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Drug Firm To Help Break AIDS Logjam

Pharmacia Corp. announced Friday it would allow generic drug companies to manufacture cheap copies of its AIDS drug to sell in poor countries — a novel approach aimed at breaking the logjam over access to lifesaving medicines.

Pharmacia Corp. said it will work with the International Dispensary Association in Amsterdam to provide licenses and technological skills to generic companies to make its drug delavirdine, an anti-retroviral sold under the trade name Rescriptor.

AIDS activists praised the idea of using a nonprofit agency as an intermediary — even if the drug on offer is not in great demand. But they stressed that without billions more in aid from the West, the world's poorest countries wouldn't be able to afford even the cheap, generic copies.

"This is half of what's needed," said Dr. Amir Attaran of the Center for International Development at Harvard University, who helped develop the model. "This helps solve the supply side, but there's no demand because these countries are deadly poor."

The plan was announced at the World Economic Forum by Pharmacia — which is being acquired by Pfizer Inc. — and groups involved in trying to bridge the often bitter divide between drug companies and activists.

The IDA — a 30-year-old organization that works to get generic drugs into developing countries — would monitor production quality and collect a 5 percent royalty to cover costs and fund new research.

The generic companies could then sell the copies in 78 countries where annual per-capita income is less than $1,200 or the HIV infection rate is above 1 percent.

The plan is meant as an alternative to compulsory licensing, under which countries facing health crises seize patent rights and make drugs without the cooperation of the original maker.

"We think its a very innovative step in the right direction," said Richard Feachem, executive director of the Geneva-based Global Fund to Fight AIDS, Tuberculosis and Malaria.

Drugs would be sold at a "reasonable price and with assured quality," Feachem said.

Most importantly for Pharmacia and other drug companies that were being encouraged to consider following suit, the copies would be different in shape, color, packaging and name from the same medicine sold in the West. This would help customs officials prevent smugglers bringing the cheap version back into developed countries.

"If low-cost products undermine the high-cost market, then the profit goes, then the research and development goes," Feachem said.

Daniel Berman, a spokesman for the Access to Essential Medicines campaign at Doctors Without Borders, called the model "really quite interesting."

"For the first time a company is offering a nonprofit organization rights to distribute its AIDS drug in a large block of developing countries," he said.

But he said delavirdine — which usually has to be taken in combination with other drugs — would not be of much benefit to people with AIDS because it's not on the World Health Organization's essential medicines list and is not much in demand.

He called on other drugs companies to follow suit — and for a mandatory system if they refuse.

"If we leave it up to the companies to decide, in most cases what the developing countries will get will be the crumbs," he said.

Pharmacia's senior vice president Michael Friedman said the company was trying to provide more "options" for poor countries.

He described the plan for delavirdine as "a model system that has to be explored," and stressed that Pfizer — the world's largest drug company — was "strongly supportive."

Feachem conceded that many countries couldn't afford even those drugs without international aid. After the Global Fund distributes its second round of grants next week — $500 million to programs in 60 countries — it will be basically broke.

"We're fully unfunded for the third round," Feachem said, calling on Group of Seven countries who created the fund to keep it alive. The fund has raised $2.2 billion but needs $6 billion more in the next few years, Feachem said.

By Paul Geitner

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