Background: Dolutegravir (DTG) is an ARV developed by ViiV. Commercialized since 2014, it has become considered one of the best ARVs and is now recommended as alternative first line by WHO. However, access remains limited in developing countries due to price barriers. A voluntary license (VL) negotiated by ViiV and generic companies through the Medicines Patent Pool (MPP) gives access to generic DTG in 92 countries. As a middle-income country (MIC), Morocco was initially excluded from the license.
Description: Moroccan authorities conducted unsatisfactory negotiations with ViiV with a too high end price of US$ 1500 pppy while generic companies were announcing prices of US$ 44 pppy. Unsuccessful negotiations would have given the ability to Morocco to issue a unilateral compulsory license (CL) and produce and/or commercialize generic DTG despite patent protection.
Two Moroccan CSOs, ITPCMENA and ALCS partnered to advocate to ViiV, Ministry of Health (MoH) and MPP for access to generic DTG.
1) Advocates met bilaterally ViiV''s representatives to demand the integration of Morocco in the VL advancing that Morocco could otherwise issue a CL.
2) Advocates had several encounters with the MPP to discuss access strategies for Morocco.
3) Advocates asked the MoH to issue a CL or formally ask the MPP to be integrated in the VL. They supported the MoH to formally request from ViiV its integration to the VL.
On the occasion of AFRAVIH 2016, ViiV announced the inclusion of Morocco to its license.
Lessons learned: Morocco did not issue a CL however discussions with Moroccan authorities introduced the idea that it was a possible strategy. On the other hand the probability that Morocco could issue a CL prompted ViiV to accept inclusion of Morocco in the VL to avoid losing its market altogether. Finally, discussions with MPP encouraged them to push for Morocco''s inclusion in the VL. The strategy of ITPCMENA and ALCS to advocate towards multiple actors enabled access to generic DTG for Morocco.
Conclusions/Next steps: Following civil society''s efforts, Morocco now has access to generic DTG. ITPCMENA and ALCS are currently advocating for the immediate inscription of DTG in the therapeutic guidelines as a first line ARV therapy.