Kaiser Daily HIV/AIDS Report - Wed, 30 Jan 2002
-----------------------------------------------
* Global Fund Meets in Geneva to Launch Initiative; Grants Could Be-
gin This Spring
* Traditional Medicine Could Help Treat HIV/AIDS, HIV Co-Discoverer
Says
* Doctors Without Borders, Activists Illegally Importing Generic AIDS
Drugs Into South Africa
* Nevirapine to be Distributed in Some KwaZulu-Natal Hospitals by
July, Health Minister Says
* Thailand to Assist Zimbabwe in Production of Generic AIDS Drugs
* Newsweek Cover Story Examines Work of Bill and Melinda Gates
Foundation, Fight Against HIV/AIDS
Global Fund Meets in Geneva to Launch Initiative; Grants Could Begin
This Spring
The first grants distributed by the Global Fund to Fights AIDS, Tu-
berculosis and Malaria, established last year by U.N. Secretary-
General Kofi Annan, could be released as early as April, Reuters re-
ports. The fund's 18-member board -- composed of representatives from
donor and recipient nations, nongovernmental organizations and pri-
vate donors -- approved rules for the disbursement of grants at its
first two-day meeting, which ended yesterday. "With this board meet-
ing, the fund has become operational," acting executive director Paul
Ehmer said. The fund, which was created last year and is estimated to
need between $7 billion and $10 billion annually to fight the three
diseases, has raised $1.9 billion so far. About $700 million of that
money will be distributed this year, and officials hope that as the
fund proves successful more donations will be made. The first round
of project proposals can be presented in six weeks. The proposals
will then be evaluated by a soon-to-be-named technical committee and
sent back to the board for a vote (Waddington, Reuters, 1/29). Fund-
ing priority will go to projects that are already in development but
have not been initiated because of a lack of money (Nullis, Associ-
ated Press, 1/29). "This fund is so important because we have good
plans but no money. It is a scandal because the technology exists to
treat these diseases that ravage our people," Francis Omaswa of the
Ugandan Health Ministry said, noting that $10 could cover TB treat-
ment for a single person and $2 could buy medicine to help alleviate
the symptoms of malaria (Reuters, 1/29).
Treatment vs. Prevention
The board will look to balance appropriations between prevention and
treatment programs, despite some protests that the resources would
best be spent on prevention. The French government and a number of
HIV/AIDS advocates have "insisted" that treatment receive funding and
that the drugs be obtained at the cheapest possible price (Nullis,
Associated Press, 1/29). Treatment and prevention efforts are "mutu-
ally reinforcing," the Stop AIDS Campaign said in a statement, noting
that to "be effective, these epidemics must be tackled on all fronts
-- including by making a wide range of drugs more available and
strengthening the health systems to deliver them." The organization
urged the fund to "declar[e] its commitment to fund the purchase of
generic versions of patented drugs where appropriate" in accordance
with the World Trade Organization's Doha declaration, which "affirmed
that international patent law should be interpreted in a way that
supports public health and access to medicines." The group also asked
rich nations to "urgently scale up their efforts" to fight HIV/AIDS
by contributing to the fund (Stop AIDS Campaign release, 1/29).
--
Traditional Medicine Could Help Treat HIV/AIDS, HIV Co-Discoverer
Says
Dr. Luc Montagnier, a co-discoverer of HIV, said Sunday that tradi-
tional medicine can play a role in treating HIV/AIDS but added that
all natural medicines must be subject to rigorous testing to ensure
their safety and effectiveness, Agence France-Presse reports (Agence
France-Presse, 1/28). In an interview with the Cameroonian newspaper
Le Messager, Montagnier said that antiretroviral therapy should be
"the base" of HIV/AIDS treatment, but added that there should also be
different treatments to "complement" this regimen (Nguichi/Dasie, Le
Messager, 1/27). Traditional medicine must only be used in conjunc-
tion with antiretroviral treatment and must be tested for safety and
efficacy, he said, adding that the benefits of such treatments cannot
be determined without "conclusive experimentation" (Agence France-
Presse, 1/28). "Regardless of whether it is a pharmaceutical or a
plant extract, a drug must be subject to strict clinical testing and
meet objective criteria in order to demonstrate its efficacy," Mon-
tagnier stated (Le Messager, 1/27). Montagnier also announced the
creation of a new AIDS research center in Cameroon (Agence France-
Presse, 1/28). One of the goals of the center will be to examine tra-
ditional medicine, "vaccine therapy" and other treatments that com-
plement antiretroviral treatment, he stated (Le Messager, 1/27).
--
Doctors Without Borders, Activists Illegally Importing Generic AIDS
Drugs Into South Africa
The Treatment Action Campaign and the Congress of South African Trade
Unions announced yesterday that they had recently secured a month's
worth of generic AIDS drugs from Brazil for a treatment project run
by Doctors Without Borders (MSF) in violation of South Africa's pat-
ent laws, Agence-France Presse reports (Agence France-Presse, 1/29).
"We are not going to stand for a situation where we would be able to
treat twice as many patients as we could by using only patented
drugs. As medical professionals, it is our obligation to put the
lives of our patients first," MSF spokesperson Toby Kasper said, ex-
plaining why the group went ahead with the importation despite the
fact that it "could be sued for patent infringement." About 50 pa-
tients participating in the MSF treatment project, located in the
township of Khayelitsha outside of Capetown, have been taking the
Brazilian generic AIDS drugs for about one month (Schoofs, Wall
Street Journal, 1/30). The generic drugs -- copies of GlaxoSmith-
Kline's zidovudine and lamivudine and Boehringer Ingelheim's nevirap-
ine -- cost only $1.55 per patient per day compared to $3.20 per day
for the patented medications (Agence France-Presse, 1/29).
Legal Response
Representatives from GSK and Boehringer said they are "observing the
situation but don't have immediate plans to take legal action." Peter
Moore, head of GSK's South African division, said he was "surprised"
by the action, especially because GSK has agreed to allowing South
African generic drug maker Aspen Pharmacare to produce copies of some
of its AIDS drugs. However, the companies have not yet obtained gov-
ernment approval for the agreement, and the drugs are not on the mar-
ket. Sibani Mngadi, a spokesperson for the South African Department
of Health, said that the government will send a team of investigators
to the MSF clinic and will "confiscat[e]" the drugs if they were im-
ported in violation of the law. MSF said it "welcome[s]" any investi-
gation, noting that it has approval from the government's Medicines
Control Council to use the drugs in a research program. The group
also said that it had received a customs waiver allowing the drugs to
be imported (Wall Street Journal, 1/30).
Calling for a Declaration of Emergency
MSF, COSATU and TAC, along with the British charity Oxfam, yesterday
also urged the South African government to issue compulsory licenses
for generic AIDS drugs to allow South African companies to produce or
import the drugs without infringing on international patent law
(Agence France-Presse, 1/29). The South African government has the
power to suspend patent regulations by declaring HIV/AIDS a national
health emergency, but it has not yet done so, despite protests from
AIDS activists. "We have an unprecedented crisis of death in our
country. It is clear what path our government should take," TAC chair
Zackie Achmat said, urging the government to demonstrate its "politi-
cal will" by declaring a national emergency (Nessman, AP/Nando Times,
1/29). South African President Thabo Mbeki has consistently ques-
tioned the safety and efficacy of AIDS drugs (Wall Street Journal,
1/30).
--
Nevirapine to be Distributed in Some KwaZulu-Natal Hospitals by July,
Health Minister Says
Zweli Mkhize, health minister of the South African province KwaZulu-
Natal, where more than one-third of pregnant women are HIV-positive,
on Monday announced that the AIDS drug nevirapine, an antiretroviral
that reduces the risk of mother-to-child HIV transmission, may be
available by July in 20 major KwaZulu-Natal hospitals, Agence France-
Presse reports. Researchers who have been administering the drug at
certain pilot sites have "made good progress" but have not yet "fin-
ished" their work, Mkhize said (Agence France-Presse, 1/28). "I am
not saying all the work is complete, but there is some indication of
what can be done ... but it cannot be done immediately," Mkhize said,
adding that "it is not as simple as going around giving the drug to
mothers" (Johannesburg Business Day, 1/29). The plan, which Mkhize
"stressed" was a "very rough guidelin[e]," would make the drug avail-
able to the province's 40 smaller hospitals "over time," Agence-
France Presse reports. Mkhize's statement follows last week's an-
nouncement by KwaZulu-Natal Premier Lionel Mtshali that nevirapine
would be made available to "all HIV-positive pregnant women." South
African Health Minister Manto Tshabalala-Msimang on Monday "con-
demned" the way the province was handling issues related to nevirap-
ine and said that Mtshali's announcement created "unnecessary expec-
tations." Mkhize has arranged a meeting with the provincial cabinet
and the national government and "hope[s]" the national government
will support KwaZulu-Natal's decision to distribute nevirapine. Ac-
cording to media reports, some South African doctors have already
prescribed the drug "in defiance of government policy." However, no
disciplinary action would be taken against KwaZulu-Natal doctors who
prescribed the drug, Mkhize said (Agence France-Presse, 1/28). South
Africa's national government, led by President Thabo Mbeki, who has
questioned the link between HIV and AIDS, does not support widespread
distribution of nevirapine (Kaiser Daily HIV/AIDS Report, 1/25).
--
Thailand to Assist Zimbabwe in Production of Generic AIDS Drugs
Zimbabwe, a country where at least 2,000 people die of AIDS-related
illnesses each week, will soon begin to manufacture 300 generic
drugs, including AIDS drugs, Health and Child Welfare Deputy Minister
David Parirenyatwa announced on Tuesday, Xinhua News Agency reports.
The generic drugs -- which will include rifampin, an "essential" tu-
berculosis medication, and ketoconazole, a treatment for fungal in-
fections in the lungs and esophagus -- will be made with the free
technological help of Thailand and its Zimbabwe-based drug companies.
Few AIDS drugs are affordable to most Africans, according to UNAIDS;
however, the generic drugs would cut the prices of those drugs ten-
fold. "Zimbabwe is one of the countries severely struck by the
HIV/AIDS pandemic, and if it means manufacturing drugs to control
this scourge then we will do it," Parirenyatwa said. Thailand has
indicated that, if the attempt in Zimbabwe is successful, the country
also would offer its help to Ghana (Xinhua News Agency, 1/29).
--
Newsweek Cover Story Examines Work of Bill and Melinda Gates Founda-
tion, Fight Against HIV/AIDS
The Feb. 4 issue of Newsweek features a cover story on the Bill and
Melinda Gates Foundation, a $24 billion fund to "save the poorest
from disease" by funding international immunization projects and vac-
cine development for HIV and malaria. The "core" efforts of the fund
-- the goal of which is to "bridge the most fundamental gap separat-
ing the poor countries of the world from the rich ones: the gap in
human health" -- include a program to increase access in 74 countries
to "traditional childhood vaccines," an effort to provide newly de-
veloped vaccines at affordable prices to the developing world and
initiatives to develop AIDS and malaria vaccines. The Gateses, who in
1999 "made news around the world" when they "unveiled" a $750 million
vaccine fund, now linked to the Global Alliance for Vaccines and Im-
munization. The foundation also backs the International AIDS Vaccine
Initiative, along with a similar initiative for malaria vaccine re-
search. The foundation also works to eliminate the "absurd obstacles
to health" in developing countries, where a vaccine may be available
but an infrastructure for its distribution is lacking (Cowley, News-
week, 2/4). Melinda Gates' "immediate global health goals" include an
AIDS vaccine and "swifter trials" for microbicides that could prevent
STDs, including HIV, she said in an accompanying interview (Cowley,
Newsweek, 2/4). The articles are available online.
--
The Kaiser Daily HIV/AIDS Report is published for kaisernetwork.org,
a free service of The Henry J. Kaiser Family Foundation, by National
Journal Group Inc. � 2002 by National Journal Group Inc. and Kaiser
Family Foundation. All rights reserved.
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