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In June 2000, the Treatment Action Campaign (TAC) began importing generic HIV/AIDS drugs in defiance of patent laws to pressure the drug companies to reduce the cost of drugs as well as pressure the South African government to allow the importation of generic versions of patented drugs.  The goal of the tactic was to increase access to affordable HIV/AIDS prescription drugs for all South Africans.

TAC’s Defiance Campaign established a network of doctors and pharmacists who prescribe high quality, low cost, generic medicines sold in other countries to South Africans infected with HIV/AIDS.  As a result, TAC experienced increased support and the political leverage necessary to provide affordable treatment to South Africans with HIV/AIDS. 

Over four million people are infected with HIV in South Africa, and high prices for patented drugs have made treatment unattainable to most people. An essential drug used to treat HIV-related illnesses is Fluconazole.  Like many other anti-HIV/AIDS medications, Fluconazole is produced under patent by a multinational company (Pfizer) and imported into South Africa at a very high price.  Generic versions of the drug are significantly less expensive.

Under earlier TAC insistence, Fluconazole’s manufacturer Pfizer announced it would provide the drug at a reduced price; however, in the months after the agreement it failed to follow through.   TAC’s important efforts pressured the Government to act under South African Patent Act, which gives the government the power to import or produce cheap copies of patented drugs through a humanitarian exemption.

To achieve this exemption, TAC worked with the World Health Organization and Medecins Sans Frontieres to confirm that the imported drugs were safe and effective. TAC arranged systems for purchasing and importing the drugs.  For example, TAC organized a trip to Thailand, where a generic form of Fluconazole called Biozole was available to the public for less than $0.28 per tablet.  

When the Biozole tablets reached the border, the South African Medicine Control Council confiscated them while members of that Council debated the issue of granting an exemption for generic Fluconazole. Following pressure from TAC and its international and local supporters, the Council permitted the generic Fluconazole to be distributed to people by one of TAC’s partners. The exemption would be reviewed once the drugs Pfizer promised to deliver to patients in March 2000 actually reached people.  By granting the exemption, the government exercised its discretionary power.

TAC’s act of civil disobedience demonstrated the urgency of the problem of access to HIV/AIDS medications by drawing attention to low cost alternatives that TAC sought to make available.   The activists were prepared to suffer the consequences of breaking the law in order to save lives, thereby applying sufficient pressure to impact national policy.   

In addition to importing generic drugs, TAC lent its support to the government in a court case brought against it by a group of 39 pharmaceuticals called the Pharmaceutical Manufacturer’s Association (PMA).  The case was brought against the South African government over its Medicines Act, which included provisions that allowed the government to import patented drugs from other countries if they were available at a lower price than in South Africa.  Under the Act, pharmacists would also be required, when presented with a prescription, to prescribe cheaper generic drugs if they were available—a requirement the PMA alleged violated patent laws.  The PMA ultimately withdrew their case.

South Africa was, and continues to be, living under the specter of a grave human rights crisis: millions of people with HIV/AIDS without access to effective medicine.  Following its success in 200, TAC continued to push for easier access to HIV/AIDS medications. In August 2003, under pressure from TAC, the South African government agreed to make anti-retroviral drugs available to all South Africans. In the new plan, unveiled that November, the government committed to providing free anti-retroviral drugs to anyone who needs them.

Photo credit: Brooks Elliott