Should South Africans pay R870,000 a year for a medicine called Lenalidomide to treat blood cancer, while that same drug's generic version costs R28,000 in India?
Activists have raised the question ahead of a World Health Organisation meeting in Johannesburg about fair pricing. 
Lenalidomide is a derivative of an older medicine, Thalidomide. Activists at Section 27 and the Cancer Alliance say its price is too high and that drug companies need to be “transparent” about what it really costs to produce,  research and develop medicines. Thalidomide is used to treat blood cancer, although it was initially marketed as a mild sleeping pill and led to pregnant women giving birth to deformed babies.
Lenalidomide was introduced in 2004 and Section 27 says its patents are in force in SA until 2028. The drug’s generic version costs R28,000 in India, where controversial patent laws allow manufacturers to make a generic medicine regardless of the patent held by the company that invented it.
“We activists have serious challenges. One of the reasons people with HIV weren’t treated with HIV medication initially is because it was too expensive,” said Treatment Action Campaign activist Patrick Mdletshe.
“Now cancer drugs are ridiculously expensive. We cannot allow this violation of human rights where pharmaceutical companies are putting profits above people’s lives.”
Cancer Alliance director Salome Meyer said pharmaceutical companies often explain the high cost of newer drugs as due to extensive “research costs”. These costs include the many hundreds of drugs that don’t come to market, as initial trials and work in the laboratory may show them to be ineffective or unsafe.
Meyer said much initial drug research at universities around the world is paid for by  taxpayers – hence pharmaceutical companies should explain what they pay for their part of the research.
The Treatment Action Campaign, Section 27, and the Cancer Alliance on Thursday protested outside Emperors Palace in Ekurhuleni at the start of the WHO meeting, which is closed to the media and public.
A spokesperson for health minister Aaron Motsoaledi, Popo Maja, said an affordable medicine is defined as what people can afford – but at a price that also gives pharmaceutical companies enough of a financial return to warrant investment and production of medicines, including older medicines with a low profit margin. 
Maja said discussions at the Fair Pricing Forum may result in a more detailed definition of the term.
“The meeting will discuss price negotiations and policies that governments can adopt to ensure their populations can access medicine,  as well as transparency in medicine pricing,” said Maja...