New tax jeopardises treatment access

A new regional tax is making it even more difficult for HIV-positive East Africans to access anti-AIDS drugs, and jeopardising the region's plans for meeting its targets under the World Health Organisation's '3 by 5' initiative, activists told PlusNews. The East Africa Customs Union has imposed a 10 percent duty on goods imported into Uganda, Tanzania and Kenya, and also on goods from Kenya exported to Uganda and Tanzania. Patients in the already overstretched public health system will be feeling the pinch, as the cost of medicines in the three countries is likely to escalate. According to intellectual property rights lawyer Peter Munyi, the pharmaceutical companies, reluctant to absorb the additional 10 percent, would pass the tax burden on to consumers. Although all medicines containing insulin will be zero-rated, antiretroviral (ARV) drugs and other essential medication have not been excluded from the tariff agreement. The customs union has levied the new duty in order to harmonise tariffs in the three neighbouring countries and it will be phased out over five years, Munyi told PlusNews. In the meantime, "the most vulnerable groups are going to suffer. Most people living with HIV/AIDS won't be able to cope with this increase," James Kamau, steering committee member of the East African Treatment Access Movement (EATAM), pointed out. HIV-positive Kenyans using the cheapest generic ARV combination, costing about 1,500 Kenyan shillings (US $20) a month, would now be expected to pay 2,000 shillings ($25) - an amount that was beyond the reach of most people living with the virus, he added. "It's not just drugs. We have to import CD4 count machines and other equipment - how much will we now have to pay for all the monitoring tests?" Kamau wondered. About 220,000 people are in need of treatment in Kenya, and the government plans to treat 95,000 by the end of 2005. But with 24,000 people currently receiving ARVs - almost half of whom are subsidised by the state - this seems unlikely. "Last year, we didn't meet the target to treat 45,000 patients and there was no tariff. Now, with the tariff, this is going to be even more difficult," Kamau warned, as the tax would also mean that funding from international donors, such as the Global Fund, would treat fewer people. The additional costs would also affect NGOs and employers providing the life-prolonging medication, who might be forced to place fewer people on treatment programmes. "It is problematic - this increase should be addressed urgently, so that we can meet our goals," Dr Patrick Orege, director of the National AIDS Control Council, told PlusNews.