Nairobi — The reduction in the price of a key Aids drug, Stocrin, is expected to put pressure on other global multinationals to reduce their medicine prices. UNAids says further reductions are essential to achieving universal access to the life-saving drugs by 2010.

The price cut, which was announced recently on the fifth anniversary of the pharmaceutical company Merck Sharp & Dohme's worldwide HIV/Aids pricing policy, will see the price of Stocrin fall by 20 per cent.

About 70,000 people in Kenya, Uganda, Tanzania and Rwanda use Stocrin every day as part of their treatment regimen, mostly in donor-supported programmes and also from private outlets.

In Kenya, where more than 20,000 people are on the drug, the monthly cost of Stocrin is set to fall from the current Ksh2,710 ($38) to below Ksh2,000 ($28) due to further benefits occasioned by exchange rate adjustments. Similar price falls will benefit another 20,000 patients in Uganda as well as 15,000 more in Rwanda and Tanzania respectively.

Critics of the price reductions by multinationals like Merck however say that they do not go far enough to allow poor countries to effect universal treatment, suggesting that the way forward is the use of more cheaply-priced generics.

In East Africa, however, the only recognised generic maker is Kenya's Cosmos Ltd, which two years ago obtained licences from multinationals GlaxoSmithKline (GSK) and Boehringer Engeilhem of Germany to manufacture generic versions of their ARVs.

Last week, international humanitarian organisation Medicins Sans Frontieres (MSF) complained that the American pharmaceutical company Abbott Laboratories had refused to lower the price of a newer version of the Aids drug lopinavir ritonavir. The drug is heat-stable and does not require refrigeration, which makes it ideal for poor countries.

"With the high temperatures and numerous daily power blackouts, our patients can't use the old version of this drug," said Christine Genevier, head of mission for MSF's Aids treatment programmes in Kenya. "It is a cruel irony that although this drug with no need for refrigeration seems to have been designed for places like Kenya, it is not available here."

Further, price reductions will be critical for East Africa, where governments have set themselves high targets in this respect, with Kenya saying that it will put 120,000 HIV-positive people on medicines by the end of the year.

Uganda, which has been cited by UNAids as having achieved the goal of treating half the people who require ARVs, is already managing nearly 100,000 people, while Tanzania is on track to reach 80,000 by the end of the year.

In all three East African countries, Stocrin or its generics are on the firstline protocols recommended for the management of HIV/Aids. People on the drug have the option of either taking one 600mg tablet once-daily or three 200mg capsules. The drug is usually taken in combination with the drugs Zerit and Epivir to complete the cocktail.

With the new reductions, the price of the 600mg formulation of Stocrin will go down by 20 per cent to $0.76 per day, or $277.40 per patient per year, from $0.95 per day.

The price of the 200mg formulation of the medicine will fall by 22 per cent to $0.36 per capsule, or $1.08 per day and about $394.20 per patient per year, from $0.46 per capsule.

According to Melanie Ribeiro, the MSD manager for Kenya, apart from East Africa, the new prices of the drug will be available to countries in the low category of the Human Development Index as defined by the United Nations Development Programme (UNDP) as well as in medium HDI countries with an adult HIV prevalence rate of 1 per cent or more as reported by UNAids.

In Africa, the latter category include Botswana and South Africa, which has the world's largest Aids caseload.

At the end of 2005, nearly 500,000 patients in 76 developing countries were being treated with regimens containing either Stocrin or Crixivan, two of MSD's current HIV/Aids medicines.

"The new lower prices will be available to all HIV/Aids care and treatment providers, who can demonstrate with reasonable assurance their capacity to ensure increased patient access, and also limit or curb pilferage and resale to developed markets," Ms Ribeiro told The EastAfrican.

"These include the government, NGOs and such private sector organisations as employers, insurers and hospitals."