While I sit in my little house in Southern Tasmania tapping away on my laptop answering emails and writing my blog, in my small way trying to help people around the world get access to affordable generic Hep C treatment, Big Pharma, with its billions of dollars and ferocious appetite for profit at any cost, does not sit idle.
Around the world Big Pharma uses its influence in the medical establishment to try to discredit generics as a viable treatment option even as the evidence mounts and mounts that generic DAAs are just as effective as the outrageously expensive branded medicines.
 
In India, where corruption within the lower levels of government is such a problem, Big Pharma is using its dollars to try to block exports. Several suppliers I know in India have had their shipments blocked in the past couple of weeks and have been working hard, negotiating with officialdom to get those blocks removed.
 
New Delhi and Mumbai Customs are on high alert. According to my sources someone working for one of the big generic manufacturers smuggled 10,000 bottles of generic DAAs to Russia and then diverted them to European countries like Serbia and Hungary where hundreds of thousands of people have Hepatitis C and can not access treatment. When this was discovered the life saving medicines were tracked down and seized in small batches. Of course a lot also got through to the people that needed them.
 
Rumors of fake medicines of Indian origin have been spread by the agents of  Big Pharma to create a climate of fear and uncertainty. Whilst there is always a small risk of counterfeit drugs I have only heard of two instances in the past year so I do not think it is a real problem and it is no problem at all if people use established and recommended suppliers.
 
There are also stories that GILEAD sponsored a sting operation to crack down on gray market selling of generics in North India. Theoretically the manufacturing license agreements prohibit export of Hep C meds out of India and the 'gray market' is that which buys the medicines locally from wholesalers and then sends them overseas.
 
Gilead calls this process "diversion", that is the medicines are purchased locally and then diverted to overseas destinations. In response to this practice, which is how most people in Europe and the Americas get their treatment, Gilead had developed an "Anti-Diversion" program.
The Anti Diversion program is generally extremely disliked by Indian companies but GILEAD has a divide and conquer strategy where they will punish one manufacturer if they discover too much of their product is reaching overseas destinations then and force them to investigate and prosecute people breaking the "no export" rule so that they can keep their extremely lucrative license. However the Indians are a resilient race with centuries of practice at doing business under oppressive conditions so my assessment is that whatever Big Pharma does to try to stem the flow of generic Hep C treatments out of India the Indians will find a way around it.
The genie is out of the bottle.