IN THE global struggle to provide affordable medicines to poor patients, Dr Yusuf Hamied has been one of the crucial figures.
At 82, he is now non-executive chairman of Cipla, the Indian pharmaceutical company which his father founded in 1935 at the behest of Mahatma Gandhi, but Hamied remains its guiding light.
He has always taken the view that medicines cannot be a conventional commercial business – “there always has to be a humanitarian aspect to it”.
In the pharma world he is already a legend for reducing the costs of AIDs drugs from $12,500 (£9,595) a year for a course of treatment that was once levied by western pharma giants to $1 (77p) a day that Cipla offered for its generic drugs – the latter figure is now down to 30 cents (23p). Thanks to his intervention, 10-15 million Africans are alive today.
Although Cipla’s headquarters are in Mumbai, Hamied merits entry on the GG2 Power List because he spends several months of the year at his home in London. He also retains close links with his alma mater, Christ’s College, Cambridge, where he did his undergraduate degree and his PhD between 1954-1960.
He has been a more than generous benefactor to the college. This summer he met professors Jane Stapleton and Frank Kelly, master of the college and her immediate predecessor, and held discussions about providing £5 million of the £15m needed to put up a large building named after Lord Todd. He was the don who admitted the young Hamied into Christ’s and later went on to win a Nobel Prize and also become master of the college. Associated with the building, there will be a Hamied Court. At Christ’s, there already exists a Yusuf Hamied Centre, comprising a lecture theatre, plus students’ accommodation called Hamied Hall, Hamied House and Hamied Lodge.
To keep himself up to date, he used to spend $750,000 (£575,634) a year on buying science magazines and journals. The cost has fallen sharply because many of the publications are now available online. But having looked through the index that is scanned by his office back in Mumbai, he marks articles of interest. These are couriered to him on a daily basis. He picks out pertinent passages and gets his staff in India to follow up on the latest findings.
This is vital, he explains. “One of the most important things in pharma is monopoly. If you invent something new you get 20 years of exclusivity. That is where the big (western) pharmas make their money. India in 1972 had abolished monopoly and that is why Indian companies prospered. But since 2005 we are back under the spell of monopoly.
“The second most important thing is obsolescence – you have a drug but after some time somebody invents a new drug for the same disease. If it is better than the older one, the older one dies.” He recalls: “When we started working on AIDS in my company in the mid-1990s, there was only one drug available in the world for HIV – AZT from Wellcome. That is not used any more. There are 20 other drugs: better drugs, a cocktail of drugs to choose from. HIV is no longer a death sentence. The stigma of HIV is not there anymore. These are big, big advancements in science.”
He went to the Crick Institute this summer to a talk by US-based oncologist Siddhartha Mukherjee, author of two bestselling books – The Emperor of All Maladies: A Biography of Cancer and The Gene: An Intimate History.
As he and Mukherjee discussed trends in cancer treatment over dinner at the Bombay Palace in Connaught Street, they were joined by Nobel laureate Prof Sir Venkatraman (“Venki”) Ramakrishnan, president of the Royal Society. Hamied has an agreement with the Royal Society, which will allow top academics from the UK to travel to India at his expense, not for fleeting visits but for a minimum of three to four months in one location.
“What Siddhartha is talking about essentially is personalised medication in cancer. You build up your immune system to cure your own cancer and this type of immuno (oncology) may be extended to other diseases as well,” reflects Hamied.
He asked Mukherjee, who is apparently keen to open a cancer hospital in India, about the role of luck in either getting or avoiding the disease. Hamied wanted to know why a child can get cancer. “He said, ‘I believe that with children who get cancer the reason has to be genetic.’ That makes sense to me.”
Such exchanges have healthcare implications, Hamied points out. If treatment for cancer is to be successful, “I strongly believe that (early) diagnosis plays a very, very important part.”
He finds it a matter of deep regret that “in India today, 99 per cent of the time breast cancer in women is detected too late: third stage, fourth stage. Why not in the first stage?
“And what about the cost of treatment? Some of the costs are obscene. I am a great believer in the public sector taking a role. How does a poor man having cancer treat himself? Impossible.”
Over breakfast at Fischer’s, an Austrian restaurant in Marylebone where he enjoys having his meetings, he goes through his diary. His appointments provide a snapshot of his hectic life and especially his attempts to do the best for the world’s poor. For example, he had a meeting with Sir Christopher Dobson, the John Humphrey Plummer professor of chemical and structural biology in the department of chemistry at Cambridge.
“He is a world authority on Alzheimer’s disease, which incidentally is going to be the killer disease in the next 10 to 15 years. I am looking to do something probably with him – getting newer medication for Alzheimer’s and Parkinson’s diseases.”
He also met Prof Sir John Pyle, head of the chemistry department at Cambridge. Hamied, who has already donated a couple of laboratories and a Todd-Hamied seminar room to the department, may fund the 1702 chemistry chair, the world’s oldest professorial chair in chemistry that was once held by Lord Todd.
Another meeting in Cambridge was with Prof Ashok Venkitaraman, the Ursula Zoellner professor of cancer research at the university and director of the Medical Research Council Cancer Unit, who spent six months in Bangalore. Their discussion was “to do with cancer”.
He has had meetings with Professor Sir Peter Piot, director of the London School of Hygiene & Tropical Medicine, and is giving financial support to the institution which offers “long-distance teaching” and degrees to students in India.
Another meeting has been with Prof Sir John Holman, president of the Royal Society of Chemistry. “I had a four-year project with them in India.” Under this plan, chemistry teachers from the UK went to India and picked 42 local chemistry teachers to whom they passed on their skills. The 42 then taught many other chemistry teachers both at school and university level. “It had this multiplier effect. In four years we have taught 18,000 teachers in India to teach chemistry.”
So successful has been the experiment that “I have extended my project for another four years. Why only chemistry? It has been extended to science. And science means it could be mathematics, physics, biology, but under the auspices of the Royal Society of Chemistry.”
He has made a similar agreement in New York with the Mailman School of Public Health at Columbia University, where he dealt with Linda Fried, the first woman dean of the school.
In London, he has met Dame Mary Archer (wife of the novelist Jeffrey Archer), who is chairman of the board of trustees of the Science Museum. “She is fundraising for a division in the Science Museum that will focus on the history of medicine.”
Other meetings aimed at helping poor patients have been held with Professor Dame Sally Davies, the chief medical officer for England who was previously the chief scientific adviser at the department of health, and with Prof Diana Gibb.
The latter is “an authority on paediatric HIV”, says Hamied. “We work very closely together. We have developed jointly many medications for HIV treatment of children.”
Sometimes it is the case that if a mother is HIV positive, so will be her baby. He adds: “If you are HIV positive your chances of getting TB goes up – your resistance is low. Between her and us, we worked out a medication approved by WHO that if you take one tablet a day along with your HIV regimentation of medication, you won’t get TB.”
Hamied has a mastery of detail, remembering names, places, dates, and precise formulations of drugs, which is remarkable given 60 per cent of Cipla products are now exported to 150 countries around the world. After India, Hamied appears to care most for Africa. When the leaders of Brazil, Russia, India, China and South Africa (Bric) gathered in Johannesburg in July, Cipla was one of the summit’s main sponsors.
He talks of his close collaboration with a malaria group in Geneva. “We have developed for the first time in the world an anti-malarial suppository. In Africa, children die when they contract malaria. They are often in remote areas. By the time the mother or the family gets them to a health centre – it could be five hours, 10 hours, 20 hours, you have to walk 5-10km – the child dies. With this suppository we have told village women it is saving lives – the moment the child gets fever, put in this suppository. If the fever is due to malaria the medicine will work. Then she can take the child to the centre. It is like an emergency treatment.”
Having been born in Vilnius, now in Lithuania, to an Indian-Muslim father, Khwaja Abdul Hamied, and a Lithuanian-Jewish mother, Luba Derczanski, he has a natural affinity for eastern Europe. In August, he flew to Minsk, capital of Belarus, where he is investing $1m in a pharmaceutical R&D centre, a joint venture with the state pharma enterprise, Academpharm. As part of the agreement, it was announced that “Belarusian specialists will be able to improve their skills at innovative Indian pharmaceutical enterprises”. As always, Hamied is willing to share Cipla’s expertise for the benefit of those who need it.
The R&D centre, which will be fully functional by 2020, is expected “to make medications to treat HIV infection, hepatitis B and C among other things”.
Hamied tells of a close friend who was diagnosed with brain cancer in October last year. “He came to Bombay (Mumbai) in October – I had him operated on, then he had a catheter put in, ultimately after six months he died. Should we have gone through all this procedure just to keep him alive for six months?”
He poses a fundamental question: “What do you want from life? Essentially that while you are still alive, you want a reasonable quality of life. You don’t want abject suffering. Even the medication one makes is perhaps with that in view. How do you alleviate suffering?”