Open Letter: Promoting Access to Affordable Medicines in South Africa through Patent Law Reform

17 October 2014 – Open letter to President Jacob Zuma and Minister of Trade and Industry Rob Davies

This is an open letter from individuals and organisations concerned with the ability of people everywhere to have access to medicines which save lives and enhance quality of life. We are writing in support of the South African government’s longstanding efforts to revise their patent laws in order to better safeguard and promote the availability of generic medicines at more affordable prices. The international community is behind South Africa—as it has been in the past—to prioritise the lives and wellbeing of its people over the private interests of pharmaceutical companies.

We encourage the Department of Trade and Industry (DTI) to immediately release the final version of its National Policy on Intellectual Property, inclusive of clear language outlining reforms that advance South Africa’s constitutional right to have access to health care services.

Admirable progress has been made over the past decade in addressing South Africa’s greatest health challenge, the HIV epidemic. Scale-up of antiretroviral treatment (ART) to millions of people living with HIV in South Africa would not have been possible without access to generic medicines, which brought down the price of individual treatment from over $10,000 per year to less than $1 per day. Today, even lower prices have been realised in South Africa for standard first-line ART.

Without access to more affordable generic medicines, it will be difficult to address other significant health challenges in South Africa. Controlling the cost of medicines is vital for the public sector, medical aid schemes, and individuals who self-finance purchases through the private sector. Everyone in South Africa has the right to access to medical innovations, be it rapid and accurate diagnostics, lifesaving medicines, or treatments which significantly improve an individual’s enjoyment of the right to health.

South Africa’s current patent laws and policies are prone to abuse by pharmaceutical companies. Companies prolong monopolies by filing multiple patents on the same medicine over time. This has a chilling effect on prices for a wide range of medicines, including those for high-burden diseases like drug-resistant tuberculosis (DR-TB), and non-communicable diseases like cancer. Abuse of patent rights also threatens affordable access to promising new therapies for HIV, DR-TB and Hepatitis C, and can limit research into optimal treatment combinations for these conditions. This does not bode well for the financial sustainability and future success of treatment programmes in South Africa.

One year ago, the DTI released a Draft National Policy on Intellectual Property (DNPIP) for public comment. The DNPIP outlined bold reforms which, once implemented, would better ensure public health was not compromised by the enforcement of intellectual property (IP) rights. The DNPIP recognised the need for laws and practices that would limit abusive pharmaceutical patent monopolies; promote generic competition and allow patent barriers to be overcome when critical medicines are priced out of reach; and incentivize models of medical innovation that do not rely on companies charging high prices in order to recoup research and development costs. All of these reforms are urgently needed in South Africa, and in line with the government’s obligations under international trade agreements, and as defined in the South African constitution.

Government representatives have made several guarantees and announcements over the past year that the National IP Policy would be finalised and released during 2014, before this point in time. But we are not there yet.

South Africa faces significant pressure from certain parties—specifically, the multinational pharmaceutical industry—to delay patent law reform. Numerous countries at the Executive Board meeting of the World Health Organisation, as well as civil society organisations and nearly 50,000 members of the global general public echoed the South African government’s condemnation of the January 2014 “Pharmagate” scandal. In 1998, 39 multinational pharmaceutical companies took Nelson Mandela’s government to court over national IP reforms made in the interest of protecting public health. International pressure helped force pharmaceutical companies to back down from the court case in 2001, and a similar global demand for social justice continues to support South Africa today to make needed legal reforms.

If the South African government is to honour its history of supporting access to medicines, the best possible action it could take would be to release a final IP policy as soon as possible, which demonstrates a concrete commitment to safeguard public health and promote the constitutional rights of the people of South Africa. We await the finalisation of such a policy.



  • AIDS-Free World
  • Health Action International
  • Oxfam International
  • Treatment Action Campaign
  • MSF Access Campaign
  • Knowledge Ecology International
  • Universities Allied for Essential Medicines
  • AIDS Foundation of South Africa
  • AIDS & Rights Alliance for Southern Africa (ARASA)
  • Student Stop AIDS Campaign
  • Stop Stockouts Coalition (South Africa)
  • Action against AIDS Germany
  • Ecumenical Advocacy Alliance (EAA)
  • Christian AIDS Bureau for Southern Africa (CABSA)
  • Brot fuer die Welt, Germany
  • The Global Network of Sex Work Projects
  • FoTAC UK
  • Treatment Access Watch Africa
  • Treatment Action Watch Cameroon
  • Coalition 15%
  • Church of Scotland HIV Programme
  • Health Poverty Action
  • ImpActAIDS (Scotland)
  • The Center for Health, Human Rights and Development (CEHURD)
  • Catholic Agency For Overseas Development (CAFOD)
  • Health GAP (Global Access Project)
  • Act Up-Paris
  • Consumer Association the Quality of Life (EKPIZO)
  • Results UK
  • International Treatment Preparedness Coalition (ITPC)-South Asia
  • Delhi Network of Positive People (DNP+)
  • Initiative for Health & Equity in Society
  • Diverse Women for Diversity
  • Positive-Generation, Cameroon
  • Initiative for Medicines, Access & Knowledge (I-MAK)
  • HIV i-Base, London, UK
  • International HIV/AIDS Alliance
  • AIDS Orphan
  • Africa Japan Forum
  • Southern African HIV Clinicians Society
  • The Open Medicine Project
  • CBSM (Consultancy Bureau voor Strategisch Management)
  • MSF Southern Africa Association
  • MSF South Africa
  • KEI Europe
  • Catholics for AIDS Prevention and Support, UK
  • Bolivian Network of People Living with HIV (REDBOL)
  • Salud por Derecho (Right to Health Foundation)—Spain
  • Congress Of South African Trade Unions (COSATU)
  • Brazilian Interdisciplinary AIDS Association (ABIA)
  • Group of Incentive to Life (GIV)-Brazil
  • GESTOS-Brazil
  • AIDS Law Project—Kenya
  • BUKO Pharma-Kampagne—Germany

Stephen Lewis & Paula Donovan
Co-Directors, AIDS-Free World

Sir John Sulston
Chair of the Institute for Science, Ethics and Innovation
University of Manchester, UK
Joint Winner, 2002 Nobel Prize in Physiology or Medicine

Professor Brook K. Baker
Northeastern U. School of Law
Honorary Research Fellow University of KwaZulu Natal
Senior Policy Analyst Health GAP
NGOs Alternate Board Member UNITAID

Dr Tido von Schoen-Angerer,
NGOs Board Member UNITAID, Health Action International

Gajanan Wakankar,
Independent Researcher on IPR matters,
Former Ambassador  of India to Jordan, Oman

Professor Yousuf A Vawda
Academic Leader: Public Law
School of Law, University of KwaZulu-Natal
South Africa
Professor Alex van den Heever,
Chair, Social Security Systems Administration and Management studies
Wits School of Governance
University of the Witwaterstrand
South Africa

Catherine Hankins MD PhD FRCPC
Deputy Director, Science
Amsterdam Institute for Global Health and Development
The Netherlands

Wilbert Bannenberg
Public Health Consultant
The Netherlands

Ellen ’t Hoen, LLM.
Medicines Law & Policy

Prof. H. David Banta M.D.
(Prof Emeritus University of Maastricht. Medical Technology Assessment)
The Netherlands

Angelica Di Battista,
IP Avvocato (IT), IP Lawyer (UK) &
Graduate Student in School of Law
University of Kwa-Zulu Natal
South Africa

drs. Lucas F.M. van der Hoeven
Consultancy Bureau voor Strategisch Management
Promovendus EU-beleid m.b.t. benzodiazepinen
Psycholoog en docent economie en maatschappijleer
The Netherlands

Mw. J.J. Sluis
Psychologenpraktuk Dongen
The Netherlands

Irene Ostermayer
Independent Mediator
The Netherlands

Joel Lexchin MD
Professor School of Health Policy and Management
Faculty of Health
York University

Michelle Childs
Medicines law & Policy

Phyllis Freeman
Professor Emerita, University of Massachusetts
Boston, USA

Meri Koivusalo
Senior Researcher
National Institute for Health and Welfare

Daniel Berman
General Director
MSF South Africa

Manica Balasegaram
Executive Director
MSF Access Campaign

Sharon Ekambaram
Head of the Dr Neil Aggett Unit
MSF South Africa

Joyce Bichler
Author of DES Daughter: The Joyce Bichler Story
San Mateo, California, USA

Gracia Violeta Ross Quiroga
National Chair

Dr. Andrew Herxheimer
Clinical Pharmacologist
Former Editor, UK Drug Bulletin

Lonias Ndlovu
Senior Lecturer, Dept. of Mercantile Law
Faculty of Commerce, Administration and Law
University of Zululand
South Africa

Dr. Klaus Seitz
Head of Policy Department
Brot fuer die Welt

Rev Dr Robin Hill
Church of Scotland HIV Programme

Anthony Robbins, MD, MPA
Professor of Public Health
Tufts University School of Medicine
Boston, Massachusetts, USA

Vincent Manning
Catholics for AIDS Prevention and Support

Dr Peter R Mansfield OAM BMBS
Healthy Skepticism, Inc.

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