South Africa, Colombia Aim to Get Lower-Cost Drugs for TB, HIV

South Africa and Colombia are among the countries aiming to push drug companies to permit low-cost versions of drugs for deadly diseases. The drugs are for people with drug-resistant versions of tuberculosis (TB) and with HIV/AIDS.

One target is the drug bedaquiline. It is used for treating people with drug-resistant tuberculosis. In South Africa, TB was blamed for the deaths of more than 50,000 people in 2021, making it the country's leading cause of death.

Johnson & Johnson is a U.S.-based drug and medical technology company. The company owns a patent for the drug bedaquiline. Patents legally protect a company's right to manufacture and sell a product that it developed or owns for a limited time. The legal protection prevents other companies from making the same drug without permission.

In recent months, activists have protested efforts by Johnson & Johnson to protect its patent. In March, TB patients asked the Indian government to make a lower cost copy of bedaquiline. The government agreed, saying Johnson & Johnson's patent could be broken.

In July, the time limit for Johnson & Johnson's patent on the drug ran out in South Africa. The company extended the patent until 2027 under South African law. However, activists became angry and accused Johnson & Johnson of trying to make a lot of money from the drug.

The South African government then began investigating the company's pricing policies. South Africa had been paying about $282 per treatment course: a full group of treatments. This was more than twice as much as poor countries involved in the Swiss-based Stop TB Partnership paid.

In September, about a week after South Africa's investigation began, Johnson & Johnson announced it would not enforce its patent in more than 130 countries. This would permit other drug makers in those countries to copy the drug.

Christophe Perrin is a TB expert at Doctors Without Borders. He called the decision "a big surprise." He said protecting patents is central to how most drug companies plan their businesses.

In October, Colombia announced that it would permit a third party to make the HIV drug dolutegravir without permission from the drug's patent-holder, Viiv Healthcare. The decision came after more than 120 groups asked the government to let more people use the drug, which is supported by the World Health Organization (WHO).

Peter Maybarduk is with the Washington, D.C., non-profit group Public Citizen. He thinks the Colombian government is trying to take control of its treatment of HIV after not having enough vaccines for COVID-19. He noted that Brazilian activists are pushing their government to do the same.

More changes needed

However, some experts say more needs to change before poor countries can produce their own medicines.

Petro Terblanche is managing director of the biotechnology company Afrigen Biologics based in Cape Town, South Africa. She said African countries produced less than one percent of all vaccines made around the world when the COVID-19 pandemic hit. But, Terblanche said, Africa used more than half of the world's supply.

Afrigen Biologics is part of a WHO-supported effort to produce a COVID vaccine using the same mRNA technology as those made by U.S.-based drug makers Pfizer and Moderna.

Terblanche also noted that African countries need to improve their ability to deliver vaccines. "If we can't get (vaccines and medicines) to the people who need them, they aren't useful," she said.

Lynette Keneilwe Mabote-Eyde is a health care activist who has ties to the noNPRofit Treatment Action Group based in New York City. She noted that South Africa has no clear law permitting the government to take legal action against a patent or a patent extension.

The South African department of health did not answer questions from the Associated Press about patents.

Fighting tuberculosis

In its yearly report on TB released in November, the WHO said there were more than 10 million people sickened by the disease in 2022 and 1.3 million deaths.

After COVID-19, tuberculosis is the world's deadliest infectious disease. It is also now believed to be the main cause of death of people with HIV. The WHO says only about 40 percent of people with drug-resistant TB are being treated.

Zolelwa Sifumba, a South African doctor, found she had drug-resistant TB in 2012. She went through 18 months of treatment, taking about 20 pills every day in addition to daily injections. These left her in severe pain and resulted in some hearing loss. Bedaquiline was not a standard treatment in South Africa until 2018.

"I wanted to quit (treatment) every single day," she said. Since her recovery, Sifumba has been pushing for better TB treatment. She said it makes little sense to charge poor countries, which have more cases of TB, high prices for necessary medicines.

She questioned why poor countries would have to pay a lot for medicine. "If the lower income countries can't get it, then what's the point? Who are you making it for?" she said.

I'm Gena Bennett. And I'm Andrew Smith.

Gerald Imray and Maria Cheng wrote this story for The Associated Press. Andrew Smith adapted it for VOA Learning English.

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deliver –v. to take something from one place to the place where it is supposed to go