International health organisations such as the Clinton Health Access Initiative, Unitaid and DFID have come in for some flak over a recent announcement outlining their anti-AIDS initiatives.

The initiatives detail price-cuts on medicines that could save them $600 million in three years – but there is just a brief acknowledgement of the role Indian drug-makers have played in supplying inexpensive AIDS medicine to such global programmes, for about a decade now.

Healthcare workers are also surprised at the timing of the announcement, coming as it does, when donor countries that fund these programmes face a funds-crisis.

Unitaid's Deputy Executive Director, Dr Philippe Duneton, told Business Line , the reason behind showcasing the anti-AIDS initiative was to demonstrate to donor nations its success and keep them committed. Because of the financial crisis, “donors want to make sure that the funds are used in the best way,” he said.

Though seven of the nine “key suppliers” acknowledged in the announcement are from India – the statement does not mention issues facing these domestic companies – something Unitaid had itself red-flagged last September.

Trade agreements

The United Nations-supported drug purchase facility arm, the Unitaid had in the past expressed concern over free trade agreements and its impact on India's capacity to make affordable medicines for domestic and overseas markets. It had then cautioned that trade agreements India was negotiating could close the tap on affordable medicines for AIDS patients.

About 90 per cent of AIDS drugs supplied in Africa are made in India, Dr Duneton said, acknowledging their contribution in making paediatric versions of the medicine, among other things. These companies need to be supported not just to make generically similar versions of original drugs, but also innovative combination drugs that help bring down prices, he said.

Indian drug-makers Aurobindo Pharma, Cipla, Emcure, Hetero, Matrix (a subsidiary of Mylan), Ranbaxy (under Daiichi Sankyo now), and Strides Arcolab were acknowledged in the note.

In fact, more people are under treatment now because Indian generic companies have been supplying medicines at a mere fraction of the originator's prices, observes the Cipla Chairman and Managing Director, Dr Y.K. Hamied.

Be it in 2001, when Cipla first cut prices on AIDS drugs in Africa, or 2003 when along with Ranbaxy and Matrix – the company supplied to the Clinton Foundation and further brought down prices – Indian companies have been key players, he said.

Alarmed at the absence of a contingency plan to ensure future production, as new AIDS drugs would not be as easily available from India, Ms Leena Menghaney, with international aid organisation Medecins Sans Frontieres' (MSF), said: “There is a growing crisis in funding and (related to) patents and the present model of procurement and funding organisations will not work, if this is not resolved.”

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