Buying antibiotics at a lower cost only useful if the drugs are generic

We read with cautious scepticism the article entitled “You will now pay less for original antibiotics” (The EastAfrican, January 25-31).

While we welcome any attempt to increase Kenyans’ access to medicines by any player, including industry, we wish to lend a realistic, public health viewpoint to the article.

First of all, “original” medicines in general are inconsequential to Kenyan health policy. It is “generic” medicines which form the backbone of Kenya’s health system, as they are more affordable for both the government and consumers. Indeed, government policy promotes the prescription and use of generic medicines.

Missing drugs

Kenya’s Essential Medicines List (based on the model list prepared by the World Health Organisation) and Standard Treatment Guidelines reflect the population’s priority public health problems. While amoxicillin/clavulanic acid (“Augmentin”) is on WHO’s EML and may at times be found in Kenya’s public health facilities (often sourced as a non-GSK generic), cefuroxime (GSK’s “Zinnat”) is not. Cefuroxime is not an “essential medicine” — either by WHO or Kenyan standards. This medicine, and any price reduction associated with it, is hence of limited significance to the health of the majority of Kenyans.

Competition’s role

Regardless, it is widely known that the greatest driver of price reductions for medicines is generic competition. Indeed, prices of antibiotics and other essential medicines have dropped over 90 per cent due to the introduction of equivalent generic versions. Even if these GSK medicines were of crucial importance to Kenyans, generic competition would drive down prices much further than GSK’s new offer, much as it is welcome.

The article notes that “because the drugs are patented, GSK holds exclusive global rights to manufacture and sell them for 15 years and no other company can formulate a similar product.” This is incorrect.

The World Trade Organisation’s Agreement on Trade-related aspects of Intellectual Property Rights (Trips) provides that public health should take precedence over commercial interest and patent rights. The manufacture and sale of generic versions of medicines of significance to Kenya’s public health problems are indeed allowed under Kenya’s patent law in line with the Trips agreement.

The majority of Kenyans live in poverty and only about 30 per cent access essential medicines. Let us focus on how public health policy can best support their right to health.

Gichinga Ndirangu, Christa Cepuch, Redemtor Atieno
Health Action International (HAI) Africa