In 2001 the head of the Indian pharmaceutical giant, Cipla, astonished and delighted the outside world by offering a cocktail of anti-Aids medication for a fraction of the going price charged by big multinationals. Cambridge-educated scientist and entrepreneur Dr Yusuf Hamied, who was subsequently awarded the Padma Bhushan by former president of India, tells Shyam Bhatia of asianaffairs what motivated him to take the bold step on behalf of the vulnerable.

AA: Has your company, Cipla, been in forefront of the fight against swine flu and, if so, where are you today and what is involved?

YH: We have been in the forefront of the fight against HIV Aids; also we are helping out today against malaria and neglected diseases in Africa. In the year 2005 when the first wave of bird flu came up, we noticed that there was only one company in the world supplying the drug called Oseltamivir. I asked an Indian government official what the country would do if bird flu were to hit India in a big way. The answer in 2005 was that we would surrender. So I looked at him and said, 'You surrender and Cipla will take up the challenge.' To cut a long story short, we did it in two months. In February 2006 Cipla started producing Oseltamivir under the name Anti Flu. The price we fixed at that time was one sixth that of some others. A pack of 10 capsules was being sold by foreign multinationals for U.S. $60 and we kept our price at $10. The next day when we got permission, the Indian government passed a bill in parliament that this drug cannot be sold on the open market in India — it can only be sold to the government because it may be misused. So we were not allowed to sell.

Then I built up surplus stock of material in India worth virtually over U.S. $10-15 million that had already been ordered. This was of no use until 2009. When I produced this drug it was at a price of $10-12 per dose. Today I am offering it at $10 and the multinationals and their cronies are offering it at $9, or $8 or $7. It's in those areas where I am allowed to sell internationally. But the Indian government puts out a tender, I quote at $8 and they quote at $7. It's very, very difficult. Abroad we are selling, no doubt, but not to the extent that we should. Our argument was should the destiny of India, or for that mater the world, be in the hands of one company?

AA: So is the drug used for treating bird flu relevant to swine flu?

YH: It's the same drug. Oseltamivir and Tamiflu — also produced by Roche — are one and the same and Anti Flu is one and the same.

AA: Does this mean that a big multinational like Roche has a complex marketing strategy for its products?

YH: They have differential pricing. In those countries where it is covered under a patent, and they have a monopoly, they can sell for whatever they want. In those countries where there can be generic competition, they can always undercut those who make it apart from themselves. The government recently said that Tamiflu can be imported duty free, because the government imports it. I am making it in India from imported intermediates, but on those I have to pay 10 per cent duty. So it's not a level playing field.
There is another drug involved for treating swine flu or bird flu and that drug is called Zanamivir, which is marketed by Glaxo GSK internationally under the name Relenza.

We have an identical drug under the brand name Virenza and this drug is given by inhalation. The Glaxo price in the underdeveloped countries is $20 per dose. Ours is about U.S. $15. But in the developed countries where they have a monopoly theirs is $30. I have never been against multinational companies, my fight is against monopolies. My argument is that our countries in the Third World cannot afford monopolies. Therefore what we require is a compulsory licence to manufacture what we like and if we are infringing anyone's patent, we pay them a suitable royalty. I do believe that an innovator has to be rewarded, but you reward an innovator according to your resources. India should reward according to India's resources, America should reward according to America's resources.

AA: Does a company like yours coordinate closely with the World Health Organisation (WHO)?

YH: Yes, WHO is relatively easy to handle. Where we find coordination difficult is with the Indian authorities. Why should we get step motherly treatment? They should take us into their confidence. After all we are an indigenous drug industry. They should be asking me, 'What should we do for India, but nobody bothers.'

AA: How seriously do you view the current swine flu pandemic?

YH: We should all count our blessings very carefully that it has not been fatal. It has been a pandemic; England is envisaging 100,000 cases a day of this H1N1. Within the next six months 20 million British will get the vaccine. So in countries where that is not possible we should count our blessings that, unlike what happened in 1918, this one does not appear to be fatal. People are getting mild flu and after three days or three months it passes. In between people are dying — people die of seasonal flu as well. Somewhere I read that America has one million. I also read that in the colder weather it will come in a big way. Call it swine flu, seasonal flu or whatever, the only two drugs that are there are Oseltamivir and Zanamivir, the ones I mentioned. We are producing both, but to produce them in quantities required in the time of a pandemic, I don't have the resources. It involves blocking millions and millions of dollars. Who is going to do that? No government is prepared to. As I said thank your blessings it's not fatal. I'm not saying people have not died, but not at the levels of 1918.

AA: Many people still remember and admire you for supplying Aids medication for Africans at affordable prices. Are you still doing that?

YH: Yes, we are still doing that. But that happened in 2001 when we offered our cocktail of drugs that was for below a dollar a drug per day, or $350 a year. At that time the cocktail offered by multinational companies came to about $12,000 per patient per year. Now people asked me at the time if I was making a profit. It depends on how you calculate. If I'm making 100 drugs today and don't make profit on two, what difference is that going to make to my company? I've got a very big basket of products; I'm looking at it in totality. I'm also looking that my factories are more than 10 years old. If I had to do my calculations on pricing and replacement costs, I will lose out. If I do it on my original costs where I bought my factory for Rs10 lakh, today it is worth Rs 10 crore. So should I take as my costing 10 lakh, or should I take it at Rs10 crore? It's a matter of opinion and I have said 'as is' basis. Don't forget we have a double edged sword because we also produce the raw material that goes into the final product. That is the key to the whole thing. The cocktail we were offering for $350 a year is now available for $80.

AA: How come and why did you do it?

YH: In the year 2000 I gave a talk at the European Union and in that talk I  offered the international community three things. I offered them this cocktail at $800, I offered the African governments — they were all there in September 2000 — that if any of you want to produce your own anti Aids drugs, Cipla will provide the technology free, and this applies to India as well. Third, mother to child, I offered free.

AA: Were you motivated by humanitarian considerations?
YH: It has to be. At that point in time there were 25 million HIV positive, only in Africa 4,000 were being treated. Today two and a half million are being treated, which is also a drop in the ocean by the way. Two and a half million out of 33 million are being treated, out of which 400,000-500,000 are on Cipla drugs.

AA: It's unusual to find someone who combines the qualities of a scientist and a businessman with a heart.

YH: That's why I'm against patents against monopolies. What I quote in speeches is that with a population of 1.2 billion India cannot afford a monopoly. Look at the disease pattern in the country. There are 110 million mental health cases, there are 80 million cardiac patients, there are 60 million diabetics, 50 million asthmatics, 50 million with Hepatitis B, the World Bank estimates that by 2015 India will have 35 million HIV positive. With this pattern it's like saying we need a particular medication, say Tamiflu, but nobody else can be allowed to make it. Unfortunately, this is what we agreed to in 2005 by joining WTO. Indira Gandhi said there should be no profiteering from life or death. She made a statement at WHO. What I'm trying to say is that India must decide its own destiny.

AA: What has India agreed to in the WTO?

YH: That we will allow patents in India for all products patented after 1995. The patent law was passed in parliament without a debate and only a show of hands. Oseltamivir and Zanamivir are pre-1995. All the Aids drugs I am producing today are pre-1995. But do remember that if you use an Aids drugs for two or three years, you develop a resistance to it. The newer ones, I cannot produce any more — the third and fourth generation anti retroviral. You know what I get from the government? 'Oh we cannot upset the international community.' Remember that the pharma industry in India boomed because in 1972 Indira Gandhi said no product patent, you cannot monopolise anything.

AA: Was the Padma Bhushan you received a recognition of the work you had done on Aids?

YH: You must understand how one gets the Padma Bhushan award. There are three ways. One, from your state government, or from the ministry under which your industry falls — ours is chemical and fertilizers, they have to recommend. But I'm in court with those people on the issue of pricing. So they would not recommend. But, like you, somebody read about the work I had done on AIDS. This person was Dr Kalam, the former president himself, which means I was his personal choice.

AA: What did he say when you met him?

YH: 'Dr Hamied, I'm very happy to meet you.' And I shook hands with him. He was very pleasant. I also met Manmohan Singh on the same day and I reminded him that the last time we had met was on September 26, 1956. We had a mutual friend in Cambridge, Swaranjit Singh, and we both were witnesses to his marriage with a German girl.

AA: How would you compare the work that Cipla does with the other pharma giants elsewhere in the world?

YH: There are two types of R&D pharma. One is concept and one is me-too. Me-too means copy. For concept, America spends $30 billion a year in pharma industry alone. This is government money going into concept. What the pharma companies do is essentially me-too. Some companies pay $7-8 billion for so-called R&D.

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