Affordable and lifesaving medication is often still unattainable in South Africa, thanks to high costs and restricted availability, enabled by patent monopolies and a lack of registration by pharmaceutical companies.
A classic example is cystic fibrosis (CF) medication Trifakta, manufactured by Vertex. Trifakta costs R50 000 a month in South Africa but could be available at a much-reduced price if things were different.
For this very reason, CF patient Cheri Nel has filed for a compulsory licence to access a cheaper generic of the drug, with Doctors Without Borders (MSF) Southern Africa and the Treatment Action Campaign (TAC) also filing papers to intervene as amici curiae (friends of the court)
The Trifakta case is not unique, but symptomatic of a perverse patent system that enables pharmaceutical companies to continue exploiting people and national health systems for their every last cent, write Candice Sehoma and Nirvaly Mooloo for Health-e News.
Lessons from India
MSF has advocated access to medicines for years, particularly for drug resistant-TB (DR-TB) treatment, one of its key demands being for improved availability of J&J’s drug bedaquiline. This groundbreaking medication has shown remarkable effectiveness by shortening treatment duration and improving patients’ chances of overcoming the disease.
South Africa is one of the pioneering nations to use bedaquiline, this year marking a decade since its introduction to patients with DR-TB.
However, its exorbitant cost is a significant barrier to access for the broader population, stemming from stringent patent protection for the drug in South Africa.
J&J will hold a monopoly here until at least 2027 due to secondary patents, yet countries like India, where the main patent for bedaquiline expired last week, have rejected these patents to extend this monopoly. This means India can now obtain cheaper, generic versions of the medication.
If South Africa were to adopt similar public health flexibilities, it would be enormously beneficial to the country.
While a last-minute agreement has been reached between the Stop TB Partnership/Global Drug Facility (GDF) and J&J to provide generic versions of bedaquiline to low and middle-income nations, however, several countries with a high burden of TB may be excluded, like SA, where national procurement rules prevent them from procuring medicines through the GDF.
Nel, the cystic fibrosis patient, plans to use a compulsory licence in this country’s law to try to obtain access to affordable CF drugs, but this is still a challenging route.
The process – under current SA laws – only allows for an application to be submitted before a court of law – requiring considerable funding for a process that could take several years for potential outcomes to be determined.
It’s been more than two decades since South African civil society organisations focused attention on the high costs of antiretroviral drugs (ARVs), ample time for government to tackle the problem and implement reforms to avoid a repeat pattern for other diseases.
It’s worth noting the pandemic could have been used to overcome some of the inequities encountered in accessing vital medical tools, and in fact the government publicly acknowledged on global platforms how patents prevented access to medicine, yet it did not see fit to expedite patent law reforms or adapt legislation.
Lives will continue to be lost because of our outdated patent laws, and because these prioritise profits over human well-being.
Candice Sehoma is a Access Campaign Advocacy adviser; Nirvaly Mooloo is an Access Campaign intern.
See more from MedicalBrief archives:
J&J patent deal allows for cheaper generic TB drugs, but SA may lose out
TB drug costs to drop after J&J loses patent extension bid
WHO may promote bedaquiline after SA brokers deal with J&J
Court battle looms over lifesaving cystic fibrosis drug