China Seeks Low-Cost Drugs for AIDS Patients

BEIJING - China's focus on HIV and Aids has moved away from dispelling doubts over the number of patients to getting the cheapest treatment for its 840,000 patients, mostly farmers, of whom 80,000 have full- blown Aids.

The Chinese government attacks the health scourge with a twin strategy. Education and prevention form one half. Treatment forms the other.

While educating people, especially in rural areas like Henan province where the disease is epidemic, has been relatively successful, the government is still grappling with ways to get patients treated at the lowest cost.

'The United States Food and Drug Administration has approved 21 drugs that can treat HIV and Aids but few of these drugs are locally made,' said Vice Health Minister Wang Longde at a State Council press conference yesterday.

Cocktail treatments, a combination of Aids drugs, work best to mitigate the illness. But a concoction from drugs patented by foreign pharmaceutical firms can cost a patient up to 40,000 yuan (about S$8,400) a year.

Mainland drug firms are able to produce five generic drugs, whose patents have expired, and bring down costs to about 3,500 yuan a year. But the Health Ministry admits they are not as effective.

'We have a few solutions but they have relatively strong side-effects,' Mr Wang said. The government has cast its eyes on several alternatives.

Among the most controversial is compulsory licensing, an action sanctioned by the World Trade Organisation in 2001. It allows poor countries to make or import drugs at prices lower than those set by foreign drugmakers, if the health threat has become severe.

Having sat on a decision for three years, the government has decided that 'conditions are not mature' for such an action.

'China is not yet in an emergency situation,' Mr Mao Qunan, deputy director-general for the Health Ministry's department of general administration, told The Straits Times.

The government, instead, has found ways to turn drugmakers into partners in Aids treatment. At least one pharmaceutical company has joined hands in a scheme to provide drugs to patients in rural areas and urban residents who lack medical insurance.

GlaxoSmithKline (GSK), the world's second-largest pharmaceutical company, is slated to sign an agreement early next month to provide the Chinese government with the drug 3TC, which is currently imported and sold at market price.

The government will buy the drug at reduced rates and provide it free to patients on the national treatment scheme.

For others, the drug will continue to be sold at retail prices on the market.

'We can supply enough of the drug to cater to China's Aids patients,' GSK spokesman Li- lian Xiao told The Straits Times.

In 2001, Merck Sharp and Dohme agreed to cut retail prices in China for its Aids drugs crixivan and stocrin.

They combine to form an effective cocktail.

Another way to knock down prices: Getting international drugmakers to localise production.

In 2002, GSK became the first global pharmaceutical company in China to plan local production of an Aids drug.

Since then, it has ploughed US$92 million (S$158 million) into a factory in Tianjin to produce combivir, but only in sample quantities for now.

Mass production can begin only after the State Drug Administration tests and approves the product.

'We are waiting for approval but so far, the process has been smooth,' Ms Xiao said.