Countries such as South Africa and Colombia, who were unsuccessful in securing coronavirus vaccines, are adopting a more confrontational stance towards pharmaceutical companies. They are also challenging policies that limit access to affordable treatment for tuberculosis and HIV for millions of people.

Specialists view this as a change in the way these nations handle large pharmaceutical companies and suggest that it may prompt further endeavors to increase access to life-saving medications.

During the COVID-19 pandemic, developed nations were quick to purchase a majority of the available vaccines, resulting in limited access for poorer nations. This has been deemed a severe ethical failure by the World Health Organization.

According to Brook Baker, a researcher at Northeastern University, underdeveloped nations are currently striving for self-sufficiency as a result of the COVID-19 pandemic, as they have come to the realization that they cannot rely on external assistance.

One of the targets is a drug, bedaquiline, that is used for treating people with drug-resistant versions of tuberculosis. The pills are especially important for South Africa, where TB killed more than 50,000 people in 2021, making it the country’s leading cause of death.

Recently, there have been demonstrations against Johnson & Johnson’s attempts to safeguard its patent for a particular medication. In March, individuals with tuberculosis petitioned the Indian government to make more affordable generic versions available. The government eventually granted permission to break J&J’s patent. Subsequently, Belarus and Ukraine reached out to J&J and requested that they drop their patents, but received minimal acknowledgement.

In July, the patent for J&J’s drug in South Africa expired. However, the company managed to get it extended until 2027, causing anger among activists who accused them of prioritizing profits over people.

The government of South Africa initiated an inquiry into the pricing practices of the company. The company had been charging 5,400 rand ($282) per treatment course, which was significantly higher than the cost for developing countries receiving the drug through the Stop TB partnership.

In September, approximately one week after South Africa initiated their investigation, J&J declared that they would relinquish their patent in over 130 countries, permitting generic manufacturers to replicate the medication.

The company stated that this dispels any misunderstandings about restricted availability of our medications.

TB specialist Christophe Perrin, who works with Doctors Without Borders, was shocked by J&J’s unexpected change of heart. In the pharmaceutical industry, safeguarding patents is usually a crucial aspect of their approach.

In Colombia, the government recently announced that it will grant a compulsory license for the HIV medication dolutegravir, regardless of Viiv Healthcare’s patent. This action was taken after over 120 organizations urged the Colombian government to increase availability of the drug, which is recommended by the World Health Organization.

Peter Maybarduk, a member of the advocacy group Public Citizen in Washington, stated that Colombia is stepping up to address the severe inequality caused by COVID and is challenging a prominent pharmaceutical company to provide affordable AIDS treatment for its citizens. He also mentioned that activists in Brazil are urging their government to take similar action.

However, according to certain professionals, there are still many necessary changes that must be made before developing countries can manufacture their own medications and vaccines.

According to Petro Terblanche, the managing director of Afrigen Biologics, when the COVID-19 pandemic began, Africa only supplied less than 1% of the total global vaccines but consumed more than half of the world’s supply. Afrigen Biologics is collaborating with the World Health Organization to develop a COVID-19 vaccine using the mRNA technology used by Pfizer and Moderna.

In the late 1990s-2000s, Terblanche approximated that approximately 14 million individuals in Africa lost their lives due to AIDS, as countries were unable to obtain the required medications.

In the past, the government of President Nelson Mandela in South Africa temporarily halted patent protections in order to increase availability of AIDS medication. This led to a legal battle in 1998 between over 30 pharmaceutical companies in a case known as “Mandela vs. Big Pharma.”

The doctors’ organization, Doctors Without Borders, labeled the incident as a “public relations catastrophe” for the pharmaceutical companies. The companies ended up dropping the lawsuit in 2001.

Terblanche stated that Africa’s previous encounter with the HIV outbreak has provided valuable lessons.

She stated that it is not appropriate for a publicly traded company to possess intellectual property that obstructs efforts to save lives. As a result, there will likely be a rise in countries taking action against this practice.

According to Terblanche, confronting pharmaceutical companies is only a part of the effort to guarantee equal access to treatments and vaccines in Africa. Building stronger health systems is also crucial.

She stated that if we are unable to distribute vaccines and medicines to those who require them, they will be rendered useless.

However, some professionals noted that South Africa’s current laws regarding intellectual property have not been adequately amended, making it too effortless for pharmaceutical companies to obtain patents and prolong their monopolies.

According to Lynette Keneilwe Mabote-Eyde, a health care activist working with the nonprofit Treatment Action Group, South Africa lacks a specific law that permits legal disputes over patents or patent extensions, unlike other developing nations.

The request for comment on drug procurement and patents from the South African Department of Health went unanswered.

According to Andy Gray, a consultant for the South African government regarding crucial medications, J&J’s choice to not protect their patent may be motivated by their projected low profits for the drug, rather than giving in to activist demands.

According to Gray, a pharmacology lecturer at the University of KwaZulu-Natal, bedaquiline is not expected to have large sales in wealthy nations. Therefore, it is a product that they would like to eventually hand off and potentially receive a percentage of profits from.

The most recent report from the World Health Organization regarding tuberculosis revealed that over 10 million individuals were afflicted by the illness in the past year, resulting in 1.3 million fatalities. Tuberculosis is now considered the most lethal infectious disease in the world, surpassing even COVID-19, and is the leading cause of death among individuals with HIV. The WHO also highlighted that only around 40% of those with drug-resistant TB are receiving treatment.

In 2012, Zolelwa Sifumba, a doctor from South Africa, received a diagnosis of drug-resistant tuberculosis while she was still a medical student. She underwent 18 months of treatment, including taking approximately 20 pills per day and receiving daily injections. This caused her significant pain and resulted in some hearing loss. It wasn’t until 2018 that Bedaquiline became a standard treatment in South Africa.

She stated that she contemplated stopping her treatment daily. After successfully recovering, Sifumba has become a supporter for improved TB treatment, questioning the reasoning behind charging impoverished nations steep prices for necessary medication.

Tuberculosis (TB) is prevalent globally but it disproportionately affects lower and middle income countries, according to the speaker. She questioned the purpose of producing the drug if it is not accessible to those in lower income countries.

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Cheng provided coverage from London.

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