/msf-viiv-must-do-more-accelerate-access-new-hiv-prevention-medicine
(4)
https://www.longactinghiv.org/files/inline-files/DavidRipin-LEAP2022.mp4
(5)
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6248837/
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