Why is Treating Cancer so Expensive in South Africa?
South Africa is not a rich country; in actual fact most of its population are poor and with an unemployment rate averaging around 26% the pinch is felt in most households. Add to this fact that in households where there is Childhood Cancer, one parent generally has to stop working in order to be with and care for their child, and the situation looks even worse.
In a Childhood Cancer household, there is not only now one less earner, but the added costs of a special diet, medications, trips to the doctor, clinic, hospital; added transport costs, and of course even if the child is being treated at a government hospital, there are medication costs as well.
It beggars belief then why the costs of medication is so high in this country. One reason is South Africa’s outdated patent laws which prohibits patients from getting generic medications.
Almost 15 years after the signing of a critical international agreement (the Doha Declaration on Public Health) that gave countries the ability to change their laws to incorporate public health safeguards, South Africa has yet to write these safeguards into our national laws. By contrast to the chronic delays in South Africa, countries like Argentina, Brazil and India have actively used these WTO-sanctioned health safeguards to protect the health of their citizens.
Earlier this year, Minister Davies delivered a landmark keynote address at the World Intellectual Property Organisation’s (WIPO) International Conference on Intellectual Property and Development in Geneva.
“Compulsory licenses are another avenue of policy flexibility permitted under the TRIPS Agreement that may be used as an instrument to promote domestic production where voluntary licenses are not available on reasonable commercial terms. There are several examples around the world where compulsory licenses were issued and employed successfully to ease access to affordable medicines,” Davies said.
In May 2016, the South African Minister of Health, Dr Aaron Motsoaledi presented the budget for his Department to Parliament and took a strong stance on the costs of cancer drugs, and it was hoped that action would soon follow, but alas…
After years of advocacy, the South African government finally committed to reforming South Africa’s patent laws in a draft National Policy on Intellectual Property published in 2013. Yet three years later, nothing has changed and many people still suffer unnecessarily.
In July 2016, Cabinet approved a new Intellectual Property (IP) Consultative Framework for South Africa. The framework now presents a new process for reforming our patent laws. Yet still nothing has happened…
On the 27th September 2016 more than 1000 activists from the Fix the Patent Laws campaign marched to the Department of Trade and Industry (DTI) in Pretoria demanding that the DTI take urgent steps to fix South Africa’s outdated patent laws so that everyone can get the medicines they need. They Fix the Patent Laws campaign also handed over a detailed submission of recommendations on this consultative framework.
“Currently people are suffering and dying because medicines for cancer, hepatitis, tuberculosis, mental health and many other diseases are too expensive,” said Nkhensani Mavasa, National Chairperson of the Treatment Action Campaign. “While we won the fight for first line HIV medicines, we lost the battle for almost all other medicines.”
“The government has a moral, legal and Constitutional obligation to ensure that everyone can access the medicines they need – yet 15 years down the line and we are still putting the profits of industry before the lives of the people,” says Cassey Chambers, from the South African Depression and Anxiety Group (SADAG).
Without these reforms, many medicines in South Africa will remain unaffordable or unavailable. Entecavir – a chronic medicine to treat hepatitis B – is unavailable in the public sector due to its cost. It is available in the private sector at over R5 500 per month, while in comparison, it is available in India at R480. Celecoxib – which treats pain in patients with rheumatoid arthritis and osteoarthritis – is 80% more expensive in South Africa than India. WHY??
Herceptin is unavailable in the public sector and costs almost R500 000 for a year’s treatment in the private sector, in comparison to a generic version of the drug produced in India, which costs a fraction of this at about R 150 000, but is blocked by Roche’s patent which expires in 2023.
Research shows that Herceptin improves the survival rates of breast cancer patients by up to 37%. In 2013, the drug earned manufacturer Roche more than R1 million. (Reuters)
“Medicines for cancer are exorbitantly priced. Many aren’t available in the public sector and even private medical aid schemes don’t want to pay for them,” said Salomé Meyer from the Cancer Alliance. “We joined the campaign because we think it is reprehensible that people cannot access life-saving medicines. The South African government must stand up to the pressure of the multinational pharmaceutical industry and urgently amend these laws.”
Bernice Lass has a neurological disorder, transverse myelitis. It causes extreme pain in her back and legs, affecting her ability to move and forcing her to quit her job as a nurse. Her doctor prescribed Lyrica.
Despite a motivational letter from Lass’ doctor, her medical aid has refused to cover the cost of Lyrica, which can cost up to about R8 000 a year. Pfizer pharmaceutical company holds the patent for Lyrica in South Africa. It prohibits the importation of cheaper generic versions of the drug, which is also used to treat fibromyalgia and epilepsy, the civil society Fix the Patent Laws campaign reports.
In 2013, Pfizer made R74 million from the sale of the drug in South Africa’s private sector. The drug is among the top 50 cost drivers of medicine expenditure in the country, according to campaign.
Lass now relies on her son and brother for the medication.
“I feel embarrassed asking them though – as before I was always independent and had my own money. I personally know others with my condition who really need this medicine to deal with their pain but just can’t afford it,” she says in a new report released by the campaign Tuesday. Lyrica is one of eight drugs in the report that are not procured nationally for the public sector or fully covered by medical aids. These medicines include drugs used to treat aggressive forms of cancer, schizophrenia and hepatitis B.
Activists want the department to introduce stricter patent criteria in line with international standards to ensure that the market for older drugs such as Lyrica is opened up to generic competition. They are also calling for a transparent patent process that would, as in India, allow the public to oppose patents.
“We need this policy changed now,” says Claire Waterhouse, advocacy officer for international humanitarian organisation Doctors Without Borders (MSF)’s Access Campaign.
“Affordable medicines need to be getting to South Africans and people living in South Africa as quickly as possible. Our report shows that this problem is not limited to certain diseases or to specific areas of the country or classes of people — it affects everyone.”
SO, Minister of Trade and Industry Rob Davies and Minister of Health Dr Aaron Motsoaledi, what are YOU doing about this? What are YOU doing to help the most vulnerable citizens of South Africa obtain the life-saving medications they need at reasonable/affordable prices?
The Fix the Patent Laws report, “Patent barriers to medicine access in South Africa: A case for patent law reform” can be read or downloaded in PDF format HERE