In June 2000, the Treatment Action Campaign (TAC) began importing generic HIV/AIDS drugs in defiance of patent laws, trying to pressure drug companies to reduce drug costs and to compel 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. Over four million people are infected with HIV in South Africa and high prices for patented drugs have made treatment inaccessible to most people.
Fluconazole is an essential drug used to treat illnesses related to HIV. Like many other HIV/AIDS medications, Fluconazole is produced by multinational companies under patent and imported into South Africa at a very high price. Generic versions of the drug are significantly less expensive. Pfizer’s patent of the drug, however, prevented the South African government from importing these generic versions. Although the South African Patent Act gives the government power to import or produce cheap copies of patented drugs, the government did not attempt to use this power.
Before importing medications, TAC worked with the World Health Organization and Medecins Sans Frontieres to confirm that they were safe and effective, and arranged systems for their purchase and import. For example, TAC organized a trip to Thailand, where a generic form of Fluconazole called Biozole was available to the public for less than US$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 them an exemption. In November 2000, under pressure from TAC and its international and local supporters, the Council permitted the generic drug to be distributed to patients by one of TAC’s partners. The pharmaceutical company Pfizer had promised to deliver its own medication to patients in March 2000; the exemption — an exercise of the government’s discretionary power — would be reviewed once this delivery actually occurred.
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In South Africa the Treatment Action Campaign engaged in civil disobedience by circumventing national laws, then pressured the government to change these laws in order to ensure treatment for people with HIV/AIDS.
By drawing attention to low-cost alternatives, this act of civil disobedience demonstrated the urgency need for access to HIV/AIDS medications. The activists were prepared to suffer the consequences of breaking the law in order to save lives, thereby applying sufficient pressure to affect national policy.
Even as it defied South African law and international patent agreements by importing generic drugs, TAC also supported the South African government in a case brought by a group of 39 pharmaceuticals, called the Pharmaceutical Manufacturers’ Association (PMA). The PMA alleged that the Medicines Act, which includes provisions allowing the government to import patented drugs from other countries if they are available at a lower prince, violated patent laws. The PMA ultimately withdrew its case.
South Africa continues to live under the specter of a grave human rights crisis: millions of people have HIV/AIDS and have no access to effective medicine. In August 2003, however, under pressure from TAC, the South African government agreed to make anti-retroviral drugs available without charge to all South Africans and confirmed this promise in a new plan unveiled in November of the same year.