Analysis of WHO table showing, per country, number - Act Up

Analysis of WHO table showing, per country, number - Act Up

FIVE YEARS AFTER DOHA:
ANALYSIS OF THE WHO DATABASE ON ARVS
SUMMARY TABLES
Here are three tables summarizing the data in the WHO’s online database on ARV
registrations in developing countries:
•
•
•
Table 1: Ratio and index for competition on ARVs, in low-income countries
(World Bank classification).
Tableau 2: ARV competition index: distribution by fractiles.
Tableau 3: Ratio and index for competition on ARVs, in all developing
countries.
Introduction
Since 2005, the World Health Organization publishes on-line a database of
which HIV medicines are available in which Member State1. According to the WHO, a
medicine is deemed available if it is registered with the national drug regulation authority
(meaning that its been official approved for marketing in the country). This registration
process is mandatory in virtually every country in the world, since it is the only thing
allowing the government to control which medicines get marketed, and thus to prevent the
marketing of bad-quality or dangerous medicines.
From the WHO database, it is possible to make a list of which patented ARVs are
available in a given country, and which generic ARVs are not available. Based on these
figures, one can calculate an « index of competition on ARVs » prevalent in a given country
(see methodological explanation in separate document on the Act Up-Paris website). From
this per-country index, an average index across developing countries can be derived.
From this analysis, it appears that, across all developing countries, 74% of ARVs
are still under monopoly – even though the 2001 WTO Declaration on TRIPS and Public
Health was supposed to lift the monopolies and ensure global access to competitively priced
medicines. In reality, there is zero competition on ARVs in about half the world’s poor
countries.
Tables
Tableau 1 : Ratio and index for competition on ARVs, in low-income countries
(World Bank classification).
Country
Ratio
Index
Afghanistan
Bangladesh
Bénin
Bhoutan
0/3
0/6
9/16
0/4
0
0
56,25
0
1
published on-line at http://www.who.int/hiv/amds/patents_registration/drs
1/6
Burkina Faso
Burundi
Cambodge
République Centrafricaine
Tchad
Comores
Congo
Côte d’Ivoire
Erythrée
Ethiopie
Gambie
Ghana
Guinée
Guinée-Bissau
Haïti
Inde
Kenya
Kirghizstan
Rép. Dém. du Laos
Libéria
Madagascar
Malawi
Mali
Mauritanie
Mongolie
Mozambique
Myanmar
Népal
Niger
Nigeria
Pakistan
Papouasie Nvelle Guinée
République Dém. de Corée
Rwanda
Sao Tome et Principe
Sénégal
Sierra Leone
Iles Solomon
Somalie
Soudan
Tadjikistan
Ouganda
Tanzanie
Togo
Ouzbékistan
Vietnam
Yémen
Zambie
Zimbabwe
Total
7/11
18/18
10/15
7/9
10/13
0/6
13/16
11/14
0/6
8/14
2/14
10/15
4/13
0/4
2/6
18/19
11/15
0/5
0/7
0/6
3/10
12/13
9/10
11/14
0/5
0/4
13/13
0/4
0/8
14/14
0/10
0/5
0/4
0/7
0/5
7/10
11/14
0/6
0/4
7/8
0/5
13/17
11/12
4/11
0/8
1/10
0/7
12/14
11/13
N/A
63,63
100
66,66
77,77
76,92
0
81,25
78,57
0
57,14
14,28
66,66
33,33
0
33,33
94,73
73,33
0
0
0
30
92,30
90
78,57
0
0
0
0
0
100
0
0
0
0
0
70
78,57
0
0
87,5
0
76,47
91,66
36,36
0
10
0
85,71
84,61
25,80
2/6
Tableau 2 : ARV competition index : distribution by fractiles.
Competition index superior to
(en %)
Fractiles
9ème décile (90%)
8ème décile
3er quartile (75%)
7ème décile
6ème décile
5ème décile (50%)
77.77
60
54.54
44.44
30
0
Interpretation :
- over 50% of developing countries have zero ARV under competition
- only 30% of developing countries have more than 44% of their ARVs under
competition
- only 10% of developing countries have more than 77% of their ARVs under
competition
Tableau 3 : Ratio and index for competition on ARVs, in all developing countries
Countrt
Ratio
Index
Afghanistan
Albanie
Algérie
Angola
Argentine
Arménie
Azerbaïdjan
Bahamas
Bahreïn
Bangladesh
La Barbade
Biélorussie
Belize
Bénin
Bhoutan
Bolivie
Bosnie-Herzégovine
Botswana
Brésil
Bulgarie
Burkina Faso
0/3
0/1
4/4
0/3
11/16
0/5
0/5
0/7
0/6
0/6
0/7
0/3
0/5
9/16
0/4
7/11
0/2
0/12
7/14
0/6
7/11
0
0
100
0
68.75
0
0
0
0
0
0
0
0
56.25
0
63.63
0
0
50
0
63.63
3/6
Burundi
Cambodge
Cameroun
Cap Vert
République Centrafricaine
Tchad
Chili
Chine
Colombie
Comores
Congo
Costa Rica
Côte d’Ivoire
Croatie
Cuba
Chypre
République Dém. de Corée
RéP. Dém. du Congo
République du Timor
Djibouti
République Dominicaine
Equateur
Egypte
Salvador
Guinée équatoriale
Erythrée
Estonie
Ethiopie
Gabon
Gambie
Géorgie
Ghana
GRèce
Guatemala
Guinée
Guinée-Bissau
Guyana (Surinam)
Haïti
Honduras
Inde
Indonésie
Iran
Israël
Jamaïque
Jordanie
Kazakhstan
Kenya
Kiribati
Koweït
Kirghizstan
Rép. Dém. du Laos
18/18
10/15
4/10
0/9
7/9
10/13
4/10
5/10
7/12
0/6
13/16
5/11
11/14
0/5
0/2
0/9
0/4
7/14
0/6
0/7
2/11
6/11
0/2
0/7
0/6
0/6
0/11
8/14
9/13
2/14
3/8
10/15
0/10
4/12
4/13
0/4
1/4
2/6
6/14
18/19
0/8
2/4
0/8
4/9
0/5
5/7
11/15
0/7
0/5
0/5
0/7
100
66.66
40
0
77.77
76.92
40
50
58.33
0
81.25
45.45
78.57
0
0
0
0
50
0
0
18.18
54.54
0
0
0
0
0
57.14
69.23
14.28
37.5
66.66
0
33.33
33.33
0
25
33.33
42.85
94.73
0
50
0
44.44
0
71.42
73.33
0
0
0
0
4/6
Lettonie
Liban
Lesotho
Libéria
Lituanie
Madagascar
Malawi
Malaisie
Maldives
Mali
Malte
Mauritanie
Maurice
Mongolie
Maroc
Mozambique
Myanmar
Namibie
Népal
Nouvelle Zélande
Nicaragua
Niger
Nigeria
Oman
Pakistan
Panama
Papouasie Nvelle Guinée
Paraguay
Pérou
Philippines
Porto Rico
Qatar
Moldavie
Roumanie
Russie
Rwanda
Samoa
Sao Tome et Principe
Arabie Saoudite
Sénégal
Serbie Monténégro
Seychelles
Sierra Leone
Singapore
Slovénie
Iles Solomon
Somalie
Afrique du Sud
Sri Lanka
Soudan
Surinam
0/9
3/7
0/3
0/6
0/10
3/10
12/13
3/10
0/5
9/10
0/8
11/14
4/10
0/5
5/12
0/4
13/13
6/12
0/4
0/8
0/7
0/8
14/14
0/5
0/10
2/9
0/5
7/10
4/17
0/8
0/3
0/6
0/2
0/7
0/6
0/7
0/7
0/5
1/4
7/10
0/7
0/1
11/14
0/7
0/8
0/6
0/4
8/13
4/7
7/8
0/5
0
42.85
0
0
0
30
92.30
30
0
90
0
78.57
40
0
41.66
0
0
50
0
0
0
0
100
0
0
22.22
0
70
23.52
0
0
0
0
0
0
0
0
0
25
70
0
0
78.57
0
0
0
0
61.53
57.14
87.5
0
5/6
Swaziland
Syrie
Tadjikistan
Thaïlande
Togo
Trinidad et Tobago
Tunisie
Turkménistan
Tuvalu
Ouganda
Ukraine
Emirats Arabes Unis
Tanzanie
Uruguay
Ouzbékistan
Vanuatu
Venezuela
Vietnam
Yémen
Zambie
Zimbabwe
TOTAL
0/7
4/7
0/5
5/11
4/11
9/15
1/8
0/5
0/6
13/17
12/12
0/5
11/12
5/12
0/8
0/7
6/11
1/10
0/7
12/14
11/13
N/A
0
57.14
0
45.45
36.36
60
12.5
0
0
76.47
100
0
91.66
41.66
0
0
54.54
10
0
85.71
84.61
26.62
6/6