Why donations will not solve the access crisis: the example of fluconazole

Figure 1: The Effects of Generic Competition Click on table to see full version
Some developing countries, such as Thailand, Brazil and India, have the capacity to produce high quality generic drugs. The local manufacture of fluconazole, a medicine used to treat AIDS-related meningitis which affects up to 25% of AIDS patients in certain countries, has led to 95% cuts in the price of this essential drug in Thailand. The chart above illustrates how the price of the same drug varies in different countries according to whether or not the drug is under patent by the patent holder, Pfizer. In March 2000, as a response to calls by South African activist groups for a price reduction or a voluntary license to allow generic production, Pfizer promised to provide a donation of fluconazole. But it was almost a year later before patients finally started receiving the drug. Since spring 2001, Pfizer has offered the possibility of a similar donation to 50 least developed nations. An adequate response to the over-whelming burden of infectious diseases will never be possible through donations from multinational pharmaceutical companies. Companies must offer prices equivalent to those of generic drugs in developing countries, and governments in those countries should issue compulsory licenses and encourage parallel imports of drugs.