22 January 2007

Miles White
Chairman and CEO
Abbott Laboratories
200 Abbott Park Rd.
Abbott Park, IL 60064-6189

Dear Mr. White:

In July 2006, a delegation of 25 people living with HIV/AIDS and their advocates from Africa, Asia, Latin America, the Caribbean, Eastern and Western Europe and the United States, met with senior staff from Abbott Laboratories to discuss access to lopinavir/ritonavir (Kaletra) and ritonavir (Norvir) for the developing world. Of particular concern to activists at this meeting was the Abbott pricing of Kaletra in both low and middle-income countries.

At the July 2006 meeting, executives from your company insisted that Kaletra couldnot be manufactured for less than US$500 per person per year, the price you have offered for sub-Saharan African countries. Unfortunately pricing Kaletra at this level means that any second-line regimens using this drug exceed the gross national income (Atlas method/World Bank) and health spending per capita in many countries, ensuring that most in need will simply not have access to this essential life-saving treatment.

In addition, this minimum concessionary pricing is only available to sub-Saharan Africa countries. As your company announced in July 2006, lower middle-income countries in Asia, Latin America, the Caribbean and Eastern Europe, are now being asked to pay more than $2000 per person per year for Kaletra, a price that again ensures that it will remain beyond the reach of many thousands of patients in need. In China, for example, Abbott company representatives recently contacted an AIDS patient directly and informed him that Kaletra was available for approximately $3600 per person per year, a price that is beyond reach for nearly all patients in China.

Furthermore, Abbott refused to offer voluntary licenses to generic manufacturers in any country to develop their own version of Kaletra or Norvir, as other companies have done with their drugs (e.g. Gilead with tenofovir), claiming again that no company could make a bioequivalent version of the drugs at a cost less than Abbott itself.

It was therefore striking for us to see the front page story in the Wall Street Journal (“New Regimen–Inside Abbott’s Tactics To Protect AIDS Drug–Older Pill’s Price Hike Helps Sales of Flagship; A Probe in Illinois” by John Carreyrou, January 3, 2007) where evidence from internal Abbott documents indicates that Abbott executives colluded to increase the price of Norvir by 400% in the United States, meaning the wholesale price rose to $257 per month. This predatory maneuver was designed to radically increase the cost of other protease inhibitors boosted with your drug and belies your commitment to humanitarianism professed at your meeting with us in July 2006.

Our concerns with the pricing of Kaletra remain: US$500 a year per patient for either the old or new formulation is unsustainable for Africa, Asia, Latin America, the Caribbean, and the states of the former Soviet Union. We are also concerned about the progress of registration of Kaletra by drug regulatory agencies in these regions. Finally, in discussions with the Clinton Foundation and others, we have reason to believe that Kaletra and/or another Norvir-boosted protease inhibitor could be developed for less than US$500 per person per year.

Your company has repeatedly expressed a willingness to continue a dialogue regarding access to these drugs, on which your company holds the patents.

Thus, we make the following requests:

• Your statements about the manufacturing costs of Kaletra and Norvir are simply not credible, particularly now in light of the January 2007 Wall Street Journal article. We thus ask that you open your books for an independent audit of the manufacturing costs of these two drugs.

• We ask that you grant non-exclusive voluntary licenses for these drugs and their active pharmaceutical ingredients to generic manufacturers in developing countries for both domestic use and export to middle income countries.

• We ask that you provide us with a listing of the countries in which you have applied for registration/marketing approval for Kaletra and/or Norvir; the dates on which you submitted these applications and the status of each of these submissions.

• We ask that you immediately make the US$500 per person per year price for your drugs available to all countries with gross national incomes per capita of $2000 and below.

There is a crisis in access to second-line antiretroviral regimens for thousands of people in our countries-the cost of your drugs and your unwillingness to negotiate further on pricing will have deadly consequences for our friends, family and colleagues. We are now considering additional actions for dealing with this matter, including organizing a worldwide boycott of Abbott’s non-ARV products and parallel importation of your antiretrovirals from Africa to other countries in the developing world. We call on all national governments, UN agencies, other AIDS activists, healthcare workers to join our campaign for affordable, second-line treatment now.

Yours truly,

The International Treatment Preparedness Coalition.

1. Sergey Kovalevsky ITPCru Russia
2. Anastasia Agafonova, ITPCRU, Russia, Saint-petersburg
3. Aleksandrs Molokovskis, Society "Association HIV.LV", Latvia, Kekava
4. Julius Amoako Bekoe,Young Activists Against AIDS,Ghana
5. Julius Amoako Bekoe,Ghana AIDS Treatment Access Group
6. Biesse Soura, Centre for Health Education, Prevention And Research (CHEPAR), Cote d'Ivoire
7. Mark Harrington, Treatment Actoin Group (TAG), USA
8. Pan African Treatment Access Movement (PATAM)
9. Victor Kamanga, Programmes Manager, Malawi Network of People Living with HIV/AIDS
10. Suerie Moon, Harvard University, USA
11. Vladmir Zhovtyak Chair Coordination Council, All-Ukraine Network PLWH,Kyiv Ukraine
12. Natasha Leonchuk, Executive Director, East European & Central Asian Union PLWH Organisations
13. Paul Thorn, Director, TB Survival Project, London
14. Mark Platt, Director UK Ukrainian AIDS Response, London, UK
15. Terry White, All Ukraine Network PLWH, Kyiv, Ukraine
16. Pablo Anamaria - Peruvian Coordination of People Living with HIV/AIDS- PERU
17. David Ernesto Munar, Chicago, IL
18. Wim Vandevelde, EATG, Belgium
19. Jaya Nair - Project Manager - Udaan Trust - Ghatkopar, Mumbai
20. Hristijan Jankuloski, HOPS-Healthy Options Project Skopje, Macedonia
21. Aruna Hewapathirane, HEAL Foundation, Sri Lanka
22. Canadian Treatment Action Council (CTAC), Canada
23. Vanessa Fuller, Health Connections International, The Netherlands
24. Chiara Mazzarella,Varese,Italia
25. Ingrosso Donatella, Lecce, Italy
26. Sagar SherchanAstha samuhaButwal,Nepal