South Africa has been overpaying for life saving drugs for far too long Photo Pexels
South Africa – The South African Competition Commission has officially announced the filing of a formal complaint earlier this week against pharmaceutical giant Johnson & Johnson (J&J) and its subsidiary, Janssen. The complaint pertains to allegations of “excessive pricing” in relation to the essential Tuberculosis (TB) medication known as bedaquiline, also marketed under the brand name Sirturo. The investigation stems from claims asserting that South Africa is confronted with pricing disparities, paying over twice the global average for bedaquiline.
The significance of bedaquiline cannot be overstated. In 2017, TB emerged as the foremost cause of mortality in South Africa, accounting for approximately 28 700 fatalities. The gravity of this health crisis continued into 2018, with an estimated 301 000 TB cases reported in the country, leading to 63 000 deaths, as reported by the National Institute of Communicable Diseases.
However, in 2018, South Africa marked a pivotal milestone by becoming the world’s first nation to incorporate the oral drug into its standard recommended regimen for treating drug-resistant TB (DR-TB). This significant development heralded the phasing out of painful and toxic injection-based treatments, replacing them with more effective and tolerable alternatives.
The impact of bedaquiline on TB mortality rates has been nothing short of remarkable. Between 2018 and 2021, there has been a discernible reduction in the death rate attributed to TB, underscoring the drug’s crucial role and the dire need for its availability. Even as recently as June 2021, Statistics South Africa’s report reaffirmed TB’s status as the primary cause of death in the three-year period spanning from 2016 to 2018.
The shocking discrepancy and the call for investigations
J&J finds itself once again thrust into the public eye, and this is hardly the pharmaceutical giant’s first encounter with controversy. Currently, the company is grappling with an astonishing 38,000 lawsuits, all of which assert that J&J’s talc-based products, including its renowned Baby Powder, were tainted by asbestos, resulting in various cancers, such as ovarian cancer and mesothelioma.
Given this litigious backdrop, it’s no surprise that concerns are mounting. Ahmed Munzoor Shaik Emam, the leader of The National Freedom Party (NFP), has raised valid questions regarding the pricing dynamics at play. He not only questions the individuals responsible for negotiating these seemingly exorbitant prices but also probes into who stands to gain from such arrangements.
“It’s totally unacceptable. If you remember during the days of Covid, the J&J vaccine, the president of our country went and negotiated directly with them even leaving out the minister of Health at the time when it came to the vaccine. There’s a whole lot that seems to be going on here and I think we need a thorough investigation. We are quite happy that the Competition Commission is investigating it but the question is why so late? Why do we have to wait so long to even investigate these things and where is the South African Health Products Regulatory Authority?”
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Profiting from misery
Emam did not mince words when he points out the suspicious nature of the pharmaceutical industry’s profits during the Covid-19 pandemic. South Africa paid exorbitant fees for the life saving Covid-19 vaccine compared to the European Union (EU). Serum Institute of India, which produced the Oxford/AstraZeneca vaccine, charged South Africa $5.35 a dose, when the EU paid just €1.78. South Africa paid $10 a dose for the J&J vaccine, 15% more than the EU paiD and the government was required to pay a non-refundable down payment of $27.5 million. Pfizer also charged $10 a dose, which is 32.5% more than the $6.75 “cost price” it reportedly charged the African Union.
“If you look at the richest people in the world and the impact that Covid-19 had on their life, they became richer. If you look at the wealth that has increased on the billionaires in the world, most of them are in the pharmaceutical industry. So really it seems like something suspicious [is going on], somebody is benefiting from it. Why did we allow it in the first place? Who negotiated the price? Where is the supply chain? Where is the treasury to ensure that there is some standardising of prices? We hope that this Competition Commission will do justice.”
The issue extends beyond South Africa, as other developing nations face similar challenges when dealing with international pharmaceutical companies. Collusion between these companies and government officials is a recurring theme, and it often comes at the expense of the most vulnerable populations. The lack of ethical leadership and the pursuit of self-enrichment in politics exacerbate the problem.
The call for an indigenous pharmaceutical industry
Emam raised a pertinent query regarding the absence of a dedicated pharmaceutical entity within Africa. He highlighted the pressing need for an indigenous pharmaceutical company committed to serving the interests of the continent, in stark contrast to the exploitation by foreign companies seeking to profit from Africa’s resources while providing life-saving medications.
“Why can’t Africa have solutions for its own problems? Why can’t we have a pharmaceutical industry created in Africa so that we could be self-sufficient rather than being at the mercy of these big pharmaceutical giants all over? … It seems like that this entire pharmaceutical industry, like many other industries, is captured. Somebody, somewhere is benefiting.”
The excessive pricing of TB drugs in South Africa by J&J is a matter of grave concern. The investigation initiated by the Competition Commission is a step in the right direction, but questions remain about why such practices persisted for so long. Transparency in drug pricing negotiations and accountability for pharmaceutical companies and government officials are essential to ensure the affordability and accessibility of vital healthcare resources for South Africans. The NFP’s call for urgent action in this matter underscores the importance of addressing these issues promptly to save lives and protect the interests of the people.
