Euphoria over generic AIDS drugs in Mali

Bamako- Mali (PANA) -- The possibility of manufacturing generic drugs in Mali is far away despite the hope raised by the recent withdrawal of a court case lodged by pharmaceutical companies against the South African government over the issue, according to sources at the Malian Factory of Pharmaceutical Products (UMPP).
The case sought to stop South Africa from using a law in favour of importing cheap anti-AIDS generic drugs.
"We are not yet in a position to manufacture today generic drugs to treat HIV/AIDS," said the UMPP Deputy Director, Bakary Nana Coulibaly.
This incapacity can be explained by the fact that the Malian pharmaceutical factories "do not yet have appropriate technologies to produce anti-HIV tablets," explained Coulibaly whose company only makes nivaquine (chloroquine), paracetamol (doliprane), aspirin and antibiotics for the Malian market.
To make generic drugs for HIV treatment in Mali, "technology transfer will be needed," he said.
The director of Mali's Care, Assistance and Counselling Centre (CESAC), Dr Aliou Sylla, said "the importing of generic drugs against AIDS must meet certain medical norms.
" Medical authorities must make the effort to import only low-cost but good quality generic drugs.
This is to avoid possible cases of resistance, Sylla explained.
Sorting out patients eligible for treatment with the anti-retrovirals must be done rigorously, he said.
These fears are also shared by Dr Bassidiki Traoré of the National AIDS Control Programme (PNLS) which felt that "the euphoria of the forthcoming arrival of generic drugs or anti-retrovirals should not make us lose sight of the implementation of our programmes to fight the pandemic.
" The personal involvement of President Alpha Oumar Konaré in AIDS control activities and the political will of his government has translated into several concrete actions, including the putting in place of a budget line of one billion CFA francs for the case management of people infected or affected by HIV/AIDS (1 USD = 750 CFA).
Following the example of other African countries, Mali has embarked on an initiative of access to care and treatment dubbed "Malian initiative for access to anti-retrovirals.
" Within this framework, the country concluded on 7 April an agreement with four pharmaceutical research laboratories, making possible the supply of anti-retroviral drugs at prices that could reach a reduction of 89 percent as compared to the prices charged in the West.
This cost reduction is God-sent for the 130,000 HIV-infected people in the country, some of whom were unable to pay every month between 310,000 CFA francs and 450,000 CFA francs.
With the help of the Care, Assistance and Counselling Centre at least 30 Malian patients freely get their supply of anti-retroviral drugs from abroad.
The signing of these agreements, as well as the putting in place of an appropriate mechanism of subsidising health care, are expected to enable Mali to treat 300 to 400 AIDS patients in 2001 and 500 to 600 AIDS patients in 2002.
The hope raised by the fall of the prices of anti- retrovirals quickly vanished, however, among many known Malian carriers of the virus.
This has also made the president of the Women's Association for Assistance and Support to AIDS Widows and Orphans (AFAS), Aïssatou Sacko, feel bitter.
Sacko said: "We have the feeling that the authorities want to marginalise us in the choice of candidates to treatment.
For as soon as the fall in the prices of anti-retrovirals was announced, many anonymous patients declared themselves as carriers of the virus.
" Sacko's words were confirmed at the National AIDS Control Programme where several patients, so far unknown, have decided to come forward.
She said she expected the government to have "the total involvement of associations of AIDS patients in the management and distribution of the anti-retrovirals.
" Cheick Kalil Tounkara of the Malian Association of People Living with HIV (AMPV) is more critical towards health authorities.
"We have always hoped that infected people, who are active members of an association, will be given priority in the treatment.
In view of the cavalier attitude of the authorities, we can only lose hope," he lamented.
The availability of anti-retrovirals is, however, has been welcomed by Mali's health workers.
General practitioner Moctar Koné, who works in community health centre (CSCOM), said that the government initiative which will give Malian patients easier access to AIDS drugs is commendable.
"It is high time that we, as care providers, got efficient drugs for our patients," he said.
Dr Abdoulaye Diallo, who provides his services in a privately-owned clinic in Bamako, warned his fellow practitioners: "Anti-retrovirals should not be administered to any patient.
" He added: "Serious medical and bio-clinical criteria must be established before beginning treatment.
The socio-sanitary staff must make a point of updating itself.

26 april 2001 08:36:00

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