Evidence of meeting #39 for Industry, Science and Technology in the 40th Parliament, 3rd Session. (The original version is on Parliament’s site, as are the minutes.) The winning word was generic.
A recording is available from Parliament.
Bloc
Luc Malo Bloc Verchères—Les Patriotes, QC
According to you and your partners in the field, that would meet Africa's current needs, would it?
President and Founder, Canada Africa Community Health Alliance
That would meet the current needs. In other words, it will take a few years before we get to that point.
Having said that, we have a real problem today: can we continue to supply medication to 5.2 million people? Some countries have trouble buying the drugs they need.
Bloc
Luc Malo Bloc Verchères—Les Patriotes, QC
Will those countries make a request to the WTO, as Rwanda did in 2007? Are they planning on doing something like that?
President and Founder, Canada Africa Community Health Alliance
Absolutely, they are already doing that. To obtain their medication, they are going through the same systems they have already used.
That said, we must open up the field for two reasons. First, there will be more markets, which could meet the needs of the African market. Second, by having more competition on this market, we will be able to further reduce the price of treatments.
Bloc
Luc Malo Bloc Verchères—Les Patriotes, QC
I see that Mr. Elliott wants to make a comment. I am going to ask my last question and then turn over the floor to you.
What you are telling us is that the drugs available on the African market are currently still too expensive.
President and Founder, Canada Africa Community Health Alliance
If we want to double the number of people getting treatment without raising the final costs—since these medications are largely paid for by the Global Fund program or by PEPFAR—we have to reduce the price of medications even further.
Bloc
Luc Malo Bloc Verchères—Les Patriotes, QC
So are we trying to take care of twice as many people with the same budget?
President and Founder, Canada Africa Community Health Alliance
Yes, without having to go back to G8 to ask once again for twice as much money.
Executive Director, Canadian HIV/AIDS Legal Network
I just wanted to add one thing. We must remember that the drugs from suppliers in India are generic drugs and these are the drugs we are currently using to treat patients with HIV. For the most part, they are first-line antiretroviral drugs. That is why we now have 5.2 million people undergoing treatment. Most of them are taking the generic drugs from India.
In the last few years up to now, we have noticed an increase in the number of people who have had to change their regimen to follow a second-line antiretroviral treatment. Under Indian legislation, these products have had patent protection since 2005. So it is not possible to get these drugs in generic form because it is not possible to produce a generic version under Indian legislation. So the drug access crisis will become worse in the future since costs will go up, especially when there is no competition on that market.
Bloc
Luc Malo Bloc Verchères—Les Patriotes, QC
What is the estimated number of patients who will need this second generation of drugs?
Executive Director, Canadian HIV/AIDS Legal Network
That is going to change, isn't it?
President and Founder, Canada Africa Community Health Alliance
When we look at the North American or European market, nearly 20% of people must follow a second-line treatment. But there is another problem: we should have never chosen the first-line treatment we chose from the beginning. It was well intentioned in the beginning, but today we realize how toxic this treatment is. When a patient follows this treatment for two or three years, the toxicity level is very significant. We will now have to replace the most commonly used molecule, which is available around the world, with something safer.
Bloc
Luc Malo Bloc Verchères—Les Patriotes, QC
So, in the long run, all the patients who must be treated will have to be treated with second-line drugs. So, we are talking about 2 million people if we take 20% of 10 million.
That really is the key issue, isn't it?
Executive Director, Canadian HIV/AIDS Legal Network
But it is not a static situation. It is dynamic.
Luc Malo Bloc Verchères—Les Patriotes, QC
Yes, of course. I am well aware that, even if we treat people, the pandemic is not contained.
Conservative
The Chair Conservative David Sweet
Thank you, Mr. Malo. Your time is up. I'm sorry, the clock always marches on.
Mr. Braid, for seven minutes, please.
Conservative
Peter Braid Conservative Kitchener—Waterloo, ON
Thank you very much, Mr. Chair.
And thank you to both of our witnesses for being here this morning. This is a very important discussion, and I appreciate your perspectives and contributions to this conversation.
I wonder if I could start with you, Mr. Kilby. As we know, Canada was the first G-8 country to develop a regime like CAMR. Are there other similar regimes to CAMR now in place in our G-8 partner countries?
President and Founder, Canada Africa Community Health Alliance
Not to the extent that Canada has, but I think Mr. Elliott could comment.
Executive Director, Canadian HIV/AIDS Legal Network
I can speak to that, because I think it's a legal question more than a medical one. There are a number of other jurisdictions that have adopted a version of CAMR. They've put in something in some form, in regulation, legislation, state directive, what have you, that implements the WTO decision from August 2003.
None of those have worked because none of them have actually done it well. They also suffer from different deficiencies. Canada has its own deficiencies, and some of those are shared by other jurisdictions. Some of the other jurisdictions have other deficiencies.
Nobody has got it right yet, but I think Canada could.
Conservative
Peter Braid Conservative Kitchener—Waterloo, ON
To take that one step further, are any of those other jurisdictions with regimes similar to CAMR G-8 partner countries?
Executive Director, Canadian HIV/AIDS Legal Network
The European Union has adopted a regulation that is applicable throughout all the EU member states. The Netherlands is not a G-8 country, but it is a high-income country. Switzerland was drafting one. And then the others would be countries like India, Korea, and so on. They're not G-8 countries but they are countries that have a significant generic production capacity.
But the EU is probably the G-8 stand-in, if you will.
Conservative
Peter Braid Conservative Kitchener—Waterloo, ON
Have any of those advanced countries then, G-8 or not, supplied any developing countries with HIV/AIDS medication through a regime like CAMR?