ABIDJAN, Ivory Coast — Far from the big courtroom battle over HIV-drug patents in South Africa, the West African nation of Ivory Coast quietly imports knockoff generic HIV drugs as it has for years without fuss, patent payments or apologies.
"Believe me, I don't care," Kassim Sidibe, director of Ivory Coast's AIDS program, said Monday of patent rights.
Dr. Marc Aguirre, director of Hope Worldwide in West Africa, talks to a patient who is HIV positive in Abidjan, Ivory Coast. While South Africa is embroiled in a courtroom battle over HIV-drug patents, Ivory Coast is quietly importing knockoff generic HIV drugs as it has for years.
"Our concern is what we can do for our people," said Sidibe, who runs the national program out of a dusty concrete compound in a working-class Abidjan neighborhood.
"The lower the prices are for us, the better for our people."
With that attitude, Ivory Coast has become one of the first African nations to negotiate at-cost deals for leading HIV drugs.
And now the country has reached a new deal that is expected to bring down the cost of a month's HIV drug treatment from $410 this year to $88 to $112 next year.
Senegal, Rwanda and Uganda announced similar deals with drug makers this month. In the West, a month's HIV treatment would cost about $1,000.
It's an example of the pressure the West's big drug makers are facing from generics, from AIDS activists and from Africa.
"We feel drug makers should make profits in Europe and North America," said Sidibe. "Not from us. We don't have anything."
In South Africa, leading drug companies went to court this month to block a law that would let South Africa both import generic drugs and make its own.
But in sub-Saharan Africa when it comes to acquiring HIV drugs, it's a little more like the Wild West
In Ivory Coast, the government gets the HIV drugs it wants by taking bids for them worldwide.
When two of the bids for 2001 came back for knockoff drugs at what Ivory Coast deemed the lowest and best offer, Ivory Coast took them.
The national AIDS program shipped in AZT and stavudine from a Bombay, India-based generic company, Cipla Ltd., bypassing their brand-name makers, GlaxoSmithKline and Bristol-Myers. Bristol-Myers markets stavudine as Zerit.
The result was a 20 percent savings in the average monthly therapy down to $410 from nearly $500, said Makan Coulabily, an official with the AIDS program.
Sidibe, the national AIDS director, didn't bother to determine whether there were patent rights at issue or not.
"We bargain until we get the minimum price," he said Monday.
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