💊 After GSK exit, Nigeria drug prices soar; ViiV’s CAB-LA still too expensive for SA; Jamjoom expands in Egypt

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Hello, and welcome back to The Kable. It’s day 44. With no clean water, fuel, food, medical supplies, and other essentials, Al-Shifa Hospital is no longer able to function. Yesterday, the WHO led a joint UN mission in collaboration with the Palestine Red Crescent Society to evacuate 31 babies from the hospital in northern Gaza to one in the south. None of the babies is accompanied by family members. All of them are fighting serious infections due to the impossibility of providing adequate care at Al-Shifa. 6 health workers and 10 of their family members were also evacuated from the hospital, but over 250 patients and 20 health workers remain there. Planning is ongoing to evacuate them, but security and logistics constraints mean that it will be some days before that can happen.

After GSK’s transition to a third-party direct distribution model in Nigeria, pharma product traders report that there has been a noticeable scarcity of GSK products nationwide. Drug prices in the country have soared as much as 1,000%. GSK blamed the scarcity of foreign exchange, the high cost of doing business, regional insecurity, the removal of fuel subsidies and other operational challenges for its withdrawal from the country. With a burgeoning inflation rate of 27.33% in October (the highest since August 2005) and high rates of out-of-pocket healthcare payments, Nigerians are sacrificing other essentials to buy medicines or switching to cheaper alternatives. Meanwhile, the country’s Coordinating Minister of Health and Social Welfare has met with representatives from pharma companies in the country to devise remedies, including stimulating private sector-led local production, to the crisis.

In Zimbabwe, an emergency has been declared in the capital city of Harare over a cholera outbreak.

South Africa has the largest HIV epidemic in the world, but access to a new anti-HIV injection may be out of reach of the country’s population. The UK-based ViiV Healthcare has lowered the price of the long-acting CAB-LA, a new preventative HIV shot, from 729 (£32) rand per shot to 540-570 rand (£23.66-£24.97). Still, the reduced cost is 3x more than what the South African health department can afford to pay. The reduced CAB-LA cost is also four times as much as the department pays for a daily HIV prevention pill. One of the solutions to this problem is letting donors like Pepfar pay for the shots. South Africa is reportedly on the list for donations in early 2024, but Pepfar has not confirmed the donation, while South Africa hasn’t decided if it will accept CAB-LA donations. Another ray of hope is Cipla, who is licensed to produce a cheap generic of CAB-LA at its plant in Durban – but Cipla is still setting up its infrastructure there to produce the generic, which will not be available until at least 2027.

Meanwhile, Egypt’s largest pharma distributor Ibn Sina Pharma has announced plans to invest EGP 200 million (~$6 million) in 2024. The company will expand its network of branches and upgrade its technological infrastructure.

Saudi Arabia’s Jamjoom Pharma has opened a new factory in Egypt. The factory, part of Jamjoom’s expansion plan to open new investment channels for African and Francophone countries, has been launched with an investment worth about EGP 3 billion.

Dammam Pharma, a subsidiary of Saudi Pharmaceutical Industries and Medical Appliances Corporation (SPIMACO), is advancing the Kingdom’s Vision 2030 to localise manufacturing. The company has inked an agreement with MSD to manufacture type 2 diabetes medications locally. Production is set to begin in Q1 of 2024. This will be the first factory in the MENA region to produce type 2 diabetes meds. The agreement will likely meet the entire demand for these medicines in Saudi Arabia. The goal is to also export to regional markets.

JP Morgan Asset Management’s Life Sciences Private Capital and Blue Horizon Advisors have announced the launch of their inaugural Life Sciences Innovation Summit in Abu Dhabi. Entrepreneurs with therapies suited to the Emirati region’s disease burdens are invited to submit applications.

In a cross-continental agreement, Cuba and Azerbaijan have inked an MoU in the fields of healthcare and medical science. The MoU covers cooperation in knowledge sharing, prescription drugs, biotech, postgraduate training, and medical tourism.

Over in Asia, Cambodia has reported an outbreak of H5N1 bird flu among backyard poultry near the Vietnamese border. This is the first outbreak in the country in nearly three years.

The WHO has inked a new five-year agreement with the Indian government’s Ministry of AYUSHto boost the WHO’s development of new technical documents for traditional, complementary, and integrative medicine (TCI). The agreement will not only support the development of the TCI Global Strategy but also support the integration of evidence-based TCI in national health systems, biodiversity conservation, and medicinal plant sustainability.

In the latest quality issue to emerge from Indian pharma, Cipla has received a warning letter from the US FDA regarding an inspection of its facility in Pithampur in February this year.

Japan’s Astellas Pharma and the University of Tsukuba have entered a strategic partnership to accelerate the digitalisation of drug discovery. The partners also aim to develop the life sciences ecosystem in Tsukuba and Kashiwa-no-ha. They will promote drug discovery, other research, and the creation of new startups through industry-academia collabs.

California-headquartered ABVC BioPharma has entered a global licensing agreement with the biotech AiBtl BioPharma. The agreement concerns ABVC’s central nervous system (CNS) drugs with the indications of major depressive disorder (MDD) and ADHD. The deal is potentially worth $667 million.

In the latest twist in the booming weight loss drug market, Lonza is experiencing no FOMO. Quite the opposite, in fact. The manufacturer has said that it will not use its fill-and-finish capacity in Switzerland to fill syringes or provide final production steps for new GLP-1s. Lonza does not produce the peptides that make up the API in GLP-1s, so they would have to start from scratch to participate in the business, they say. Upcoming Alzheimer’s drugs, like one by Eli Lilly, appear more up Lonza’s alley.

Coming to Big Pharma and its Big Problems. Bayer’s Monsanto business has been found liable for claims of negligence, design defects, and failure to warn plaintiffs of the potential dangers of using its Roundup weedkiller. A jury in the US has ordered Bayer to pay $1.56 billion to four plaintiffs who claim the weedkiller was the reason they developed non-Hodgkin lymphoma. After initially being found not liable in 9 consecutive trials, this is now Bayer’s fourth courtroom loss. About 50,000 Roundup-linked claims remain pending.

Science? Who needs science? Pew Research Center claims that science is falling more and more out of favour with Americans. There has been a more than 100% jump in the proportion of American adults who distrust scientists. We can’t wait for the increase in flat Earther and climate denier discourse. Exciting times.

And finally, dogs in the US are coming down with a mysterious respiratory illness which does not respond to antibiotics. Since there isn’t yet a clear way to define the disease or test for it, it’s been hard to estimate how many have died from a severe form of the infection.