Nigeria set to introduce cut-rate AIDS drugs
According to the latest sentinel survey of HIV/Syphilis prevalence in Nigeria (which involved testing a representative sample of the population at a limited number of locations), over three million Nigerians — around 2.5 per cent of the population — have HIV. And Nigeria is second only to South Africa in terms of the total number of infected people, according to a December 2001 report by the Society for Family Health.
The drug distribution programme initially aims to provide anti-retroviral drugs to 10,000 adults and 5,000 children infected with HIV. Stephen Lewis, the UN Secretary General's Special AIDS Envoy to Africa, told journalists after a visit to Nigeria in July that he expected these figures to "go up by the thousands over the next two years".
Anti-AIDS drugs would normally be well beyond the means of Nigerian HIV sufferers — the monthly minimum wage is only 7,500 Naira (US$57). But following a deal struck with the Indian drug manufacturer Cipla in April, as well as a decision to provide a substantial subsidy themselves, the Nigerian government has managed to dramatically cut the cost of the anti-retrovirals to 1,000 Naira (US$7.50) for a month's treatment per patient.
"The entire dosage for the whole year would cost 45,000 Naira (US$350), but in addition to this subsidy which we got from India, the Nigerian government has further approved another local subsidy," says Minister of Health, Professor Alphonsus Nwosu.
The ability of developing countries to import generic drugs is strongly opposed by large pharmaceutical firms that claim it undermines international patent rules set out by the World Trade Organisation (WTO). Nigeria’s programme will therefore be closely watched by other countries in sub-Saharan Africa, where HIV/AIDS is now the leading cause of death.
The generic production of drugs on the grounds of public health is permitted under the WTO’s Trade-Related Intellectual Property Rights agreement (TRIPS) — through so-called compulsory licensing — and was affirmed at last month’s ministerial summit. The issue of importing these generic drugs was not clarified although, as a developing country, Nigeria does not yet have to comply with TRIPS.
Originally due to start in September, the Nigerian programme has suffered several delays. An official at the Ministry of Health attributed the current delay to “logistics and organisational problems”. Nwosu is confident that the programme will take off “very soon” but could not be tied to an exact date.
Although 18 health centres have been selected by the programme, working out the details of distributing the drugs — including training of staff to handle and dispense drugs, as well how to register patients — appears to have been problematic.
The repeated delay has worried some of the prospective beneficiaries of the programme. “I am getting sick and tired of the postponement,” says Kazeem Lawal, a 24-year old mechanic who is HIV-positive. “I am even more concerned about the lack of information about how we can get the drugs and where we can register for them. Except for scant media reports on the matter, there has been no attempt to educate and inform those of us who may need cheap drugs.”