Appeal for Malaysians to have access to affordable medicines

OPEN LETTER TO PRIME MINISTER DATUK SERI ABDULLAH AHMAD BADAWI (sent to
the Malaysian media on 3 March 2006)

Appeal for Malaysians to have access to affordable medicines

We understand that the Malaysian Government is about to begin
negotiations with the USA for a free trade agreement (FTA). As a group
representing people living with HIV/AIDS (PLWHAs) in our country, we are
very concerned that the life-saving medicines we need may become even
more unaffordable if a FTA is signed with the USA.

Excessive, high prices of antiretroviral drugs (ARVs) due to patents in
the hands of some big global drug companies have led to world wide
outcry in recent years. When there was competition from generic ARVs
used to treat AIDS, the prices of patented drugs fell from US$11,000 per
patient per year to US$150 per patient per year. Even then, this is too
expensive for those who are poor and in deed of treatment. That is why
generic drugs are so very important.

No generic drugs means no access to affordable life-saving AIDS drugs.
This will translate to more deaths to PLWHAs. In Malaysia, figures in
June 2005 show that there are 63,438 reported cases of HIV infection,
and 10,044 AIDS cases in Malaysia. Between
1986 and June 2005, we have already lost 7,673 lives.

At the same time, we understand that the Ministry of Health (MOH) is
looking at reaching out to 1,200 intravenous drug users as a target for
their Harm Reduction program. With this program, MOH is also
establishing a strong referrals system to hospitals, rehabilitation
centres, substitution therapy, etc. This program is an entry point
towards encouraging more voluntary testing and counseling. Therefore,
there are more likely cases of HIV/AIDs to be detected amongst this
invisible population. This in turn will lead to a bigger number of
detected HIV/AIDS cases in Malaysia. The impact of the FTA will also be
on this invisible population. The World Health Organization in June 2005
has already warned that an HIV epidemic is knocking on Malaysia’s door.

We were very encouraged when the Government issued a special compulsory
licence in 2003 to import some generic ARVs from India for use by MOH.
The monthly treatment cost by government hospitals and clinics fell by
81% from US$315 to US$58. MOH has targetted 4,000 people to be on ARVs
therapy. But this is still below the more than 10,000 AIDS cases that
need urgent treatment. The import licence has also come to an end. So we
hope and trust that the Government has plans to ensure continuing access
to affordable ARVs. Without ARVs, more PLWHAs will die.

That is why we are very worried about news reports on FTA negotiations
with the USA. We do not know what is being proposed in the Malaysia-US
FTA, but based on previous US FTAs and the US proposals in the
controversial Thai-US FTA negotiations, there are a number of common
provisions which are very alarming. We believe the US will demand that
Malaysia also agree to similar provisions, and these will make all
medicines more expensive.

For example, US FTAs usually force more medicines to be patented and the
patents have to continue for more than 20 years, which is the length of
time for patents to run. When a medicine is patented, it means there is
a monopoly and so no other manufacturers can make that medicine. That
means that the patent owner can charge as much as it likes because there
is no competition.

We have learnt that US FTAs also impose monopolies for at least five
years even when there is no patent, by blocking the use of test
information by health authorities to register generic versions of the
patented drugs.

We make a strong plea to Datuk Seri and the whole Malaysian Government
to reassure us that public health will always be a top priority and that
FTAs with Malaysia will not contain anything that goes against access to
affordable medicines. We urge Datuk Seri to hold consultations so that
we, the PLWHAs, and all Malaysians can learn more about FTAs that will
be negotiated and how they will have an impact on public health and
access to affordable medicines. We also urge Datuk Seri to continue with
the Government’s promise of transparency by making public suggestions
and proposals in the FTAs.

For PLWHAs, the treatment that we need is a life long treatment. For us,
it is a matter of life and death. So we strongly appeal to you, Datuk
Seri, to safeguard our human right to affordable medicines and
treatment. Please do not allow an FTA with the USA or any country that
will harm the health of Malaysians.

Thank you.

  1. Positive Malaysian Treatment Access & Advocacy Group (MTAAG+) [ A group of People Living with HIV/AIDS doing treatment literacy, treatment advocacy and networking]
  2. Positive Living, PT Foundation. [ A program of Community Based Organization to provide drop in center, outreach and peer counseling for People Living with HIV/AIDS.]

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