India and Thailand led the way in Asia in compulsory licensing - see here for some background. Indonesia is following suit. Indonesian President Susilo Bambang Yudhoyono apparently signed a decree in early September which allows generic companies to produce variants of certain key HIV drugs. Several have been named in news reports which include GSK's Ziagen (abacavir), Merck's ) Sustiva (efavirenz), Abbott's Kaletra (lopinavir + ritonavir), Gilead's ($GILD) Truvada (tenofovir + emtricitabine) and Atripla (tenofovir + emtricitabine + evafirenz). Indonesia has apparentyly set a 0.5% royalty. The decree says it is necessary to meet the urgent need for antiviral and antiretroviral treatments.
Although the WTO's Doha Agreement allows countries to use compulsory licensing for a public-health emergency it has been rarely used. The official figure of 310,000 people living with HIV in Indonesia, Southeast Asia's largest country is believed to be far short of the real figure.
This would be a massive step by Indonesia. The International Federation of Pharmaceutical Manufacturers and Associations expressed concern. But Indonesia is the fastest growing pharma market in SE Asia, so presumably the innovator pharma companies will accept this while growth in other sectors is strong.
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