Our campaigning in Eastern Europe and Central Asia is focused in Georgia, Kazakhstan and Moldova.
Only 25% of people in need of antiretroviral drugs (ARVs) in Eastern Europe and Central Asia are currently getting them.
Healthcare professionals have revealed a growing need for second and third-line ARVs but they are substantially more expensive than first-line drugs. Hepatitis C (HCV) co-infection is also a key issue and the newest direct-acting antivirals used to treat HCV are not available in the region.
Our focus countries are characterized by a number of common features. They are middle-income countries, and ones with a relatively small absolute number of people living with HIV and HCV. Unfortunately, they have a patent system that creates barriers for those people to access the newer HIV and HCV drugs.
Moldova and Georgia have entered an association agreement with the European Union, and Kazakhstan is a member of a customs union with a strong patent protection system, resulting in high prices for medicines. Brand companies are generally quick to secure patents in these countries, yet slow to register drugs for the market.
There is a tendency to exclude middle-income countries from voluntary licenses concluded between brand and generic companies, or brand companies and the Medicines Patent Pool. Even if the countries are included in voluntary licenses, prices tend to be higher than the price that can be achieved through competition from generic drug manufacturers.
Our partner ITPC-EECA aims to see generic drugs accessible in its three focus countries, and to prevent unmerited patents from being granted. The current target drugs are sofosbuvir and daclatasvir, which are used to treat HCV. In collaboration with other organizations, ITPC-EECA has prepared draft compulsory licenses for Moldova and Kazakhstan, intended for use in negotiations with the governments. A meeting with generic manufacturers in Georgia is also planned to discuss the best way to remove the barriers to treatment there. Experts from around the region will join, and the outcome will be an implementable roadmap to get affordable drugs into the country.