Kaiser Daily HIV/AIDS Report - Fri, 16 Nov 2001
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* African Leadership Must Become More Involved in Fight Against AIDS,
Critics Say
* United Nations Population Fund Shifts Reproductive Health Focus
From Family Planning to AIDS in Kenya
* Kaiser Daily HIV/AIDS Report Rounds Up News and Opinions on WTO
Sum-mit, Access to Medicines
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African Leadership Must Become More Involved in Fight Against AIDS,
Critics Say
Six months after African leaders at an Abuja, Nigeria, summit pledged
to devote more attention and greater resources to the HIV/AIDS epi-
demic, many health experts say "far too little" has been accom-
plished, Reuters reports. "There's a lot of talk and many people
think there's a lot more talk than action," Bunmi Makinwa, a team
leader for UNAIDS workers in eastern and southern Africa, said. While
most African leaders say that problems surrounding AIDS stem from
lack of money, critics contend that the "quality of leadership, not
poverty, is the key." They point to South African President Thabo
Mbeki's public skepticism about the causal link between HIV and AIDS
as an example of something that has "blunted" the fight against the
disease in South Africa, which has more HIV-positive people than any
other country in the world, with an estimated five million HIV-
positive citizens. "We need the president, the minister of health and
most cabinet members to change their tune to end the confusion,"
Zackie Achmat, head of South Africa's Treatment Action Campaign,
said. By contrast, nations that have taken early action against HIV
have seen their infection rates decrease. Senegal reduced its infec-
tion rate from 2% to 1.4% through early government intervention. Suc-
cesses in places like Senegal and the increasing openness of leaders
like Festus Mogae of Botswana and Olusegun Obasanjo of Nigeria are
signs that HIV prevention and treatment efforts are "gaining momen-
tum" in Africa. Botswana and Tanzania have made moves to provide
pregnant women with drugs to prevent vertical HIV transmission, but
few governments are providing condoms or targeting prevention efforts
at high-risk populations such as sex workers and teenage girls. "Com-
munities can organize themselves, but without political will it just
doesn't work," Mark Aguire, director of HOPE's medical center in
Ivory Coast, said (Green, Reuters, 11/15).
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United Nations Population Fund Shifts Reproductive Health Focus From
Family Planning to AIDS in Kenya
The United Nations Population Fund has "broadened its mandate" in
Kenya and is now developing reproductive health programs in which
family planning is "only a small component" in light of the AIDS epi-
demic, Kenya's Daily Nation reports. It is "not practical to ask
mothers whose children are dying at birth to plan their families,"
Wangoi Njau, a UNFPA senior official working with the Family Planning
Association of Kenya, said, adding that AIDS was killing the "most
productive" members of society in Kenya. She said that her agency
will now focus on both preventing AIDS and reducing unintended preg-
nancies, noting that the majority of family planning devices "also
double as HIV/AIDS prevention tools, so we are using one stone to
kill two birds." Njau, who is working with the Kenyan family planning
group to establish reproductive health centers in 21 districts of the
country, spoke at the UNFPA Reproductive Health Commodity Security
workshop in Mombasa. The workshop, which runs all week, is focusing
on "empowering women to take a more active role in their reproductive
health" by discouraging early marriage and promoting the education of
girls (Kithi, Daily Nation, 11/14).
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Kaiser Daily HIV/AIDS Report Rounds Up News and Opinions on WTO Sum-
mit, Access to Medicines
A number of newspapers today ran articles and opinion pieces related
to the World Trade Organization ministerial summit in Doha, Qatar.
WTO ministers this week approved and issued a declaration stating
that developing nations can override patent protections to produce
medicines during public health emergencies. The declaration states
that WTO member nations should be able to use the flexibility of the
Trade-Related Aspects of Intellectual Property Rights agreement to
protect public health and "promote access to medicines for all." The
declaration says that each WTO member has the right to issue compul-
sory licenses and the liberty to determine when to issue those li-
censes. However, the question of whether countries can also import
generics from other nations has been referred to a council, which is
expected to report its findings before the end of 2002 (Kaiser Daily
HIV/AIDS Report, 11/15). The following are summaries of some of the
recent news related to the summit:
* BBC News, "Hollow Victory for Drugs Campaigners?": In an interview
with the BBC World Business Report, Pharmaceutical Manufacturers' As-
sociation of South Africa CEO Mirryena Deeb said that many developing
nations will not benefit from the declaration's statements because
they are not seen as profitable by generic drug makers. Deeb said
that most generic drug firms "only want to target countries where
there are patent laws, where the product has been widely marketed and
they can piggyback on current demand." She added that few generic
drug makers target markets without patent rules, countries that often
have "the most abysmal access to quality health care and medicine in
general" (BBC News, 11/15).
* BBC News, "WTO Deal Gets Mixed Reaction": About 100 "mainstream"
non-governmental organizations were allowed to attend the Doha sum-
mit, and some that were barred entry, including the Third World Net-
work, say that the ministerial meeting was "a massive defeat for poor
people around the world." However, other NGOs were largely pleased by
the Doha talks (BBC News, 11/15).
* New York Times, "A Catch-22 on Drugs for the World's Poor": Devel-
oping nations scored a victory this week when WTO ministers stated
that they have the right to produce cheaper versions of patented
drugs to protect public health; however, many nations lack the fa-
cilities to create these medicines, the Times reports. In addition,
the ministerial declaration does not give a ruling on the issue of
parallel importation, through which companies can import generic
medicines from foreign nations such as Brazil or India (Dugger, New
York Times, 11/16).
* New York Times, "Brazil Welcomes Global Move on Drug Patents": Bra-
zil, which has been producing generic versions of AIDS drugs since
1998, "hailed" the WTO declaration as "an important victory for the
developing world," the Times reports in an overview of Brazil's ef-
forts to produce low-cost AIDS medicines (Rich, New York Times,
11/16).
* Wall Street Journal, "Public Health Groups Act Like Companies in
Bid to Fight Disease in Poor Nations": Organizations such as the In-
ternational AIDS Vaccine Initiative and the Global Alliance for TB
Drug Development have become "catalysts" in the search for cures for
diseases that primarily affect developing nations, the Journal re-
ports. These groups contract with laboratories and companies to pro-
vide research and say they would use their control of any yielded
treatments to provide access to the medicines in poorer countries.
The Journal reports that if successful, these ventures "could provide
a model for how to attack a number of public health crises in devel-
oping countries while avoiding the kinds of patent-rights disputes
that have erupted over AIDS drugs" (Fuhrmans, Wall Street Journal,
11/16).
* Wall Street Journal, "U.S. Industry Takes Mixed Views of WTO
Talks": The Journal provides an overview of different industries' re-
actions to the WTO meeting, stating that although the pharmaceutical
industry was "disappointed" by the declaration, it maintains that the
text does not alter world trade agreements regarding patent rights
(Matthews et al., Wall Street Journal, 11/16).
* Washington Post, "Getting WTO's Attention": The Post highlights the
actions of advocacy groups that have for years pushed for increased
access to medicines. Groups such as Doctors Without Borders and the
Consumer Project on Technology are responsible for the "populist im-
pulse" behind the declaration on medicines and patents, the Post
states (Blustein, Washington Post, 11/16).
Opinion
Several opinion pieces and editorials on the Doha summit and its im-
pact on access to medicines were published today in several newspa-
pers. Some of the pieces are summarized below:
* San Jose Mercury News, "U.S. Finally Gets the Message: AIDS Drugs
Must be Affordable": The United States' anthrax scares "taught the
U.S. government the folly of insisting on absolute protection of 20-
year drug patents," especially patents on drugs made to treat "a far-
worse threat than anthrax," a San Jose Mercury News editorial states.
The editorial says, "The U.S. turnabout [in Doha] was a humanitarian
and practical response. It would be unconscionable to stand by while
AIDS continues to ravage scores of countries around the globe" (San
Jose Mercury News, 11/16).
* Wall Street Journal, "Doha Hurrah": A Wall Street Journal editorial
states that U.S. Trade Representative Robert Zoellick's approval of
the declaration "makes us ... nervous" because patents are "a bedrock
of global trade." The editorial says that efforts to loosen patent
protections in the name of public health are "usually pitched as com-
passion for countries ravaged by AIDS," but adds that there are al-
ready exceptions in place for nations facing health crises. The "real
drivers" behind the Doha declaration were Indian generic drug firms,
which are trying to "poach off U.S. research" but which are not
"known for coming up with cures for AIDS or any other global
scourges" (Wall Street Journal, 11/16).
* Wall Street Journal Europe, "Politics and Patents: Property
Rights=Prosperity": "The proposition that intellectual property pro-
tection is at odds with growth and development (including public
health) does not bode well for future progress. More to the point, it
is simply wrong," Geralyn Ritter and Alain Strowel write in an opin-
ion piece published in the Wall Street Journal Europe. Ritter, a
trade counsel with Covington & Burling, and Strowel, head of Coving-
ton & Burling's intellectual property division in Brussels, state
that although AIDS is a "genuine crisis" for developing nations, the
epidemic "does not have its roots in the TRIPS accord, and 'clarifi-
cation' of that agreement is not the solution." They add, "The TRIPS
agreement already provided sufficient flexibility for patent holders
and public health authorities to find a solution, but the issue be-
came politicized." Stating that intellectual property protections are
important to spurring research and development, they conclude that
the priority now should be on helping developing nations implement
TRIPS, with a focus on those countries that "continue to neglect
their commitments to enforce intellectual property rights in areas
that have nothing to do with public health" (Ritter/Strowel, Wall
Street Journal Europe, 11/16).
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