North Africa

We work in Morocco, Tunisia and Egypt to reduce the price of medicines. Across these countries an estimated 43,600 people are living with HIV.

The problem

These countries are part of the Middle East and North Africa (MENA) region which has one of the fastest growing epidemics in the world; it also has the lowest coverage of antiretroviral treatment (ART). By the end of 2012, less than one in eight people eligible for ART were receiving it.

Closing the treatment gap will be unaffordable while countries are forced to pay exorbitant prices for patent-protected antiretroviral drugs (ARVs). Although prices aren’t reducing, funding is. Treatment budgets are generally dependent on international donor funding which is diminishing for middle-income countries. In addition, the HIV epidemics in these three countries are concentrated in vulnerable, often criminalized, communities, which means they are more difficult and costly to reach.

Voluntary licenses have been the preferred mechanism for ensuring access to treatment. They allow generic companies to produce medicines for certain resource-limited countries. These licenses are either initiatives of multinational companies or negotiated through international organizations like the Medicines Patent Pool. However, until recently, all licenses excluded MENA countries.

The background

During the past decade, competition from generic drug manufacturers opened up and led to progressive price reductions. This played an important role in scaling up access to treatment in these countries, and across the region. However, the price decreases witnessed for first-line therapy are unlikely to happen for more recently developed ARVs as these newer drugs are increasingly protected by patents.

As a result, very few countries in the region have third-line treatment options available. Where they are available, the cost to the national budget to buy ARVs is so high that it will be very difficult to sustain given the rising number of people in need of treatment.

Our partner, ITPC-MENA, has coordinated research on the patent status of HIV and Hepatitis C (HCV) medications to identify where intellectual property (IP) barriers are preventing access to treatment. The WHO has included our information in the Patent Landscape of HCV Medicines, published in 2015.

ITPC-MENA has developed a training curriculum on IP and access to medicines. To date, 35 civil society representatives, people living with HIV, media and other stakeholders have been trained in Morocco, Tunisia and Egypt.

In 2014, ITPC-MENA was part of a successful campaign which blocked the negotiations for a trade agreement between Morocco and the EU. ITPC-MENA organized a public debate on IP and medicines which led to media and public scrutiny of the deal. ITPC is ready for when negotiations start again.

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