E-DRUG: Drugs for AIDS in Africa
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[editorial in NYTimes, 24 August 99; copied as a fair use]
The average African nation spends less than $10 per person each year
on health care. The mix of drugs, including the new protease
inhibitors, necessary to turn AIDS from a death sentence into a
chronic disease costs at least $12,000 per person each year. That
disparity virtually guarantees that most of the 22 million Africans
infected with the AIDS virus will not get the best available
treatment. Few will even be able to afford less expensive
life-prolonging drugs such as AZT or ddI or -- far cheaper and just as
crucial -- medicines to fight the infections that accompany AIDS.
Washington is now arguing with South Africa about a new law in that
country that could allow South Africa to make cheap versions of
still-patented drugs or import them at less than the manufacturers
want to charge. The debate is important, and it has revealed the need
to broaden the Administration's policy, which has been dominated by
trade issues and the desire to protect American pharmaceutical
patents. Washington should stop pressuring South Africa to change the
law, but even then far more will need to be done to get lifesaving
medicines to poor Africans with AIDS.
Part of the challenge is to increase the avail- ability of already
affordable drugs. Last month, the Administration announced a $100
million effort to fight AIDS in Africa. It will buy and help countries
use some cheap treatments, like medicines for tuberculosis and other
AIDS-related infections and drugs to prevent mother-child
transmission.
While some pharmaceutical manufacturers, most recently Bristol-Myers
Squibb, are making substantial donations to fight AIDS in poor
countries, they want to see governments or health organizations bear
the cost of AIDS drugs. But most of the newer ones are far too
expensive. Many third-world countries have long responded to the high
cost of patented drugs by copying them, sometimes for a tenth of the
patented price. The pharmaceutical industry argues that this pirating
discourages the search for new medicines, as patented drugs are priced
high in part to allow manufacturers to recover the research and
development costs of all their projects, even the unsuccessful ones.
The drug companies, and the Clinton Administration's trade
negotiators, have fought the efforts of third-world countries to
manufacture or import cheap versions of still-patented drugs. American
trade pressure on Thailand throughout the 1990's, for example, caused
the country to put restrictions on its manufacture of cheap patented
drugs and ban their import, which AIDS doctors say reduced the
country's ability to fight the disease.
What really worry the drug industry today, however, are the new
intellectual property rules of the World Trade Organization. Over
Washington's objections, poor nations won the right to make patented
drugs in certain situations, especially when there is a ''national
emergency.'' While Washington says it objects to technicalities in the
new South African law, the larger reason trade officials have pressed
so hard is that the industry fears South Africa could set precedents,
within the world's trade rules, for the manufacture of cheap drugs.
Drug makers have sued in South African courts to block the law.
While defending intellectual property is important, the narrowness of
the Administration's views is dismaying. Pharmaceutical companies
would lose little if they found legal and controllable ways to let
poor countries -- which offer scant market anyway -- reproduce drugs
or buy them cheaply.
In addition, some of the most important AIDS drugs were discovered in
the National Institutes of Health, or with Government grants. Two
examples are ddI and the protease inhibitor Norvir. That financing may
well give Washington the right to allow the World Health Organization
to license the drugs' manufacture, for sale only in poor nations in
case of emergency. The Administration should explore this option for
all such vital medicines developed at taxpayer expense. The desires of
America's pharmaceutical companies have been the overwhelming force
driving American policy on the issue of drugs in poor nations. Surely
the needs of 35 million people infected with H.I.V. worldwide should
count for more.
Copyright 1999 The New York Times Company
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