As the global race for COVID-19 vaccines underscored stark inequities in access, countries like South Africa, Colombia, and others left behind in securing vaccines are now adopting a more assertive stance against drug manufacturers. Their focus is on challenging policies that restrict affordable access to crucial tuberculosis (TB) and HIV treatments.
This shift in approach signals a departure from the past and could pave the way for broader efforts to ensure life-saving medications are accessible to a larger populace.
During the COVID-19 crisis, wealthier nations procured the majority of vaccines, leaving limited doses for poorer countries, resulting in a disparity criticized by the World Health Organization as a “catastrophic moral failure.”
The shift in strategy in poorer nations aims at increased self-reliance, acknowledging that dependence on others may not always guarantee equitable access, as observed by Brook Baker from Northeastern University, focusing on treatment-access issues.
A prime target in this battle is the drug bedaquiline, vital for treating drug-resistant TB, especially crucial in South Africa, where TB caused over 50,000 deaths in 2021, becoming the leading cause of mortality.
Activists in various nations have voiced concerns against Johnson & Johnson’s patent protection over the drug. Several actions ensued, such as Indian TB patients petitioning for cheaper generics, eventually receiving approval from the Indian government to break J&J’s patent. Similar appeals from Belarus and Ukraine had minimal effect on J&J’s stance.
South Africa investigated J&J’s pricing policies, revealing a stark price difference, leading to public outrage. Following the probe, J&J announced the abandonment of patents in over 130 countries, allowing generic drug manufacturers to replicate the drug.
This change in stance by J&J surprised experts like Christophe Perrin from Doctors Without Borders, highlighting how aggressive patent protection is typically integral to pharmaceutical strategies.
Colombia made headlines with its declaration to issue a compulsory license for the HIV drug dolutegravir, challenging Viiv Healthcare’s patent. This move aligns with over 120 groups urging expanded access to the WHO-recommended drug.
Despite this activism, experts caution that more comprehensive changes are necessary for poorer nations to produce their medications and vaccines. Petro Terblanche from Afrigen Biologics stressed Africa’s past challenges during the HIV epidemic and the imperative need for equitable access to life-saving drugs.
While progress has been made, concerns linger over intellectual property laws in South Africa, which favor pharmaceutical companies. The absence of clear laws allowing challenges to patents or extensions impedes fair access, according to Lynette Keneilwe Mabote-Eyde, a health care activist.
Andy Gray, an essential medicines advisor, suggested that J&J’s decision not to enforce patents might be more about limited future earnings from bedaquiline. The drug’s potential for high-volume sales in high-income countries remains uncertain.
The fight against TB continues, highlighted by the WHO reporting over 10 million cases and 1.3 million deaths last year. TB is now the top killer of people with HIV, with only a fraction receiving treatment, as emphasized by Zolelwa Sifumba, a South African doctor who experienced the challenges of TB treatment.
Sifumba advocates for equitable access to essential medicines, stressing that charging exorbitant prices in poorer nations defies logic when addressing a global health crisis like TB.
“TB is everywhere, but the burden rests on lower and middle-income countries,” she said, questioning the purpose of medications if they’re inaccessible to those who need them most.