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HIV confererence may improve treatment access

29 July 2008

From 3 to 8 August, Mexico City will host the 17th Annual International AIDS Conference.    One issue certainly to be discussed is the high price of treatment. From The (Mexico City) News:

Congress’ Permanent Commission urged the Health Secretariat on Friday to reform laws to allow the purchase of generic anti-HIV medicine.

Congress called on Health Secretary José Angel Córdova to guarantee universal access to antiretroviral drugs. Although Mexico claims to offer coverage for all, overpriced medication is one impediment to sustained treatment for people living with the virus, the non-binding congressional resolution said. Pharmaceutical companies currently charge Mexico up to 30 times more for medication than countries with similar GDPs, the resolution said.

“We are far from reaching universal coverage in diagnosing and treating the 182,000 people who are estimated to be living with HIV in Mexico,” said the resolution from the Permanent Commission, which meets while Congress is officially out of session.

Two things worth noting.  The HIV rate in Mexico is relatively low, thanks to widespread acceptance of sexual education, and former Heath Secretary Julio Frenk Mora’s corageous stand in tackling the religious and social taboos within his own department and political party, allowing Mexican health workers to treat HIV as a public health problem.   The infection rate, however, has been creeping up — in part because of continued reluctance of people at risk to be tested, and lack of health care among Mexicans working abroad.

The other thing is the high cost of treatment.  The government keeps pharmaceutical costs low (there is a price ceiling on medication printed right on the package of any drugs you buy at the pharamacy, and most pharmacies advertise at least 60% off on common prescriptions, largely though buying directly from the manufacturers, or — for pharmaceuticals not manufactured in Mexico — through Mexican bulk distributors like NADRO (which provides PEMEX health care facilities).

Mexico has a robust pharaceutical manufacturing industry, but generics have been somewhat neglected for political reasons (the largest generic drug manufacturer, Labratorios Best, is part of the Farmacias Similares chain, which finances a number of political and social movements.  Because of the Torres family (which control the Similares group) ties to the Green Party (founded by one member of the family, and chaired for a time by his son) previous attempts in Congress to pass legislation that would allow the government health services to buy generics were beaten back as “special interest” legislation.

At the time, the Chamber of Deputies and the Senate had a PAN majority.  The party’s social conservatives — who were uncomfortable dealing with HIV issues in any form (and created problems for Dr. Frenk Mora) — and the free marketers — who didn’t see a need for creating a government program for a small number of individuals — both made it impossible to take the Brazilian or Indian approach.  Both those countries broke foreign patents, and began manufacturing their own generic HIV medication, as a national security measure.  The latest Permanent Committee recommendation does not go that far, which might make it easier to sell to the conservative Calderon Administration.

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