Fix The Patent Laws

Doctors Without Borders calls for SA to override patent on key HIV medicine after widespread stock out problem

Posted on | October 29, 2015 | No Comments

This statement was originally published on 26 October 2015 at

Patients sent home without drugs while pharmaceutical company AbbVie refuses to license patent to generic companies  

Johannesburg — After six months of persistent supply problems with the key HIV medicine lopinavir/ritonavir (LPV/r), the international medical humanitarian organisation Doctors Without Borders (MSF) urged the South African government to put the public’s health first and override pharmaceutical company AbbVie’s patent with a ‘compulsory licence,’ in order to allow generic versions of LPV/r to be used in the country.

AbbVie, which markets LPV/r as ‘Aluvia’, is the sole supplier in South Africa for a medicine which is a life-line for nearly 10% of the country’s approximately 3 million people on HIV treatment. In the majority (65%) of LPV/r stock out cases reported by patients or health care workers in South Africa since April 2015 to date, patients were sent away with no medicine, and in 35% of cases, people were sent away with insufficient supply.

According to a consortium monitoring medicine stock outs in South Africa, the stock outs were wide spread and acute – about 10% of facilities, mostly large district hospitals, had more than 500 patients per facility being affected.

“People are being turned away from clinics without medicine and are being asked to purchase it on the private market. Many simply cannot afford it and this causes distress,” said Dr. Amir Shroufi, MSF’s Deputy Medical Coordinator in South Africa. “Alarmingly, people without access to treatment over time can become resistant to lopinavir/ritonavir and require more expensive medicines – they also risk falling sick and could even die.”

To assess the current situation, a separate rapid survey was conducted in October, with 12% of 796 responding facilities experiencing an ongoing LPV/r stock out. In over 50% of these cases, the duration of the stock out was longer than 30 days.

Several producers of LPV/r, other than AbbVie, have quality-assured generic versions of the drug registered in South Africa, or have filed for registration of other ritonavir-based treatments that the World Health Organization suggests could be used as an alternative to LPV/r. AbbVie’s patents prevent the use of generic versions of LPV/r in South Africa, and the company has refused to provide voluntary licences to the Medicines Patent Pool which could improve security of LPV/r supply in developing countries.

“Since AbbVie has refused to act appropriately to ensure that patients obtain the medicines they need to stay healthy and alive, the South African government should be compelled to take action,” said Dr. Shroufi. “The government should take steps to ensure that the company’s patents no longer block people from getting this essential drug from other suppliers.”

LPV/r is protected by multiple patents in South Africa, but the Department of Health has the authority to allow generic manufacturers to supply patented medicines when patent holders like AbbVie are not meeting demand. The process of issuing a compulsory licence has been carried out in numerous countries, such as Brazil and India, to improve access to life-saving medicines.

“With thousands of lives hanging in the balance, the challenges of overcoming LPV/r patent barriers to resolve the current crisis must not prevent the government from taking action. Many of the patent-related problems that have led to shortages of LPV/r could have been avoided if South Africa stopped blindly handing out patents, and had more pro-public health laws in place,” said Catherine Tomlinson, of MSF’s Access Campaign in South Africa.

“If South Africa examined patent applications, LPV/r might not have been granted multiple patents for a prolonged patent monopoly, and if the process for issuing compulsory licences were less onerous, alternative suppliers could have been on the market years ago.”

A process to reform South Africa’s patent law has been underway at the Department of Trade and Industry (DTI) since 2009. Two years after the public comment period closed on a draft national intellectual property policy, the DTI has failed to finalise it or embark on proposed reform of the Patents Act.

“MSF calls on the government to take action now: issue a compulsory licence so generic versions of lopinavir/ritonavir can be imported or produced in-country,” said Tomlinson. “The South African government must urgently amend the country’s patent laws so people don’t go without the medicines they need in the future.”


Today, Doctors Without Borders released a short video featuring Thandi Shabangu and Khaya Mkhize*, two patients affected by the LPV/r stock outs. “I went to the clinic, they told me, ‘no, we don’t have Aluvia, so you’re supposed to go to the chemist to buy [it]’… If now my pills are finished, what am I going to do? [Because] I don’t have money,” said Shabangu. She fears how the stock outs will impact on her health and treatment, explaining, “The problem is very big… because it’s life and death, if you don’t drink your Aluvia you are going to resist.”

View the video at:

* At his request, Mkhize has been given a pseudonym to protect his anonymity


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  • About the Campaign

    fix the patent laws
    Fix the Patent Laws is a campaign co-founded by SECTION27, Treatment Action Campaign (TAC) and Doctors Without Borders (MSF) in 2011. Since then, the coalition has grown to include 38 other organisations fighting together to push South Africa to amend its patent laws to prioritise public health. Through this blog we will highlight how amending South Africa’s Patents Act 57 of 1978 will reduce the cost of medicines, improving the health and saving the lives of millions of South Africans.

    The members of the Fix the Patent Laws Campaign are as follows: Treatment Action Campaign (TAC), Doctors Without Borders (MSF), SECTION27, the South African Non-Communicable Diseases Alliance (SANCD Alliance), DiabetesSA, EpilepsySA, Marie Stopes South Africa, Stop Stock Outs Project (SSP), South African Depression and Anxiety Group (SADAG), Cape Mental Health (CMH), the South African Federation of Mental Health (SAFMH), Schizophrenia and Bipolar Disorders Alliance (SABDA), as well as the following members of the Cancer Alliance and Advocates for Breast Cancer: Breast Course 4 Nurses, Breast Health Foundation, Cancer Association of South Africa (CANSA), Cancer Heroes, Can-Sir, CanSurvive, Care for Cancer Foundation, Childhood Cancer Foundation of South Africa (CHOC), Hospice Palliative Care Association (HPCA), Igazi Foundation, Look Good Feel Better, Love your Nuts, Lymphoedema Association of South Africa (LAOSA), Men’s Foundation, National Council Against Smoking, National Oncology Nursing Association of SA, Pancreatic Cancer Network of SA (PanCan), People Living With Cancer (PLWC), Pink Trees for Pauline, Pink Phoenix Cancer Foundation, Pocket Cancer Support, Project Flamingo, Rainbows and Smiles, Reach for Recovery, South African Oncology Social Work Forum (SAOSWF), The Pink Parasol Project, The Sunflower Fund, Vrede Foundation and Wings of Hope.

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