South Africa, Colombia Aim to Get Lower-Cost Drugs for TB, HIV

South Africa, Colombia Aim to Get Lower-Cost Drugs for TB, HIV

南非、哥伦比亚寻求获取更低成本的结核病和艾滋病药物

【原文听力】

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　　By Andrew Smith

　　04 December 2023

　　South Africa and Colombia are among the countries aiming to push drug companies to permit low-cost versions of drugs for deadly diseases. The drugs are for people with drug-resistant versions of tuberculosis (TB) and with HIV/AIDS.

　　One target is the drug bedaquiline. It is used for treating people with drug-resistant tuberculosis. In South Africa, TB was blamed for the deaths of more than 50,000 people in 2021, making it the country's leading cause of death.

　　Johnson & Johnson is a U.S.-based drug and medical technology company. The company owns a patent for the drug bedaquiline. Patents legally protect a company's right to manufacture and sell a product that it developed or owns for a limited time. The legal protection prevents other companies from making the same drug without permission.

　　In recent months, activists have protested efforts by Johnson & Johnson to protect its patent. In March, TB patients asked the Indian government to make a lower cost copy of bedaquiline. The government agreed, saying Johnson & Johnson's patent could be broken.

　　In July, the time limit for Johnson & Johnson's patent on the drug ran out in South Africa. The company extended the patent until 2027 under South African law. However, activists became angry and accused Johnson & Johnson of trying to make a lot of money from the drug.

　　The South African government then began investigating the company's pricing policies. South Africa had been paying about $282 per treatment course: a full group of treatments. This was more than twice as much as poor countries involved in the Swiss-based Stop TB Partnership paid.

　　In September, about a week after South Africa's investigation began, Johnson & Johnson announced it would not enforce its patent in more than 130 countries. This would permit other drug makers in those countries to copy the drug.

　　Christophe Perrin is a TB expert at Doctors Without Borders. He called the decision "a big surprise." He said protecting patents is central to how most drug companies plan their businesses.

　　In October, Colombia announced that it would permit a third party to make the HIV drug dolutegravir without permission from the drug's patent-holder, Viiv Healthcare. The decision came after more than 120 groups asked the government to let more people use the drug, which is supported by the World Health Organization (WHO).

　　Peter Maybarduk is with the Washington, D.C., non-profit group Public Citizen. He thinks the Colombian government is trying to take control of its treatment of HIV after not having enough vaccines for COVID-19. He noted that Brazilian activists are pushing their government to do the same.

　　More changes needed

　　However, some experts say more needs to change before poor countries can produce their own medicines.

　　Petro Terblanche is managing director of the biotechnology company Afrigen Biologics based in Cape Town, South Africa. She said African countries produced less than one percent of all vaccines made around the world when the COVID-19 pandemic hit. But, Terblanche said, Africa used more than half of the world's supply.

　　Afrigen Biologics is part of a WHO-supported effort to produce a COVID vaccine using the same mRNA technology as those made by U.S.-based drug makers Pfizer and Moderna.

　　Terblanche also noted that African countries need to improve their ability to deliver vaccines. "If we can't get (vaccines and medicines) to the people who need them, they aren't useful," she said.

　　Lynette Keneilwe Mabote-Eyde is a health care activist who has ties to the nonprofit Treatment Action Group based in New York City. She noted that South Africa has no clear law permitting the government to take legal action against a patent or a patent extension.

　　The South African department of health did not answer questions from the Associated Press about patents.

　　Fighting tuberculosis

　　In its yearly report on TB released in November, the WHO said there were more than 10 million people sickened by the disease in 2022 and 1.3 million deaths.

　　After COVID-19, tuberculosis is the world's deadliest infectious disease. It is also now believed to be the main cause of death of people with HIV. The WHO says only about 40 percent of people with drug-resistant TB are being treated.

　　Zolelwa Sifumba, a South African doctor, found she had drug-resistant TB in 2012. She went through 18 months of treatment, taking about 20 pills every day in addition to daily injections. These left her in severe pain and resulted in some hearing loss. Bedaquiline was not a standard treatment in South Africa until 2018.

　　"I wanted to quit (treatment) every single day," she said. Since her recovery, Sifumba has been pushing for better TB treatment. She said it makes little sense to charge poor countries, which have more cases of TB, high prices for necessary medicines.

　　She questioned why poor countries would have to pay a lot for medicine. "If the lower income countries can't get it, then what's the point? Who are you making it for?" she said.

　　I'm Gena Bennett. And I'm Andrew Smith.

　　Gerald Imray and Maria Cheng wrote this story for The Associated Press. Andrew Smith adapted it for VOA Learning English.

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　　作者：Andrew Smith

　　2023年12月4日

　　南非和哥伦比亚等国家正在寻求推动药品公司允许生产治疗致命疾病的低成本药品版本。这些药品是为了治疗有抗药性结核病（TB）和艾滋病的人群。

　　其中一个目标是贝达喹琳这种药物。它被用于治疗有抗药性结核病的人。在南非，2021年有超过50,000人因为结核病死亡，使其成为该国的主要死因。

　　强生是一家美国的药品和医疗技术公司。该公司拥有贝达喹琳这种药物的专利。专利法律上保护了公司在有限时间内制造和销售其开发或拥有的产品的权利。这种法律保护防止其他公司在未经许可的情况下制造相同的药物。

　　近几个月来，活动人士抗议强生公司保护其专利的行为。今年三月，结核病患者请求印度政府制造贝达喹琳的低成本版本。政府同意了这一请求，表示强生的专利可以被打破。

　　七月份，强生在南非的药物专利期限到期。然而，该公司根据南非法律将专利期延长到2027年。然而，活动人士对此感到愤怒，并指责强生试图从这种药物中赚取大量利润。

　　随后，南非政府开始调查强生的定价政策。南非一直在为每个治疗疗程支付约282美元：一整套治疗。这比参与瑞士基础的Stop TB Partnership的贫穷国家支付的金额多出一倍以上。

　　九月份，南非开始调查大约一周后，强生宣布在130多个国家不会执行其专利。这将允许这些国家的其他药品制造商复制这种药物。

　　Christophe Perrin是无国界医生组织的结核病专家。他称这个决定为“一个大惊喜”。他说，保护专利是大多数药品公司规划业务的核心。

　　十月份，哥伦比亚宣布将允许第三方在未经药物专利持有者Viiv Healthcare许可的情况下制造HIV药物dolutegravir。这个决定是在120多个团体请求政府让更多人使用这种药物之后做出的，这种药物得到了世界卫生组织（WHO）的支持。

　　Peter Maybarduk是华盛顿特区非营利组织公民公共的成员。他认为哥伦比亚政府在没有足够的COVID-19疫苗的情况下，试图控制其对HIV的治疗。他指出，巴西的活动人士正在推动他们的政府做同样的事情。

　　然而，一些专家表示，在贫穷国家能够自行生产药品之前，还需要做更多的改变。

　　Petro Terblanche是位于南非开普敦的生物技术公司Afrigen Biologics的董事总经理。她表示，在COVID-19大流行爆发时，非洲国家生产的疫苗不到全球总量的1%。但是，Terblanche说，非洲使用了全球一半以上的供应。

　　Afrigen Biologics是世界卫生组织支持的一项努力的一部分，该努力旨在使用与美国药品制造商辉瑞和Moderna相同的mRNA技术生产COVID疫苗。

　　Terblanche还指出，非洲国家需要提高他们的疫苗接种能力。她说：“如果我们不能把（疫苗和药物）送到需要的人那里，它们就没有用。”

　　Lynette Keneilwe Mabote-Eyde是一位与纽约市非营利组织Treatment Action Group有关系的医疗保健活动家。她指出，南非没有明确的法律允许政府对专利或专利延期采取法律行动。

　　南非卫生部没有回答美联社关于专利的问题。

　　对抗结核病

　　在11月发布的关于结核病的年度报告中，世界卫生组织表示，2022年有超过1000万人患上了这种疾病，死亡人数达到130万。

　　在COVID-19之后，结核病是全球最致命的传染病。现在也被认为是HIV患者的主要死因。世界卫生组织表示，只有大约40%的耐药性结核病患者正在接受治疗。

　　Zolelwa Sifumba是一位南非医生，她在2012年发现自己患有耐药性结核病。她经历了18个月的治疗，每天要服用大约20粒药丸，此外还要每天注射。这些治疗让她痛苦不堪，并导致了一些听力损失。贝达喹琳直到2018年才在南非成为标准治疗方法。

　　她说：“我每天都想放弃（治疗）。”自从她康复以后，Sifumba一直在推动更好的结核病治疗。她说，对于结核病病例较多的贫穷国家，收取高昂的必需药物价格是没有多大意义的。

　　她质疑为什么贫穷的国家需要为药物支付高昂的费用。她说：“如果低收入国家买不起，那有什么意义呢？你是为谁制造这些药物的呢？”

　　我是Gena Bennett。我是Andrew Smith。

　　这个故事由Gerald Imray和Maria Cheng为美联社撰写，Andrew Smith为VOA学英语改编。

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　　这个故事中的词汇

　　deliver - v. 将某物从一个地方送到预定的地方