Demonstrations held at Roche & pharma associations in South Africa, Malaysia, UK, France, Zambia, Brazil, US – 108 organisations endorse a letter to Roche Tuesday, 7th February 2017 –

Swiss multinational company Roche faced global condemnation today from women living with cancer, families of people with cancer, activists, scientists, researchers and health professionals from across the world. They highlighted the immoral and unconscionable tactics employed by Roche across the developed and developing world. Roche’s greed is preventing women from accessing affordable versions of trastuzumab, an essential medicine used in the treatment of breast cancer.

The global day of action was led by women living with cancer in South Africa who gathered outside Roche’s office in Johannesburg demanding justice for Tobeka Daki – a leading cancer activist from South Africa whose own struggle against cancer ended last year.

In South Africa today, we launched the Tobeka Daki Campaign for Access to Trastuzumab. In loving memory of a fearless activist who lead our struggle to ensure women could get this medicine,” said Salomé Meyer of the Cancer Alliance in South Africa. “Even as the likelihood of her being able to get trastuzumab diminished, Tobeka’s determination to ensure other women could access the medicine only grew stronger.”

Despite being a good candidate for trastuzumab, Tobeka was never able to access the treatment due to its high cost. In South Africa the annual price charged by Roche in the private sector is around US$ 38 365 (ZAR 516,700). The few public facilities which can access trastuzumab do so at a lower price of around US$ 15 735 (ZAR 211,920) per year. But, health economists have shown that a year’s worth of trastuzumab can be produced and sold for only US$ 240, a price that includes a 50% increase above the cost of production for profit. Roche maintains its high prices in every way possible.

Roche holds multiple evergreened patents on trastuzumab in certain countries across the world. In South Africa, for example, multiple patents extend Roche’s monopoly until 2033. In countries where the patents expired or do not exist, Roche is using other means to block potentially more affordable biosimilar versions coming to market.

In India Roche have embroiled India’s drug regulatory body and biosimilar producers in long-running and increasingly complex litigation to prevent the widespread availability of potentially affordable versions of trastuzumab,” said Kalyani Menon Sen, a women’s rights activist from India.

Even as Roche withdrew its patent applications on trastuzumab in India in the face of patent oppositions that were likely to succeed, it applied new ways to continue to be the sole supplier. We are demanding that they immediately cease all litigation against biosimilar products.”

In Brazil and Argentina, Roche is one of the pharmaceutical companies litigating against those governments for their attempts to use legal international safeguards to protect public health. “The Brazilian government pays 73 times more than what health economists estimate trastuzumab could be sold for. It’s just too expensive,” said Graciela Rodriguez, a women’s rights activist from Brazil. “Worse now, Roche are also suing our government – through a case filed by Interfarma – for attempting to stop abusive patenting practices more broadly. Roche doesn’t like the fact that the Brazilian government have a system of examining patent applications and rejecting those that don’t meet our standards.” “I stand in solidarity with people living with cancer around the world.

The high cost of my own treatment has affected my ability to follow doctors’ orders to remain healthy,” said Timothy Lunceford-Stevens of ACT UP New York, a two-time cancer survivor who also lives with other disabilities.

I have been refused Pharma support programs because my government assistance program for people with disabilities disqualifies me. In the United States, seniors and people with disabilities are particularly vulnerable to the high cost of medicines by pharmaceutical companies like Roche, and the government’s system to help get medicines to patients is rigged.”

Melanie Kennedy, a breast cancer patient and mother of two from Northern Ireland in the UK said,

“Roche’s behaviour in South Africa is an outrage. The price they are charging for trastuzumab firmly puts their profits ahead of the lives of women with breast cancer. As a breast cancer patient in the UK this comes as no surprise. Roche are trying to charge a price for T-DM1, the drug I will need to take after trastuzumab, that is so high even the UK cannot afford it. Patients in the NHS are in the same situation as patients in South Africa – paying with their lives for Roche’s greed. They must drop the price – and if they don’t our governments must take action to protect women’s lives by over-riding Roche’s patent and securing affordable versions of their medicines.”

In 2015 Roche made US$ 8.9-billion profit. In the same year CEO Severin Schwan earned US$ 12-million. It is highly plausible that Roche could cut the price of trastuzumab dramatically and still be very profitable.

Demands to Roche: – Drop the price of trastuzumab and T-DM1 so that all women living with HER2+ breast cancer who need these medicines can access them; – Immediately cease all litigation against biosimilar versions of trastuzumab; – Stop abusive patenting practices that needlessly extend patent monopoly on trastuzumab and other medicines; and – Immediately cease litigation against the Brazilian and Argentinian governments for their use of TRIPS flexibilities.

Follow the twitter conversation #RocheGreedKills #ForTobeka Endorsed by:

ACT UP London, United Kingdom ACT UP New York, United States ACT UP Paris, France AIDS Access Foundation, Thailand AIDS and Rights Alliance of Southern Africa (ARASA) All India Drug Action Network (AIDAN), India All-Ukrainian Network of PLWHA, Ukraine Alliance of Doctors for Ethical Healthcare, India Asia Pacific Council of AIDS Service Organisations (APCASO), Thailand Asia Pacific Network of People Living with HIV/AIDS (APN+) Asia Pacific Network of Sex Workers (APNSW) Association of Korean medicine Doctors for Health rights (AKDH), South Korea Association of Physicians for Humanism (APH), South Korea Brazilian Interdisciplinary AIDS Association (ABIA), Brazil Cancer Alliance, South Africa Cape Mental Health, South Africa Center for Health and Social Change (SHSC), South Korea Center for Research of Environment, Appropriate Technology, and Advocacy (CREATA), Indonesia Charitable Foundation of Patients “Blood drop”, Ukraine Child With Future, Ukraine Children with Hemophilia, Ukraine Coalition Plus, France Community Development Centre, Malaysia Crisis Care Home, Malaysia Delhi Network of Positive People (DNP+), India EVA Non-Profit Partnership, Russia Fix the Patent Laws Coalition, South Africa Fundación Grupo Efecto Positivo, Argentina Global Network of Sex Work Projects (NSWP), International Health GAP, International Health Poverty Action, United Kingdom HIV i-base, United Kingdom Housing Works, United States Human Rights Law Network, India I-MAK, United States Indonesia AIDS Coalition (IAC), Indonesia Indonesia For Global Justice (IGJ), Indonesia Indonesia Positive Women Network (IPPI), Indonesia Initiative for Health & Equity in Society, India Intellectual Property Left, South Korea International Treatment Preparedness Coalition, Global International Treatment Preparedness Coalition, Middle East and North Africa (ITPC-MENA) International Treatment Preparedness Coalition, Russia (ITPCru) International Treatment Preparedness Coalition, South Asia Jaringan Peduli Tuberkulosis Indonesia (JAPETI), Indonesia Just Treatment, United Kingdom Kartini Samon, Indonesia Kesatuan Nelayan Tradisional Indonesia (KNTI), Indonesia Knowledge Ecology International (KEI), International Korea Alliance of Patients’ Organization, South Korea Korea Congenital Heart Disease Patient Group, South Korea Korea Heart Disease Patient Group, South Korea Korea Kidney Cancer Association, South Korea Korea Leukemia Patient Group, South Korea Korean Dentists Association for Healthy Society (KDAH), South Korea Korean Federation of Medical Groups for Health rights (KFHR), South Korea Korean GIST Patients Organization, South Korea Korean Pharmacists for Democratic Society (KPDS), South Korea Korean Progressive Network-Jinbonet, South Korea Lawyers Collective, India LOCOST, India Lusiana, Indonesia Médecins Du Monde, France Mr. Charles Santiago, Member of Parliament, Malaysia Mr. Mark Cheong, Lecturer, School of Pharmacy, Monash University, Malaysia MSF Access Campaign, International MSF Southern Africa, South Africa Muskan Sanstha, India National Working Group on Patent Laws, India Network of Marginalised Peoples JERIT, Malaysia Patients of Ukraine People’s Health Institute, South Korea People’s Health Movement Global People’s Solidarity for Social Progress, South Korea Pink Ribbon of Ukraine Positive Malaysian Treatment Access & Advocacy Group (MTAAG+), Malaysia Positive Women, Ukraine Rare Immune Disease, Ukraine RED Argentina de Personas Positivas, Argentina Red Latinoamericana por el Acceso a Medicamentos (RedLAM), Argentina Rural Women’s Assembly, South Africa SAMA – Resource Group for Women and Health, India SANGRAM, India SECTION27, South Africa Seruni, Indonesia Socialist Party of Malaysia Solidaritas Perempuan (Women’s Solidarity for Human Rights), Indonesia Solidarity for HIV/AIDS Human Rights-NANURI+, South Korea Solidarity for Worker’s Health (SWH), South Korea Sonke Gender Justice, South Africa South African Depression and Anxiety Group (SADAG), South Africa South African Non-Communicable Diseases Alliance (SA NCD Alliance) Spark of Hope, Ukraine STOPAIDS, United Kingdom Talking about Reproductive and Sexual Health Issues (TARSHI), India Thai Network of People Living with HIV/AIDS, Thailand Third World Network, International Transnational Institute (TNI), International Treatment Action Campaign (TAC), South Africa Treatment Action Group (TAG), United States Treatment Advocacy and Literacy Campaign (TALC), Zambia Union for Affordable Cancer Treatment (UACT), United States Universities Allied for Essential Medicines (UAEM), International Veshya Anyay Mukti Parishad (VAMP), India Vietnam Network of People living with HIV (VNP+) Wahana Lingkungan Hidup Indonesia (WALHI), Indonesia WOMIN, South Africa Young Professionals Chronic Disease Network (YP-CDN), International Youth STOPAIDS, United Kingdom


Who is Tobeka Daki?

Tobeka Daki was a single mother from Mdantsane township in South Africa who was diagnosed with HER2+ breast cancer in 2013. Following her diagnosis, Tobeka was informed that she needed trastuzumab, in addition to a mastectomy and chemotherapy, to improve her chances of survival. Despite being a good candidate for the treatment, Tobeka was never able to access trastuzumab due to its high cost. Her cancer metastasized and on 14 November 2016 she died in her home. She was unable to access this treatment due to the exorbitant price charged for trastuzumab by pharmaceutical company Roche.

Despite her declining health, Tobeka threw herself into advocating for access to healthcare for all women during 2016. In March she gave testimony to the United Nations Secretary General’s High Level Panel on Access to Medicines and led a picket outside the Roche offices in Johannesburg . In July, she shared her story at the International AIDS Conference in Durban and led a vigil at Roche’s conference display booth. Later, in September she led a march to the offices of the Department of Trade and Industry calling on government to finalise delayed legal reforms that would improve medicine access in the country.

Today, it is impossible to definitively say whether Tobeka’s life would have been saved if she had been able to access trastuzumab treatment. However, there is clear evidence that trastuzumab would have significantly improved Tobeka’s chances of survival. A chance of survival that she and her family were denied – not for medical reasons – but rather because they could not afford to buy it.

What is trastuzumab?

Trastuzumab is recommended by the World Health Organisation as an essential medicine for the treatment HER2+ breast cancer. Clinical trials have demonstrated that the provision of trastuzumab, in addition to chemotherapy, improved the survival of women with early or locally advanced breast cancer by 37%. However, in many countries it is priced so high that governments cannot afford to buy it. Women pay the price with their lives.

What prices does Roche charge for trastuzumab across the world?

The price of trastuzumab varies in countries across the world. These prices aren’t always public. They are agreed behind closed doors. In South Africa – USD 38 365 (ZAR 516,700) in private sector / USD 15 735 (ZAR 211,920) public sector In Brazil – USD 17 562 (R$ 53 040) In Malaysia – USD 17,929 (RM 80,682) in public sector In France – USD 30,595.76 (EUR 28 459) in public sector In India – USD 10 938 (Rs 735,000) based on two free doses *All conversions based on exchange rate at time of print.

What is T-DM1?

Trastuzumab emtansine (T-DM1) is another drug made by Roche for the treatment of HER2+ breast cancer. It combines trastuzumab with another drug resulting in better targeting of cancer cells, affording women who can access it months and often years of extra life with few side effects. The list price in the UK is £90,000 per patient per year and although Roche have offered a confidential discount, the UK’s medicines decision-making body, NICE, ruled it was still to expensive for the NHS in a preliminary ruling in December. Unless that decision is reversed when the final ruling is announced in early February women across the UK will lose access to the drug. Campaigners have called for the UK government to issue a compulsory licence (in UK law a Crown Use licence) allowing an affordable, bio-similar version to be developed and used by the health service. Taking such a step is likely to force Roche to offer a reasonable price to the NHS.

Why is Roche suing the Brazilian and Argentinian governments?

Brazil and Argentina have taken the challenge of maintaining universal public health systems, including free distribution of essential medicines to all. Many lives rely on these public health policies. As the dramatic increases on the price of new medicines is linked to the way pharmaceutical patents are examined and granted, Brazil and Argentina have created strict standards and procedures for patent examination in the pharmaceutical sector and have successfully blocked several undeserved patents, ensuring generic competition and price reductions. In 2014 and 2015, the associations of transnational pharmaceutical companies (INTERFARMA – Associação da Indústria Farmacêutica de Pesquisa in Brazil and CAEME – Cámara Argentina de Especialidades Medicinales in Argentina) went to court suing the national governments for adopting pro public health measures in intellectual property (IP) laws in the two countries. In Argentina, Big Pharma is challenging the national patent examination guidelines. In Brazil, they are challenging the participation of health authorities in the analysis of pharmaceutical patent applications (known as “ANVISA’s prior consent”). Both provisions aim to avoid the granting of unmerited pharmaceutical patents.

Details of demonstrations, letters of support & media contacts globally

BRAZIL: Pedro Villardi | ABIA | +55 21 99438 0399 | FRANCE: Activists will carry out a publicity stunt in Paris to raise awareness of the lack of availability of trastuzumab MALAYSIA: Activists will gather outside Roche Malaysia and deliver a memorandum Roche (Malaysia) Sdn. Bhd. Level 21, The Pinnacle, Persiaran Lagoon, Bandar Sunway 47500 Selangor Darul Ehsan, Malaysia. Time: 14h00 (Malaysia time) Ed Low | | +60 12 327 8812 SOUTH AFRICA: 500+ women with breast cancer & activists will gather outside Roche offices in Johannesburg and deliver a memorandum Roche South Africa, 24 Fricker Rd, Illovo, Sandton, Johannesburg Time: 10h00 – 13h00 (South Africa time) Lotti Rutter | Treatment Action Campaign | +27 81 818 8493 | Catherine Tomlinson | Cancer Alliance | +27 76 318 5632 | UK: Activists will gather outside the Association of the British Pharmaceutical Industry of which Roche is a member to deliver a memorandum to Roche. 7th Floor, Southside, 105 Victoria St, Westminster, London SW1E 6QT Time: 8h00 Diarmaid McDonald | Just Treatment | +44 7894 455 781 | US: Activists gathered outside Roche in New York – a video will be put online on 7th February. Bryn Gay | Act Up New York | +1 954 482 1421 | ZAMBIA: Activists from the Treatment Advocacy and Literacy Campaign (TALC) and people with cancer will deliver a letter to Roche c/o the Swiss Consulate in Lusaka Michael Gwaba | TALC | Felix Mwanza | TALC |



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