Mexican advocates push for drug access

Over 150 Mexican AIDS advocates staged a protest on Sunday (June 22), pressing Mexico’s Secretary of Health to declare HIV/AIDS a national emergency.  According to the protesters, this would make drug treatments, including less expensive generic medications, available to more patients.  According to a spokesperson, of 180,000 Mexicans known to be living with HIV/AIDS, only 38,000 are currently receiving treatment.  The protest comes on the heels of a letter to Mexico’s Health Secretary from a coalition of about 60 NGOs, making the same demands.  See this article from Medical News Today and this article from the Kaiser Network for details.

The situation in Mexico provides an interesting case study of some of the complexities of prescription drug access on the international scene.  Read on for more on that aspect of this story.

The main concern of these Mexican AIDS advocates is to make ARVs (HIV medicines called antiretrovirals) cheaper and therefore more accessible to poor Mexicans.  Some longish excerpts from the Kaiser Network article (for reference purposes, KN 6/18/08) and the Medical News Today article (MNT 6/22/08) should help shed more light on this.

In their letter to Health Secretary Jose Angel Villalobos, a coalition of NGOs

criticized the high price of antiretrovirals “set by the pharmaceutical industry.” It added that declaring HIV/AIDS a national emergency would . . . permit the government to “gain access to the mechanisms established by the World Trade Organization for obtaining better prices,” as well as allowing for the purchase and importation of generic antiretrovirals, according to the coalition. In addition, the coalition said it is necessary to rescind a law that requires a manufacturing or pharmaceutical license to import and register medicines in Mexico. The law “limits our access to many options for importing generic medicines,” the coalition said.  (KN 6/18/08)

Mexico is, in fact, in a tricky situation when it comes to negotiating ARV prices:

Certain world bodies classify Mexico as a middle-income country using Gross National Income (GNI) as its measure. The country has a per capita income of roughly USD $7,310; however, AIDS drug treatments that can cost as little as USD $150 in what are designated least-developed or low-income countries in Africa and elsewhere (e.g. Uganda, Malawi) can cost as much as USD $8,000 in Mexico – or about 9.5% more than and average person’s income, making these lifesaving AIDS regimens all but unaffordable to the majority in need there.

This is in part because middle-income countries are usually not proffered the same drug price reductions as low-income countries. However, when it comes to country classification, higher overall average income – middle-income versus low-income – does not necessarily indicate less poverty, and GNI, which divides a country’s total income by its total population to arrive at an estimate of average individual incomes, often obscures the fact that the majority of a country’s citizens may live in poverty.  (MNT 6/22/08)

And there’s the rub.  By the relevant measures, Mexicans aren’t poor enough to get the cheapest prices on HIV/AIDS drugs . . . yet most are too poor to afford the drugs at the prices available to them.  How’s that for irony?

This situation illustrates some of the problems involved in classifying countries according to income, and in deciding which areas need the most help.  If nothing else, it certainly seems like there should be a better method for figuring out “average income.”  Mexico has huge disparities between rich and poor, which means that not very many wealthy people can “balance out” a whole lot of very poor people in this type of calculation.*  Maybe it would make more sense to look for the median individual income?

Prescription drug access and pricing is a huge (HUGE!) issue, and I have to admit that I know a lot less about it than I’d like.  I hope to research it further and post more information on this site.  In the meantime, the situation in Mexico, in addition to being important in itself, illustrates some of the main questions and concerns about prescription availability around the world.  This issue is certainly worth some thought, not to mention some prayers.

(Here’s a link to a WHO page with info on drug pricing.  A heads up, though: it looks pretty technical.)

 

*  I can’t help but remember driving through the city of Juarez (right on the border between Mexico and Texas) on a youth group mission trip in high school.  We saw some big houses, mansions even.  But it didn’t take long to get past them and come to the expansive slum where we were working.

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~ by h.e.g. on June 24, 2008.

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