HIV/AIDS treatment

Christoph Bonsmann, pharmacist at the German medical aid organization Medeor, has been looking forward to this day. He helped set up a production plant that manufactures HIV/AIDS medication in Tanzania. Now he's in Arusha, where the plant has been set-up, and he's preparing to celebrate its opening with Medeor's local partners.

Production of the first test series of drugs is scheduled to start in January 2012, says Bonsmann. The pharmaceuticals will then need approval from Tanzanian authorities.

Funds to support the project came from the European Union which provided five million euros. Medeor contributed 500,000 euros and local partner "Tanzania Pharmaceutical Industries" gave 700,000 euros.

From Tanzania for Tanzanians

The antiretroviral pharmaceuticals Bonsmann wants to produce in Arusha stop the virus from spreading in the body and reduce the risk of infection. According to a recent UNAIDS report, about half of HIV carriers in developing and emerging countries receive this kind of medication for treatment.

"Next year, starting in April, the first pharmaceuticals could be approved for the market and could be used," Bonsmann said. The first AIDS medications produced are intended for distribution by the government in Tanzania. But Bonsmann hopes to attain the approval of the World Health Organization (WHO), which would allow for global distribution of the drugs by the international organization Global Fund.

The production plant is set to produce enough medication to provide for the treatment of 100,000 people diagnosed with HIV or AIDS. The medication is a generic drug that uses the same active ingredients as its more expensive original counterpart.

"Generics account for 80 to 90 percent of the AIDS medications in developing and emerging countries," said Dr. Richard Laing, a medical officer with the WHO and a member of the organization's Essential Drugs Action Program.

Competition from India

Most generic drugs for HIV/AIDS treatment come from India. Companies in India produce large quantities at low cost, making it difficult for new companies to enter the market, said Laing.

But South Africa, Kenya, Zimbabwe and Uganda are now producing WHO-approved AIDS medication.

"Aspen Pharmaceuticals in South Africa for instance has put a lot of effort into coping with competition and was able to undercut prices of Indian companies. But the first years can be hard," said Laing.

Despite the challenges, Christoph Bonsmann remains hopeful about the Medeor's project in Arusha. Local production is intended to make Tanzania less dependent on imported drugs and improve the country's own economic independence. According to their calculations, the plant should be able to maintain competitive prices, Bonsmann explained.

"We calculated that they [the pharmaceuticals] will be in the lower third of prices that are offered by other suppliers worldwide. So we are competitive in regards to the Asian producers, and we are already on location."

Pharmaceuticals are available, but not for everyone

Not everyone who needs antiretroviral medication gets access to the drugs. According to a recent UNAIDS report, about half of those infected with HIV in Tanzania do not have access to the necessary medication.

Bruno Ghumpi is the director of the Tanzanian NGO Wamata in Dar es Salaam. He counsels those people infected with HIV as well as patients who are suffering from AIDS. He explains that anyone who has been diagnosed with HIV is referred to local healthcare centers.

This is where they measure the CD4 cell count by drawing blood. This reveals information about the progression of an HIV infection and indicates how well the patient's immune system is coping. If the CD4 count drops below 400 cells per microliter, the patient will receive antiretroviral medication. But healthcare centers tends to be located in cities. Those living in rural areas often have to travel long distances in order to seek care.

"So the problem is not the distribution of the pharmaceuticals, but the fact that not everyone has access to them," said Ghumpi. She's pleased that Tanzania will open its own medication plant. "But no matter where the drugs are coming from, the quality has to be first class."

The new production facility has not yet had an official inspection. It will be examined by both Tanzanian officials as well as experts from the WHO. But it could be a while before the WHO inspection takes place. Meanwhile, ownership of the plant will be transferred to Tanzanians at the end of next year.

Author: Friederike Müller /sst
Editor: Saroja Coelho