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Vol. VII, No. 13 - San José, Costa Rica, March 30, 2001
AIDS Activists Cheer Treatments Drug Discount
By Tim Rogers
Tico Times Staff

AIDS activists in Central America this week applauded a recent announcement that CRIXIVAN and STOCRIN, two of the most widely used antiretroviral medicines for the treatment of the HIV infection, will now be made available throughout the isthmus at dramatic new price reductions.

Merck and Co., a leading research-driven U.S.-based pharmaceutical company that develops and markets the two "combination" drugs, announced last week the lowering of its prices by almost 85 percent in Central American countries.

According to Richard Stern, director of the Costa Rica-based Agua Buena Human Rights Association, the pharmaceutical company’s announcement translates into a price of $600 per year for CRIXIVAN in the countries of Belize, Guatemala, Honduras and Panama, and a new price of $1029 per year in Costa Rica, El Salvador and Nicaragua.

Meanwhile, STOCRIN will now be offered at $500 per year in Belize, Guatemala, Honduras and Panama, and sold for $920 per year in Costa Rica, El Salvador and Nicaragua.

The price differences, according to Grey Warner, Merck’s vice president for Latin America, are based on a United Nations index of incidence of AIDS in each country. The countries which have an incidence of AIDS greater than 1 percent—as is the case in Belize, Guatemala, Honduras and Panama — receive a discount larger than countries where the number of incidences is less than 1 percent.

With the announcement of new discount prices on CRIXIVAN and STOCRIN, Merck will no longer profit from its drug sales to developing countries.

"Our goal is to spur efforts to accelerate access to these life-saving medications in those developing countries where the HIV/AIDS epidemic has taken a widespread and devastating toll on the lives of those living with HIV, their families and their communities," said Raymond Gilmartin, president of Merck.

"The epidemic also places a heavy burden on health care systems already under severe resource constraints. Through this action, we hope that more governments and other purchasers will invest more funding toward infrastructure and HIV care and treatment."

Although now being hailed as a victory by regional AIDS activists, when Merck made its original announcement of price reductions for "the developing world" on March 7, it extended the offer only to the countries of Sub-Saharan Africa, excluding the nations of Central America—a region that earned the company $4 million per year in profits from its drug sales.

Undeterred by the setback, regional activists, headed by Stern, launched a campaign to convince Merck to reconsider its offer and include the nations of Central America on the list of "developing countries" eligible for the discount prices.

A letter of petition written by Stern March 26 and signed by 234 activists from around the world persuaded Merck to give in and offer the same price reductions to the countries of Central America.

"The result of the petition was obvious," said Stern. "Merck decided against making a major stance in Central America against price reductions and, in fact, acted swiftly to curb any continuing negative publicity."

CRIXIVAN and STOCRIN are combination antiretroviral agents indicated for the treatment of HIV infection. CRIXIVAN is one of the most widely used protease inhibitors worldwide, with some 200,000 people with HIV/AIDS in more than 80 countries currently using it as part of their regular daily treatment.

"Even at these new lower prices, the issue of access is not solved," said Per Wold-Olsen, president of Merck’s human health business in Europe, the Middle East and Africa. "Antiretroviral therapy will remain out of reach for millions of people in poor countries where the epidemic’s ravages are the worst. In the long run, the only sustainable way to provide care and treatment for the millions of people living with HIV/AIDS in these settings in through public and private partnerships to address all of the barriers to care."

While an under-reporting of the incidents of AIDS in the region makes it difficult to assess the total number of people who are affected by the plague, Stern estimates that 90 percent of people living with AIDS in Central America have "totally inadequate medical care."

Although the number of people with AIDS is growing throughout the region, authorities estimate that 60 percent of all Central American AIDS cases are in Honduras—a country whose population accounts for just 17 percent of the region’s total.

"I consider this announcement by Merck to be good news for the region," Stern said. "What follows are continued efforts to work on infrastructure and distribution, as well as to pressure other companies which produce antiretrovirals to make similar discounts."


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