In How Safe are Anti-retroviral Drugs? Thompson Ayodele makes a telling point that several HIV drugs from the WHO’s ‘pre-qualified’ list have turned out to be substandard and are now being withdrawn by the companies, almost all of which are Indian. I am no votary of WHO, but blaming it all on WHO seems hardly justified. Well, yes, I too never thought that i would come to the defense of WHO!

First, if the companies are selling substandard drugns then they should be liable, and if the tort laws are not working well in Africa, as in Asia, then the necessary reform lies there. Second, WHO’s ‘pre-qualification’ comes with a huge warning (discussed in the article itself). Shouldn’t the caveat emptor apply to WHO’s ‘marketing’ as it applies to say Pfizer’s marketing? The liability of WHO, like any private endorser/marketer, is to the extent of the damages caused by its products. But the article doesn’t once mention tort, negligence or liability. It insinuates that the sole cause is Indian companies violating IPR of the western pharmas. Though it seems unlikely that our judgement of the issue be different if these drungs were not under patent. That is, even if they were really generics, the sale of substandard drungs would have the same consequences for HIV patient-users. Of course the effect would not be the same for the patent holding pharma companies. The patent holding companies could also sell substandard patented drugs. Just because they know the right formulation does not automatically guarantee that they actually sell genuine drugs. What then is the main concern of the article–African HIV patients or the IPR regime?

“In the fight against AIDS, there is an increasing variety of drugs available to help relieve the symptoms for unlucky sufferers. Properly administered and manufactured, anti-retroviral (ARVs) drugs can help the victims of AIDS live longer and more useful lives. However, the widespread use in Africa of poor quality generic copies of these drugs is threatening to undermine their clinical effectiveness, bringing with them the possibility of new, drug-resistant strains of HIV.

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The opinions expressed in this essay are those of the authors. They do not purport to reflect the opinions or views of CCS.

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Parth Shah

Parth J Shah is founder president of Centre for Civil Society, a think tank that promotes choice and accountability across public and private sectors. He is co-founder and Director of Indian School of Public Policy. Parth’s research and advocacy work focuses on the themes of economic freedom, choice and competition in education, property rights approach to the environment and new public governance. He recently edited Liberalism in India.