Some nations, such as South Africa and Colombia, are adopting a more aggressive stance against pharmaceutical companies after being left behind in the competition for COVID-19 vaccines. They are also resisting policies that prevent access to affordable treatment for millions suffering from tuberculosis and HIV.

Many experts view this as a change in the approach of these countries towards dealing with large pharmaceutical companies and suggest that it may lead to increased efforts in increasing access to life-saving medications.

During the COVID-19 pandemic, wealthy nations purchased the majority of available vaccines in advance, resulting in a limited supply for poorer countries and causing a significant gap that the World Health Organization deemed as a “disastrous ethical lapse.”

According to Brook Baker, an expert on treatment access at Northeastern University, developing nations are now striving towards self-sufficiency in light of the pandemic, as they have come to understand that they cannot rely on others.

One of the goals is to focus on bedaquiline, a medication utilized to treat individuals with drug-resistant strains of tuberculosis. These pills hold significant value for South Africa, where tuberculosis claimed the lives of over 50,000 individuals in 2021, ranking as the primary cause of death in the country.

In the past few months, protesters have objected to Johnson & Johnson’s attempts to safeguard their patent for the medication. In March, individuals with tuberculosis urged the Indian government to make more affordable generic versions available; eventually, the government gave permission for Johnson & Johnson’s patent to be invalidated. Belarus and Ukraine also reached out to the company, requesting that they waive their patents, but received minimal acknowledgement in return.

In July, the patent for Johnson & Johnson’s medication ended in South Africa, but the company was able to prolong it until 2027, causing anger among activists who accused them of seeking excessive profits.

The government of South Africa initiated an investigation into the company’s pricing practices.

The treatment course had a cost of approximately 5,400 rand ($282), which was more than double the amount paid by impoverished countries receiving the drug through the Stop TB partnership.

In September, approximately one week after the start of South Africa’s investigation, Johnson & Johnson declared that it would relinquish its patent in over 130 countries, permitting generic manufacturers to replicate the medication.

The company stated that this dispels any false belief that our medications are not easily accessible.

According to Christophe Perrin, a specialist in tuberculosis working with Doctors Without Borders, Johnson & Johnson’s change of heart was unexpected. This is because strong patent protection is usually a crucial aspect of pharmaceutical companies’ approach.

In Colombia, the government recently announced that it will grant a compulsory license for the HIV medication dolutegravir, bypassing the need for approval from its patent-holder, Viiv Healthcare. This decision was made in response to the request of over 120 organizations to increase accessibility to the drug, which is recommended by the World Health Organization.

Peter Maybarduk from the Washington-based organization Public Citizen stated that Colombia is stepping up to address the severe inequality caused by COVID and is challenging a major pharmaceutical company to provide affordable AIDS treatment for its citizens. He also mentioned that Brazilian activists are urging their government to take similar action.

However, according to certain professionals, there are still many necessary changes that must take place before developing countries are able to manufacture their own medications and vaccinations.

According to Petro Terblanche, managing director of Afrigen Biologics, during the onset of the coronavirus pandemic, Africa accounted for less than 1% of all vaccines produced worldwide, yet consumed over 50% of the available supply. Afrigen Biologics is collaborating with the WHO to develop a COVID vaccine using mRNA technology, similar to those created by Pfizer and Moderna.

During the late 1990s and into the 2000s, Terblanche approximated that approximately 14 million individuals passed away from AIDS in Africa due to the unavailability of necessary medications.

During that time, the administration of President Nelson Mandela in South Africa decided to temporarily stop enforcing patents in order to increase availability of AIDS medications. This led to a legal battle in 1998, known as the “Mandela vs. Big Pharma” case, involving over 30 pharmaceutical companies.

In 2001, the drug companies dropped the lawsuit, which was deemed by Doctors Without Borders as a “public relations disaster.”

According to Terblanche, the HIV epidemic has been a valuable learning experience for Africa.

She stated that it is unacceptable for a company to possess intellectual property that hinders the ability to save lives, and therefore, more countries will likely take action against this.

According to Terblanche, it is essential to address pharmaceutical companies in order to guarantee equal availability of treatments and vaccines in Africa. However, equally important are the development of stronger healthcare systems.

She stated that if we are unable to distribute vaccines and medicines to those in need, they will not be beneficial.

However, some specialists have noted that South Africa’s intellectual property regulations have not been adequately modified, making it too simple for pharmaceutical corporations to obtain patents and prolong their monopolies.

According to Lynette Keneilwe Mabote-Eyde, a healthcare advocate working with the nonprofit Treatment Action Group, South Africa does not have a specific law in place to permit legal disputes for patents or patent extensions, unlike other developing nations.

The request for comment on drug procurement and patents from the South African Department of Health was unanswered.

According to the World Health Organization’s recent tuberculosis report, over 10 million individuals were affected by the illness and 1.3 million lost their lives due to it in the past year. Tuberculosis is currently the most lethal infectious disease globally, surpassing COVID-19, and is the leading cause of death among those with HIV.