In Guatemala, 67,000 people - of which 4,800 are children - are living with HIV/AIDS.9 Not much attention is given to HIV/AIDS in the country. ARVs are available, but unaffordable: treatment from originator companies costs from $320-$800 per month, and the average income is about US$160 a month. MSF treats nearly 400 patients with ARV therapy in hospitals in Guatemala City and Coatepeque, and plans to double the number of patients under treatment next year.
Since ARVs are not protected by patents in Guatemala, MSF uses generic ARVs in its programs. Just one year ago, this meant the price differential between what MSF paid for generics and the price the Guatemalan government paid for originator drugs was between 75- 99% (see table). Although the prices of originator ARVs have fallen dramatically in the past year due to generic competition, they are still on average two to five times as expensive as quality generic alternatives.
Should the government decide to launch a national treatment program and use generic medicines, under today's laws it would have the right to buy the affordable medicines that MSF is purchasing.
But if FTAA introduces new, more stringent rules, access to affordable medicines will be much more difficult and already strained health budgets will not stretch nearly as far.
Patents are not the only way that the FTAA could restrict access.
In April 2003, under pressure to adopt US standards for protection of pharmaceutical test data, the Guatemalan government modified its national intellectual property bill by passing a decree. This decree gives originator pharmaceutical companies five years of exclusivity on the test data they must provide to get a drug approved by the DRA. This means an automatic five-year delay in the availability of generic drugs even if they are not under patent.
For thousands of Guatemalans living with HIV, five years without access to affordable ARVs can be the difference between life and death.
MSF, in conjunction with Guatemalan civil society groups, is urging the government to repeal the decree and abolish data exclusivity, in order to promote generic competition and improve access to quality medicines.
As it stands, Guatemala is the only country in Central America that gives five years of exclusive protection for test data, but the FTAA threatens to extend such a provision to all countries of the Americas.
© Juan Carlos Tomasi
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An MSF doctor examines a man living with HIV in Guatemala.