Cheap generics no panacea for India’s poorest

Even if all of that money were spent on the generic version of Nexavar, it would buy enough for barely 16 sufferers.

Tata Memorial, which gets government and private funding, performs about 70,000 major and minor cancer surgeries every year and chemotherapy sessions for more than 300 patients a day.

Patients with oxygen tubes in their noses sleep on benches in the corridors and families huddle on the floor of the teeming waiting area for cancer patients. Upstairs the ward is filled to the brim. At night, many will go back to sleep on the roadside or to cheap dormitories that charge 50 rupees a night.

“Here, consultations are free. But drugs are expensive. And so is the cost of an overnight stay,” says Savla, as people queued for bowls of rice from his charity’s pot by the roadside.

“HUGE DEBT”

Natco expects to sell $5-$6 million worth of generic Nexavar a year, its finance chief has said, equivalent to around 2,500 people using the drug for a full 12 months.

India has around 2.5 million people living with cancer, or about one in every 500 people, according to government reports and medical organizations. That figure might be below the mark.

“This is a gross underestimation,” said Nair, who is the country’s only representative on the advisory committee for the World Health Organization’s Director General.

“Suppose someone in a rural area has cancer of the stomach,” Nair explained. “He will have pain for 2-3 months. He will try indigenous medicines. Finally he will die. No one will record his true cause of death.”

There is a growing focus among global healthcare campaigners on the burden in poor countries of non-communicable diseases (NCDs) - chronic diseases like cancer and heart disease that kill millions who would survive with Western-style treatment.

The scale of the problem is immense. More than 36 million people die every year from NCDs - 80 percent of them in poor nations where access to diagnosis and treatment is very limited, according to the World Health Organization.

United Nations (UN) Secretary-General Ban Ki-moon told a high-level UN meeting in New York on the subject last September: “NCDs hit the poor and vulnerable particularly hard and drive them deeper into poverty.”

India has joined Thailand as only the second country to grant a compulsory license for a cancer drug, and legal experts say compulsory licensing could follow for other expensive treatments, including the latest types of HIV/AIDS medicines.

A provision of the Indian Patents Act allows for a compulsory license to be awarded after three years of the grant of patent on drugs that are deemed to be too costly.