The world is changing fast and to keep up you need local knowledge with global context.
Over the last few years, with improved treatments and in the face of extensive government intervention, South Africans have lost their sense of urgency over the HIV/Aids pandemic. However, as Adcock senior executive Stavros Nicolaou points out, the battle against HIV/Aids is far from won. Although some 2.2m South Africans are receiving treatment for Aids, about 20% of those who are medically eligible for such treatment are not getting it. And, of course, new infections continue to occur daily. While South Africa has achieved a great deal in the fight against Aids, there is plenty still to be done. – FD
ALEC HOGG: Well, ahead of World Aids Day this weekend, our programming is exploring different elements of the deadly virus. Joining us now to discuss the treatment and medicines for HIV/Aids is Stavros Nicolaou, Aspen Pharmacare’s Senior Executive of Strategic Trade Development. Stavros thanks for coming through to the studio.
STAVROS NICOLAOU: Thanks for having me.
ALEC HOGG: It’s almost like Aids is now becoming passé. We aren’t having as many people dying as there were in the past, because of efforts of people like yourself and Aspen. Surely, there’s a danger here that we start ignoring the reasons why HIV/Aids is transmitted in the first place.
STAVROS NICOLAOU: Well, I think probably the best way to answer is to highlight some statistics. We currently have, in Sub-Saharan Africa, around 25 to 30 million infected people, so we as a continent, collectively harbour the majority of the disease burden. There are only around seven million or so that are being treated. Of those seven million, 2.2 million happen to reside in our country, here in South Africa. If you look at the South African statistics, there are close to six million people infected, and as I said earlier, 2.2 million are currently on treatment. It doesn’t mean that everyone who’s infected is eligible for treatment because there are certain treatment protocols and guidelines that need to be followed. Suffice it to say that certainly on the continent, there’s a huge unmet need still – around 40 percent of the people who need to be treated, are currently receiving treatment. Our numbers are a lot better here in South Africa where it’s closer to around 80 percent of people requiring treatment, are presently receiving treatment. I think the point I’m trying to make though, is that in the years to come – because people are living longer with the pandemic – those numbers are going to ratchet up. The WHO has a target it set itself: it’s called 15 by 15. In other words, that’s 15 million patients on treatment by 2015 in developing and emerging markets.
ALEC HOGG: So the numbers are going to ratchet up. Is that the number infected or the number being treated?
STAVROS NICOLAOU: The number of people being treated primarily, but the pandemic is not dead, so there are people that are being infected every day. Although the numbers aren’t as scary as they were five years ago in terms of the number of new infection rates, there certainly are people that are being infected at the rate of roughly 800 to one thousand per day. That’s how many new infections you’re seeing in developing and emerging markets. As I said, a huge number of people that will require treatment in future or that still currently require – that are not receiving treatment… I think that’s probably where we need to keep the focus, or one of the focal points. There are a couple of others that we can discuss but certainly, the numbers are still telling us a story, that we need to be vigilant and certainly, can’t become complacent.
GUGULETHU MFUPHI: What’s Aspen’s role in ensuring, or rather providing the need out there…providing more treatment to those who are affected?
STAVROS NICOLAOU: I think charity always begins at home, so I think Aspen’s focus has largely been on being a significant contributor in the South African environment. We’re presently the largest supplier, both in the private as well as the public sectors, of anti-retrovirals. Just to give you a sense…we provide over one million monthly patient treatments into the public sector, and roughly 100 of the 200 thousand, so about 50 percent contribution in the private market, so we’re a significant contributor. It’s a high volume, but very low margin business and sometimes it’s hard not to view it as almost a corporate social responsibility initiative, because the margins are very low but it’s something we’ve done since inception over the last decade. We launched the first generic ARV in South Africa, against the odds. It’s something we’ve been committed to and it’s something that, if we were to pull the plug on it would have severe consequences. So obviously, we have to keep supplying, delivering, and contributing.
ALEC HOGG: I can’t let you go without some comment on your potential new competitor coming from Chile – the whole Adcock-Ingram CFR deal. How are you guys viewing it at Aspen?
STAVROS NICOLAOU: I don’t think I’m in a position to comment. We don’t even know who the new competitor will be.
ALEC HOGG: You know CFR, though.
STAVROS NICOLAOU: We do know CFR, but the way I understand it, shareholders have until the 18th.
ALEC HOGG: Yes but do you bump into them in the international markets? That’s really…
STAVROS NICOLAOU: Very remotely, I’d say. We know who we are because we try to keep on top of our business. We’re quite strongly represented these days in Spanish and Latin America, so obviously we’re aware of who they are. I think we need to wait and see what deal is consummated, if any.
ALEC HOGG: You’re not quaking in your boots at the fact that they could be…
STAVROS NICOLAOU: I think Aspen is quite a diverse business today. Our biggest market geographically, is in fact Asia, which includes Australia. That’s our biggest market, South Africa’s second biggest, and then you get Latin America, so we’re quite a diversified business. 70 percent of our turnover comes from offshore these days.
ALEC HOGG: We’re very proud of Aspen being a South African business, too.
STAVROS NICOLAOU: Thanks very much.
ALEC HOGG: If you could hear from Kruger there, a bit earlier… It’s great that you’re making your contribution, particularly in the fight against HIV/Aids in our country.
STAVROS NICOLAOU: Thanks so much. Thanks for having me.
ALEC HOGG: That was Stavros Nicolaou, Aspen Pharmacare’s Senior Executive of Strategic Trade Development.
Cyril Ramaphosa: The Audio Biography
Listen to the story of Cyril Ramaphosa's rise to presidential power, narrated by our very own Alec Hogg.