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札幌医科大学医学部

分子医学研究部門　　近況と話題 　

2001年４月２６日　HIV/AIDS Treatment for Millions

おとといの話題の続きです。大学院生のための講義のため準備しながら考えをまとめています。きのう届いたScienceのなかに関連記事を見つけました。

Hans P. Binswanger HIV/AIDS Treatment for Millions Science 292: 221-223, 2001. (April 13, No. 5515)

この記事にHIV/AIDS治療薬に関する現状がまとめてありました。ここに引用されていた文献も調べてみました。WHOのホームページで、大変参考になります。

UNAIDS, IAS, and WHO, Use of Anti-Retroviral Treatments in Adult, with particular reference to resource limited settings, January 2001; available at www.who.int/HIV_AIDS/WHO_HSI_2000.04_1.04/

UNAIDS and WHO: Patent Situation of HIV/AIDS-related drugs in 80 countries, Geneva, January 2000; available at www.unaids.org/publications/documents/health/access/patsit.doc

少し長いですが、サイエンスの本文から引用します。

Nevertheless, many efforts have been initiated. Boehringer Ingelheim is offering its drug nevirapine free of charge for a period of 5 years for the prevention of mother-to-child transmissions (MTCT) and is collaborating with the Elisabeth Glaser Pediatric AIDS Foundation. The first shipment was provided to Brazzaville in the Republic of Congo last October. The French Fonds de Solidarite Therapeutique is providing ARV treatment to a handful of mothers whose children have benefited from MTCT treatment in several countries. Pfizer has agreed to provide diflucan to treat dangerous opportunistic fungal infections free to government clinics in South Africa. The first shipment of drugs has finally left at the beginning of March.

Thirty-two countries have expressed interest in participating in the UNAIDS drug access initiative. Under this initiative the Fonds de Solidarite of the Ivory Coast provides subsidized or free ARV medication to around 1000 patients. Last summer, the Bill and Melinda Gates Foundation, Merck, and the Republic of Botswana launched a program to accelerate the prevention, treatment, and care of HIV-related illnesses. Bristol-Myers Squibb has started its 100 million dollar "Secure the Future" program for South Africa and four more Southern African countries. Launching these programs has involved complex, time-consuming consultations and negotiations among a range of partners, including governments. Bolder approaches are needed if patients in the nearly 80 poorest countries in the World are to be reached.

この３月ぐらいから、いろいろな動きが明らかになってきたようです。

また、一方で、
Recently, the pharmaceutical company GlaxoSmithKline objected to the export of ARV drugs by Cipla to Ghana, and threatened them with litigation. A consortium of 39 drug companies is currently challenging the South African government in court on similar issues.
とあるように、特許侵害の裁判も始まっています。

Poor countries therefore need to frame their own patent laws to make maximum use of the flexibility offered by WTO regulations. They also need to ensure that drug importing and marketing in their countries are highly competitive.

WTOの規制、というのは（今日の授業でやりますが）、1991年、 GATTウルグアイ・ラウンドで決まったTRIPS協定（知的所有権の貿易関連の側面に関する協定）のことです。1999年まで、28ヶ国（米、欧、日など）、９億人が特許法の規制の下にあっただけなのです。しかし、この知的所有権協定(TRIPS)にともない2000年からは、120 ヶ国（ロシア、東欧を含めた市場経済移行国と開発途上国）、４２億人に対しても知的所有権の保護が導入されました。 2006年からは、後発開発途上国(48ヶ国、6億人)にもTRIPS履行義務が生じます。2000年からは、まさに全世界がプロパテントの時代に入ったといって良いでしょう。
濱田洋文

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