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ARV supply causing concern
news24
2004-05-21

As government's national rollout of antiretrovirals intensifies, there is growing concern that the available sources of supply could be pressured by the demand.

As government's national rollout of antiretrovirals intensifies, there is growing concern that the available sources of supply could be pressured by the demand.

Cape Town - As the government's national roll-out of antiretrovirals (ARVs) intensifies, there is growing concern that the available sources of supply - including the only South African company manufacturing generic ARVs, Aspen Pharmacare - could be pressured by the demand.

The risk at the moment is that we can't predict how much we need, both from Aspen and outside the country, said Andy Gray, senior lecturer at the department of pharmacology at Nelson R Mandela School of Medicine.

Gray said already shortages had been noted, with stocks of branded products not being available at times. Manufacturers and suppliers need to plan production and possibly import more raw materials in future, but are hampered by a lack of information about potential demand, he said.

Gray said two factors holding up generic ARV supplies were the need for licences to be granted by patent holders - such as Boehringer Ingelheim, GlaxoSmithKline and Merck - to produce generics, and delays in the registration of generic medicines by the Medicines Control Council (MCC).

The government is in a difficult position... with some generics sitting with the MCC for more than a year waiting for registration, meaning that, in essence, they (the government) must buy from brand-name sources.

Gray said if South Africa had a range of suppliers selling products at the same, or similar, prices, this could help guard against shortages. He said that besides Aspen Pharmacare, which was physically making ARVs in South Africa, two other SA-registered companies had the potential to be large-scale suppliers of ARVs in the country.

These are the Indian-based Cipla and Ranbaxy, both of whom manufacture ARVs abroad at competitive prices. Ranbaxy has formed a joint venture with Adcock Ingram to market ARVs locally, trading as Thembalami.

These companies, and Aspen, were expected to tender as suppliers of the government's ARVs, Gray said. According to Medicins Sans Frontieres (MSF or Doctors without Borders), the advantages of having a local manufacturer and distributor of generic ARVs were the creation of wealth.

But, even more important, having local manufacturing offers the government the possibility to set up price-control policies on the ARVs to ensure affordability and sustainable supplies for the public sector, said Dr Marta Darder, head of the Access-for-Drugs campaign.

Darder said a potential problem with companies such as Aspen was that it was 100% in private hands and would follow the rules of the market. (Source: www.news24.com, May 17 2004)

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