17 June 2017

South Africa: Battle for Affordable Breast Cancer Treatment Continues

The activist who devoted the last part of her life to fighting for affordable cancer treatment would have been thrilled by the announcement of a Competition Commission probe into pharmaceutical companies, the Cancer Coalition said on Thursday.

"We will continue to fight to ensure Tobeka Daki's death was not in vain," the coalition's co-ordinator Salomé Meyers told News24.

She said when Daki was diagnosed, she knew nearly nothing about cancer drugs and then dedicated her life to fighting for cancer treatment for all.

On Tuesday, nearly three years after Daki's battle against these companies began, the Competition Commission announced a large-scale investigation into three pharmaceutical companies for allegedly fixing the price of cancer-treating drugs. The companies include Roche Holdings AG.

Meyers said she celebrated this victory with Daki.

"She was a wonderful lady, a brave lady, who defied all odds."

Daki died of breast cancer in November 2016, two years after she was diagnosed as HER2 positive in the Eastern Cape.

Also read: 'People have died because of this' - cancer patient on price fixing allegations

HER2 is a gene responsible for breast growth. In the case of cancer, it can cause breast cells to grow and divide uncontrollably. It is estimated that 25% of breast cancer patients are HER2 positive.

"The last time I saw Tobeka Daki she told me she'll probably wouldn't live to see her grandchildren grow up. That was two weeks before her death," Meyers said.

Meyers, a breast-cancer advocate for over 20 years, met Daki at a breast cancer advocacy training session in the Eastern Cape in 2014. This was shortly after Daki was diagnosed.

The Fix the Patent Laws coalition realised it needed to put a face to its campaign to have patent laws amended to make the drug Herceptin available to all women with breast cancer, Meyers said.

"Knowing very well she might die, Daki voluntarily became a fierce advocate for access to Herceptin," Meyers said.

She believes it could have saved Daki and thousands of other women. Herceptin is commercially known as Trastuzumab.

Patent laws

Fix the Patent Laws is a group of organisations that includes the Cancer Coalition, Treatment Action Campaign (TAC) and Section27.

Daki was one of a small group of people who testified before a UN panel, established on the instruction of then UN commissioner Ban Ki-Moon, to investigate the exorbitant prices of medicine.

"She decided to literally stand up and speak up and fight. That's bravery," Meyers said.

In an open letter addressed to UN high commissioner for human rights, Zeid Ra'ad Al Hussein, a campaign started in Daki's name calls on the UNHRC to investigate Roche Holdings AG. It has a sole patent on producing Herceptin in South Africa until 2020.

It asks the council to ensure that women's right to life and health is not held at ransom by monopolies of the pharmaceutical industry.

Meyers said Roche had a global patent on Herceptin. It, however, had "evergreen patents" in specific countries that extend the shelf life of patents.

"The global patent will cease in a couple of months, but because of this evergreen patent it will live until 2023," she said.

This meant competing pharmaceutical companies could not produce similar, possibly cheaper, products until the patent had expired.

Meyers says one full course of Herceptin in the private sector costs roughly R500 000, and R120 000 in the public sector.

'Life-saving drug'

In written answers to News24 on Thursday, Roche said it was aware of a Competition Commission investigation.

"We are confident that the pricing of our life-saving pharmaceutical products is done strictly in accordance with the regulatory framework of the country," spokesperson Aadila Fakier said in a statement.

"We, unfortunately, cannot comment further on the merits of this matter until the investigation is completed."

Swiss-based Roche posted a profit of roughly $9.7bn in 2016, according to the company's website.

On Thursday, News24 reported allegations that state hospitals do not test for the HER2 gene as Herceptin is not administered in the public health sector.

Health department director Gavin Steel said HER2 might be tested for depending on the "diagnostic work up of the patient which informs the treatment plan".

He reiterated earlier statements by Wits University medical professor Guy Richards that Herceptin was used as complementary treatment for HER2 positive-type breast cancer.

Meyers, however, disagreed and said Herceptin was a life-saving drug for women diagnosed with early-stage breast cancer.

"Patients are rarely diagnosed early in the public sector. There's a difference between late state and early state breast cancer treatment."

The national health department said the public sector would start administering Herceptin in a test period from July after cancer treatment guidelines had been amended.

When the department last conducted a survey, the Kimberley Hospital was the only one in the country administering Herceptin.

The Western Cape Health department told News24 that the national health department did not list Herceptin as an essential drug and therefore the provincial department did not get it.

Parliament's health portfolio committee chairperson, Mary-Ann Dunjwa, did not respond to repeated requests for comment.

Meyers said the work she did was sometimes draining. However, she was encouraged by public awareness of the cost of cancer treatment which the announcement of the Competition Commission's investigation had created.

Source: News24

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