It is clandestine diversion of shipments of HIV medicines — intended to be sold to impoverished Africans at reduced prices — back to Europe for sale on normal prices.
Since July last year, nearly $18 million worth of HIV drugs sent to Africa by GlaxSmithKline in response to an appeal by the WHO and AIDS activists have been hijacked and sold in Germany, Britain, Switzerland, the Netherlands and Belgium by an organized gang.
In another such incident, a huge quantity of Diflucan drug tablets donated by Pfizer for poor AIDS patients in Uganda was reported missing. Later, with the help of the US intelligence personnel, the expensive medicine was found to have landed in private pharmacies and clinics of Kampala. The drug which is available in the market at a price from $1.60 to $6 was meant for free distribution. About 290,000 tablets were handed over to Uganda in February. There are 1.8 million HIV positive in the country but only 20,000 have access to expensive medicines.
Regarding Glaxo’s drugs, the shipments which came from its factory in France never made out of the airport and were turned back to Europe by the wholesalers. The thievery and fraud was described in an internal Glaxo document which was obtained by The Washington Post last month.
Meanwhile, the European Commission, alarmed by the disclosures, has asked the member countries to ensure that the developing countries were guaranteed access to cut-price HIV/AIDS, TB and malaria medicines by special registration and labelling. It is the relentless campaign by the health NGOs in recent years that has ultimately compelled some of the world’s biggest pharmaceutical companies to slash the price of some of their products for Africa’s AIDS patients. Many of these patients are destined to die because multinationals’ medicines are too expensive to buy.
Another reason for this unexpected charitable approach on the part of the corporate sector is its need to thwart growing inclination among the African countries to buy generic drugs for their AIDS patients because these are cheaper and affordable. Such medicines, which are mostly produced by Brazil, Thailand and India, were agreed to be marketed in countries found to be suffering from devastating pandemics like the AIDS under an accord at Doha conference of the WTO. The accord was celebrated as “a victory of patients over patents”.
Even before Doha, the corporations had suffered a major setback, and a threat to their business, when they, having filed a lawsuit against South Africa’s government for allowing import of generic drugs, were compelled to withdraw it under international pressure.
But the incidence of recent shipment diversions has posed a problem both for the patients as well as the companies. The patients have been deprived of the opportunity to buy reputed western brands at as cheap a price as the generic ones could offer. And, to add to their woes, some companies are having a second thought about going ahead with cut-price scheme for Africa. Even, some of them are thinking in terms of cutting research funds if illegal re-exports of their drugs did not stop. The UN figures show that while more than 28 million people have HIV/AIDS in sub-Saharan Africa, only 30,000 receive the treatments as available in the West.
Glaxo is one of the six multinationals participating in the HIV drug discount programme for developing countries. The medicines being discounted by Glaxo are Combivir, Epivir and Trizivir which averagely cost between $4 and $6 a pill in western Europe. Its discounted price is 80 cents a pill in sub-Saharan Africa. The diverted medicines were intended for use in Congo, Senegal, Ivory Coast, Togo and Guinea-Bissau. The fraud has been going on since July 2001 but remained undetected until this past July, when customs inspectors in Belgium noticed irregularities in a shipment sent from Senegal by a Dutch wholesaler that was passing the medicine along to another Dutch wholesaler.
Glaxo estimates that 28 shipments were diverted through July of this year, totalling close to 3 million doses. Those shipments moved from five African countries through Paris and Brussels, then into Antwerp (Belgium). The drugs did not have special packaging or markings to differentiate them from the medicines offered for sale in Europe. It is the first documented case of AIDS drugs being re-exported from Africa since leading manufacturers launched the cut-price scheme two years ago.
The European Federation of Pharmaceutical Industries and Associations has said that stamping out the trade will require governments to look at customs procedures and that how products can be tracked.
Uganda’s health ministry has, meanwhile, also announced a crackdown after it discovered that most of the 290,000 Diflucan tablets donated by Pfizer were being sold in the open market. In Kampala, police is investigating whether the drugs were actually distributed as shown by a list given to the health minister. This is not the first such incident of theft of the drugs meant for public health institutions. In the past, there have been several reports of such thefts. But the case of the Pfizer donation is more annoying because the government did not know about the theft until authorities in the US discovered it and informed the government.
However, the theft of the Diflucan drugs has marred the reputation of Uganda abroad. There is an apprehension that Uganda’s fight against AIDS will no more be seen in good light because of its irresponsible handling of expensive donations. So far, the country has been a role model in the war on the killer disease. Many people have died in Uganda because of rampant theft of medicines. Even simple drugs, which can save lives, are frequently stolen.
In another development, it is interesting to note that even in Texas, President Bush’s home state, cancer drugs worth millions of dollars were recently stolen from a hospital and sold in the black market. The drugs, Procrit and Neupogen, were taken from pharmacies at the University of Texas Anderson Cancer Centre. During the past three years, at least $2 million worth of cancer drugs have been stolen. The scheme came to light in March when the suspects robbed a truck with $500,000 worth of drugs.