The Medicine Goes Down: And in the US, it will cost $150 per day

On World AIDS Day, December 1st, 2019:

Cipla is an Indian pharmaceutical company that manufactures generic drugs.  They don’t develop drugs, they make drugs which are out of copyright or can be made cheaply because copyrights don’t apply to certain markets.  As a result, they produce a lot of drugs that save lives in developing countries, but still make a huge profit.

The most common anti-HIV drug used in Africa is a syrup that must be given to infants daily.  It contains 40% alcohol and has a metallic taste, and children either don’t want to take it or vomit if they do.  Without it, the death rate amongst children with HIV would skyrocket.

Cipla has reformulated the medicine into granules the size of sugar and taste like strawberries, making it much easier (and more willing) for children to digest.  It can be mixed with milk or food.  The new drug will cost $1 per day, the same as the unpalatable drug.  In a developing country, that’s still a lot of money, but it gives the children a fighting chance.

And that $1 per day is a money loser.  Cipla’s chairman, Dr. Yusuf K. Hamied, said in 2001 the company was losing money on each child the break even point being $600 per year.  He plans to continue selling it cheaply to save lives.

This is called being a decent human being.

If it were sold in the US, pharmaceutical companies would gouge hundreds of dollars out of people, just as they did with PrEP.

New Strawberry-Flavored H.I.V. Drugs for Babies Are Offered at $1 a Day

About 80,000 babies and toddlers die of AIDS each year, mostly in Africa, in part because their medicines come in hard pills or bitter syrups that are very difficult for small children to swallow or keep down.

But on Friday, the Indian generic drug manufacturer Cipla announced a new, more palatable pediatric formulation. The new drug, called Quadrimune, comes in strawberry-flavored granules the size of grains of sugar that can be mixed with milk or sprinkled on baby cereal. Experts said it could save the lives of thousands of children each year.

“This is excellent news for all children living with H.I.V.,” said Winnie Byanyima, the new executive director of UNAIDS, the United Nations agency in charge of the fight against the disease. “We have been eagerly waiting for child-friendly medicines that are easy to use and good to taste.”

Cipla revolutionized the provision of AIDS drugs for adults almost two decades ago, pricing them at $1 a day. The new pediatric formulation will likewise be priced at $1 a day. The announcement by Cipla and the Drugs for Neglected Diseases Initiative, an offshoot of Doctors Without Borders that supported the development of the drug, was timed to coincide with World AIDS Day, which is Sunday [December 1].


Cipla, founded in 1935, was the first generic drug company to offer H.I.V. drugs in Africa. In 2001, its chairman, Yusuf K. Hamied, upended the global pharmaceutical industry by offering to supply a three-drug cocktail to Doctors Without Borders for $1 a day.

At the time, multinational drug companies were charging up to $15,000 for their regimens and refusing to lower prices except in secret negotiations with a few countries and were working to block generic competitors from the market. An estimated 25 million Africans were then infected and thousands were dying every day. (The industry was also suing South Africa’s president, Nelson Mandela, over a law he had signed authorizing the government to cancel drug patents and award them to generic makers.)