Government awards ARV tender

The awarding of a new tender for antiretroviral (ARV) drugs by South Africa's health department will mean important savings for the state's treatment programme, already the largest in the world and still growing.

The health department has chosen six companies to supply ARV drugs over the next two years. More than 50 percent of the R3.615 billion (US$455.8 million) tender was awarded to Aspen Pharmacare, South Africa's largest manufacturer of generic medicines. Adcock Ingram, another local company, won 21 percent of the contract to supply the state programme. Only two multinational firms were awarded contracts to provide drugs that do not yet have generic competitors.

A statement issued by the health department noted that high volumes of the drugs and the production of generic versions had helped drive down prices. The government will pay between 20 and 71 percent less for most of the drugs than it did in the last tender, which ran for three years.

Andy Gray, a pharmacist at the Centre for the AIDS Programme of Research in South Africa (CAPRISA), at the University of KwaZulu-Natal, pointed out that the production of cheaper generic ARV drugs was less the result of government intervention than the work of activists and lobby groups like the AIDS Law Project (ALP), which have fought for patent restrictions and pressured pharmaceutical companies to issue voluntary licenses to generic manufacturers.

It's one thing to procure the drugs, it's another to provide them to people

Jonathan Berger, an attorney with the ALP, voiced reservations about government's lack of transparency or consultation in issuing the specifications for the tender, but said he was "largely happy" with the prices government had secured.

"There really has been a substantial reduction in price," he told IRIN/PlusNews. "It shows what can be done when you have government and civil society working towards the same goals."

According to health department spokesperson Charity Bhengu, prices may fluctuate within set limits over the tender's two-year duration, to allow for changes in labour and material costs as well as exchange rates.

What role newer drugs like tenofovir will play in the treatment programme remains unclear, as treatment guidelines on their use have yet to be released.

The health department statement noted that with more than 478,000 patients on ARV treatment by the end of April 2008, "the South African government ARV tender is the largest in the world."

Berger pointed out that South Africa, with the largest burden of HIV infections in the world, also has the largest need for ARVs. "It's one thing to procure the drugs," he cautioned, "it's another to provide them to people."

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