It is indeed an honour for me to be here. I represent Cipla, a leading international generic company with an enviable reputation. We are respected everywhere for our quality, reliability, integrity, sustainable supply and above all for our humanitarian approach to healthcare. We strongly believe that the whole of Africa and in particular South Africa offers hope and opportunity. We believe that Africa should decide for itself its own destiny. India is there to assist you in whatever way possible. In the area of healthcare, Cipla will give South Africa whatever help and assistance they require to develop the indigenous pharma industries. I believe that every country should be self-reliant and self-sufficient, particularly in healthcare.
Till recently, I was unaware of “OWETHU”. It is a fully serviced modular clinic. It will provide access to primary medical treatment and information. It will deliver services such as HIV testing, ARV distribution, respiratory screening, drug testing, health and nutrition counseling, T.B information, de-worming of children and dental care.
OWETHU will be run in partnership with the local community, local NGO’s, so that they are self-sustained. They will be run and managed with strict medical protocols. The South African government is fully committed to provide access to affordable healthcare for all. Our Cipla Foundation has been involved in the development of the OWETHU model to assist the government in this humanitarian task. We strongly believe that the Government should also have an in-licensing policy to enable the country to access the latest drugs and make them available here at affordable prices.
The OWETHU concept will ultimately treat 44 million patients. It clearly shows that the Government can unite with industry to provide a major change in the health and welfare sector. We ourselves are hopeful to place our Cipla drugs within easy reach of everyone in Africa.
Let me give you some India-Africa statistics. India’s trade with Africa is approximately 9.5% of India’s total trade. India is the fourth largest trading partner for Africa. The total business with Africa for the year 2014-2015 was US$ 72 billion, exports from South Africa to India was US$ 33 billion and imports US$ 39 billion. The China Africa trade is far higher, but India’s engagement with Africa is certainly more human in approach and offers more in agriculture, education, healthcare, sharing of technology, working together in joint programs at all levels. India has offered help to setup a PAN India Virtual University. We have common concerns with Africa as regards fighting terror and to secure maritime safety. We are working together in many areas such as development of solar energy. We back each other in many global forums. Both Africa and India want International representation and recommendations. India has historic ties with Africa going back many centuries. We share a long history of colonial rule. In particular, we share with South Africa the fight against apartheid with Mahatma Gandhi at the forefront prior to 1915.
Later in 1939, Mahatma Gandhi visited Cipla and told us that the British had approached him and that they would consider giving India independence if India assisted Britain in the forthcoming war. Medicines at that time had stopped coming to India from Europe and England and he wanted Cipla to produce medicines for the war effort. This we did and this was the start and impetus Cipla needed to progress over the years.
I would like to specifically profile healthcare in South Africa. The market size in 2014 was US$ 3.5 billion. The estimated growth is approximately 8% to 10% annually. The market is essentially of branded generics and branded products, of which the generic share is approximately 27%. Private spending is extremely high at 85%. The regulatory environment is very similar to the International markets of Europe and the USA. The government supports the pro-generic industry. The government is in the process of implementing a National Health Initiative (NHI). The local drug formulation industry here is well established with many of the leading companies being domestic. For India, in healthcare South Africa features among the leading export destinations and in the year 2014 this totaled just under US$ 500 million.
With this introduction, I would like to mention what Cipla has done in the recent past, with particular reference to Sub-Saharan Africa and the HIV/AIDS epidemic. All the suffering and death from war, famine and natural disasters in the last century could have been eclipsed by HIV/AIDS, since it was first detected around the early 1980’s. The HIV/AIDS virus has already killed 30 million people worldwide since then. It eats deep into our lives and spares nobody. It transcends all Nationalities, Race, Religion, Social and Political boundaries. We need the will and courage to fight this crisis with all the energy and resources at our command. With so much God given life at stake, this is one battle the human race cannot afford to lose.
It is sad that even today over 33 million are afflicted in Africa alone and 45 million worldwide. Of the 16,000 children born daily in Africa, 10% are HIV positive. The tragedy that faced us in 2001 was that the medicines were available, which could extend and improve the quality of life, were simply not accessible at affordable prices.
The pharma industry of which Cipla is a part is the healthcare custodian of the world, today and in the future. Cipla initiated the campaign to fight HIV/AIDS in the year 2000 when only 2000 – 4000 people were being treated in Africa and this so far has helped save over 10 million lives. India today produces 92% by volume of all the AIDS drugs produced worldwide, selling them for US$ 1 billion and the balance 8% is sold by multinational’s in access of US$ 16 billion. What gives me the greatest satisfaction is that today 13.50 million HIV positive persons are being treated in Africa alone and that over 10% are on Cipla’s medications. It is estimated that our 2001 initiative has helped save over 10 million lives to date. The overall success of a company or industry cannot be judged by its profitability or monetary gain, but by its capacity and capability to contribute its moral and social obligations to society.
The world stands divided into the Rich and the Poor, Developed and Developing countries, global North with 600 million and global South with 3 billion people. Those countries who most desperately need medicines are those who can least afford them. Enabling access to good quality, affordable medicines is a basic, fundamental human right. It is about preventing disease, fighting infections, easing suffering and saving lives. One third of the world’s population lacks access to even basic medicines. In Asia and Africa this goes up to over 50%. The right to live should not be contingent on the ability to pay. Lives cannot be sacrificed at the altar of corporate profit and greed. It is unfortunate that economic power is stronger today than moral values.
It is important to ensure that essential life-saving and vital drugs are available and accessible at affordable prices, not only in the developing world, but wherever needed. None should be denied healthcare. As a Scientist, I believe that an inventor or innovator of a new drug has to be suitably rewarded, but that the drug, particularly if essential, should not be sold under monopoly. What is the value of discovering a new medicine if the patient cannot afford it. We all want a world where healthcare is provided to one and all, where every citizen can dream of a decent quality of life. We should all commit ourselves to this philosophy and dream.
Cipla will cooperate with one and all in this Herculean task. I quote a 1981 WHO statement of Indira Gandhi, late Prime Minister of India, “My idea of a better ordered world is one in which medical discoveries would be free of patents and there would be no profiteering from life or death”. It is appropriate to quote Nelson Mandela, who said that “AIDS is no longer a disease, it is a Human Rights issue”. To this should be added “AIDS is no longer a Death Sentence. It should be regarded as a chronic ailment”. The stigma surrounding HIV and AIDS has virtually been eliminated and the disease is very much under control.
We strongly believe that when there are impending health emergencies internationally, then the patents involved should be made available to anyone on payment of a maximum 4% royalty to the inventor. This would ensure that there would be no monopoly and life-saving drugs needed could be made freely available again at affordable prices. The destiny of the world should never be allowed to rest in the hands of a single inventor or a single company.
My personal fight today on behalf of the third world and developing world is for access to medicines without monopoly at affordable prices and that none should be denied medication. Africa and in particular South Africa must ensure compulsory licensing and no monopoly in healthcare. South Africa is in the process of framing a new Patent Act and it is therefore imperative that its main aim has to be no monopoly. This can be done within the framework of the TRIPS agreement and a compulsory licensing system similar to what Canada had in their Bill S91, way back in 1969 and which was law in Canada until 1992. Apart from this a big issue for South Africa is that many of its neighboring countries are designated as least developed in these countries TRIPS will only take shape after 2033. A product therefore patented in January 2033 will perhaps only see the light of day by 2040. South Africa will therefore be at a disadvantage and therefore requires a pragmatic and much needed positive approach, so that newer medicines remain accessible and affordable. This will not only serve to boost the local economy, but also it will enable South Africa to export throughout Africa. Companies like Cipla would then choose to invest more in South Africa and avail of the benefits of a pragmatic patent act. You need a policy that is nationalistic in approach as this is in the overall interest of public health.
Some of you may remember as to what happened on 14th November 2001 when the Doha Declaration was passed. 149 countries including SA voted in favour. Clause 5 (c) said that any country could decide for themselves as to what was a national health crisis. This included HIV/AIDS, T.B., Malaria and other epidemics. In 2003, this declaration came up for ratification. The USA objected to the words “other epidemics” and wanted this removed. All the other countries insisted that it should remain. They put it to the vote, which was 148 against 1 and because of the one adverse vote, the Doha Declaration is still not ratified. It could have done a great deal of good for the developing and third world. In conclusion, I would like to stress once again that Cipla is more than willing to assist South Africa to frame their healthcare laws, be they IPR, regulatory or pricing.”
DR YK Hamied