Fighting to keep ARV drugs within population's grasp

Augustin Dokla has been at the forefront of the fight against HIV/AIDS ever since he was diagnosed as HIV-positive 10 years ago. Now he is setting his sights on keeping the supply of cheap antiretroviral drugs (ARV) in Togo from drying up. India, the world's fourth-largest pharmaceutical manufacturer and a key producer and exporter of generic ARV drugs, has proposed amendments to its patent laws which would stop it providing affordable life-prolonging drugs to people living with AIDS in developing countries, including Togo. The Indian parliament is trying to tackle implementation of the World Trade Organisation's (WTO) agreement regulating patents on medicines. But according to AIDS activists, 50 percent of Indians and 30 percent of Africans who are HIV-positive use the cheaper versions of branded ARVs, made and marketed by the world's biggest democracy. Dokla, who is the head of a network of ten AIDS support groups called RAS+Togo, says most of the generic ARVs on the market in his tiny West African nation come from India and Thailand. "The attitude of the Indian government means certain death for all those who found hope when generics came onto the market," 33-year-old Dokla told IRIN. "We cannot accept it. We cannot tolerate this mercenary exercise from the Indian government which is playing with people's lives." Togo government statistics show an HIV prevalence rate among Togo's adult population of about six percent in 2001, making Togo the third worst-affected country in the region after Cote d'Ivoire and Liberia. But less than 20 percent of the 15,000 Togolese people who need ARV treatment are actually taking the drugs, Dokla said, explaining that affordability, not availability, was the problem. "It's an alarming situation because even though prices have dropped, the cost of ARVs is still beyond the reach of the average Togolese. Lots of affected people are not in a position to look after themselves," the AIDS campaigner said. Even though prices have fallen, treatment works out at about 13,500 CFA (US$ 27) a month, a hefty chunk of average earnings in Togo, estimated at US$270 per person a year. And if the cheaper generic drugs stop flowing into Togo, then prices will only rise again. "Public health is going to be affected by India's decision and our efforts at prevention will be reduced to nothing because people won't see the point in getting themselves tested any more," Dokla said. The 10 AIDS associations that make up RAS+Togo have between 150 and 1,500 members each. Last week Dokla and his colleagues tried to organise a sit-in in front of the Indian embassy in the capital, Lome, to protest against Delhi's actions. But they were not granted the necessary permit by Togo's Interior Ministry, which was worried about public gatherings in the run-up to the state funeral of recently-deceased president Gnassingbe Eyadema. "We hope that the authorities give us the green light for the sit-in very soon," Dokla said. "Time is short because the Indian politicians have said they will vote on this suicidal reform during the parliamentary session... which runs to the end of March." "We in Togo are not the only ones to take issue with India's decision. In other countries like Burkina Faso and Niger, people have been in the streets and there have been petitions." "I don't hesitate to speak openly," the campaigner continued. "I have been lucky in that I was neither rejected nor stigmatised by my family or my country." But he admits that not all Togolese living with HIV/AIDS are as lucky. "I know people who have been sacked because they were HIV positive. It was done using another pretext but our investigations showed that it was their HIV status that led to their dismissal," Dokla said. He wants to get married and have children, like most men, he says. But he adds that that will only be possible if ARV drugs are for sale at affordable prices and he will not be giving up the fight in a hurry. "Fighting against AIDS, that's my everyday life."