Threat of TB forces manufacturers to sell drugs cheaply

The threat of a global epidemic of drug-resistant tuberculosis, and a drop in revenues, has persuaded major drug manufacturers to provide cheap treatments for developing countries.

The companies, including Eli Lilly, will sell three treatments for TB at between half and one-tenth of their usual cost in a deal brokered by the World Health Organisation (WHO). They will be used to treat people in countries such as Russia, Peru and the Philippines. Latvia and Estonia should join the scheme shortly.

But the companies involved fear that, if the scheme is not rigorously policed, the bacteria will develop resistance to the three drugs. This would make them not only useless, but wipe out the companies' profits.

"We're taking a huge financial loss doing this," said Laura Jacobus, founder of Jacobus Pharmaceuticals of New Jersey, US, which is supplying one of the drugs. "We must be careful it's not mismanaged."

New Scientist magazine reports today that the drugs will be offered at deep discounts to their normal price, as companies contemplate the spread of resistant strains.

It says that Eli Lilly will provide two treatments ­ capreomycin and cycloserine ­ to the WHO for $1, a 97 per cent discount on its normal price.

The move mirrors the way treatments for Aids have been made available to developing countries ­ though often only after a long struggle with pharmaceutical companies, which wanted to keep prices up, and countries such as the United States, which threatened trade sanctions when developing countries tried to lower prices.

Although only 1.5 per cent of the 8 million cases of TB worldwide annually are "multi-drug-resistant", the bacterium is evolving rapidly in a number of countries. Resistance tends to appear where patients begin treatments but stop taking them before completing the course. That is common, for example, in prisons in the republics of the old Soviet Union.

The pills to treat normal TB cost just £7 on the world market for a complete course. But, for a resistant strain, that leaps to £1,100 per patient, beyond poorer countries' budgets.

Using the drugs will be difficult: some need daily injections for two years, and hospital monitoring to ensure the regime is followed. Eli Lilly and Jacobus warn they will pull out if they find this is not done.

The WHO is still trying to seal agreements for cheap supplies for two other drugs, ofloxacin and ciprofloxacin.