Do patents for antiretroviral drugs constrain access to AIDS treatment in Africa?
Do patents for antiretroviral drugs constrain access to AIDS treatment in Africa?
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DOI：
10.1001/jama.286.15.1886
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发表时间：
2001-10-17
影响因子：
120.7
通讯作者：
Gillespie-White, L
中科院分区：
文献类型：
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作者：
Attaran, A;Gillespie-White, L
最近，公众的注意力和辩论集中在受艾滋病严重影响的贫穷国家，如非洲国家获得艾滋病治疗的问题上。目前尚不清楚非洲抗逆转录病毒药物的专利是否阻碍了2500万感染人类免疫缺陷病毒的非洲人获得挽救生命的治疗。我们研究了53个非洲国家的15种抗逆转录病毒药物的专利状况。使用调查方法，我们发现这些抗逆转录病毒药物在少数非洲国家获得专利（中位数，3;众数，0），在存在抗逆转录病毒药物专利的国家，通常只有一小部分抗逆转录病毒药物获得专利（中位数和众数，4）。所观察到的专利稀缺现象不能简单地用缺乏专利法来解释，因为大多数非洲国家多年来一直为药品提供专利保护。此外，在这一特定情况下，专利的地理覆盖范围似乎与非洲获得抗逆转录病毒治疗的机会无关，这表明专利和专利法本身并不是获得治疗的主要障碍。我们的结论是，各种事实上的障碍是阻碍获得抗逆转录病毒治疗的主要原因，这些障碍包括但不限于非洲国家的贫困、抗逆转录病毒治疗的高昂费用、国家对药品的监管要求、关税和销售税，以及最重要的是，缺乏足够的国际财政援助来资助抗逆转录病毒治疗。我们根据在贫穷国家增加抗逆转录病毒治疗机会的政策来考虑这些发现。
Public attention and debate recently have focused on access to treatment of acquired immunodeficiency syndrome (AIDS) in poor, severely affected countries, such as those in Africa. Whether patents on antiretroviral drugs In Africa are impeding access to lifesaving treatment for the 25 million Africans with human immunodeficiency virus infection is unknown. We studied the patent statuses of 15 antiretroviral drugs in 53 African countries. Using a survey method, we found that these antiretroviral drugs are patented in few African countries (median, 3; mode, 0) and that in countries where antiretroviral drug patents exist, generally only a small subset of antiretroviral drugs are patented (median and mode, 4). The observed scarcity of patents cannot be simply explained by a lack of patent laws because most African countries have offered patent protection for pharmaceuticals for many years. Furthermore, in this particular case, geographic patent coverage does not appear to correlate with antiretroviral treatment access in Africa, suggesting that patents and patent law are not a major barrier to treatment access in and of themselves. We conclude that a variety of de facto barriers are more responsible for impeding access to antiretroviral treatment, including but not limited to the poverty of African countries, the high cost of antiretroviral treatment, national regulatory requirements for medicines, tariffs and sales taxes, and, above all, a lack of sufficient international financial aid to fund anti-retroviral treatment. We consider these findings in light of policies for enhancing antiretroviral treatment access in poor countries.