E-DRUG: Washington Post on AIDS drugs development
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[copied from PHARM-POLICY with thanks; WB]
This is the editorial from Today's Washington Post. Among other
things, it fairly closely follows the big PhrMA talking points and PR
efforts.
A few points,
- The statement that "Last year the pharmaceutical industry
allowed firms in South Africa to distribute cheaper copies of their
products," is completely false.
- The statement on the poor developing country infrastruture
overlooks the cases where the infrastructure does exist (why are't drugs
cheap in Thailand? for example), or where compliance and infrastructure
issues are not as severe (i.e. fluconazole).
- The reference to the Sach's proposal for funding a market for
vacinnes ignores some other models, such as public funding of the
research, and it does not address the important issue of who gets the
intellectual property rights from a multi billion public investment.
No mention at all is made of US trade policy -- as if this was never
an issue fit for public debate, despite current disputes in Thailand,
Philippines, Dominican Republic and many other countries over IPR
issues.
jamie
Editorial from today's Washington Post.
Fighting AIDS
Thursday, January 6, 2000; Page A18
NEXT MONDAY the United Nations Security Council will, for the first time
in its history, convene to discuss action on a health issue. Also for
the first time, the meeting will be chaired by an American vice
president. The health issue in question is the spread of the HIV virus:
Since AIDS, the disease to which the virus leads, is killing far more
people than war, it richly deserves the Security Council's attention.
The question is what to do about it.
The first answer is to resist the temptation to place excessive hope in
the wonder drugs that have cut mortality from AIDS in rich countries.
These drugs cost around $20,000 per person per year; many of the poor
countries that bear the brunt of AIDS have annual health budgets of less
than $20 per person. There have been welcome efforts to reduce the cost
of treatment: Last year the pharmaceutical industry allowed firms in
South Africa to distribute cheaper copies of their products.
But even if the cost of treatment could be radically reduced, it would
remain impractical in much of the developing world. Anti-HIV drugs need
to be administered with a precision that rudimentary health
infrastructures cannot aspire to.
The second answer is to invest in the development of a cheap, easily
delivered vaccine--but not to expect a quick victory. Even if a vaccine
were discovered tomorrow, its efficacy could not be known until it is
tested; and tests involve monitoring large groups of people over
extended periods. There are plans afoot for the world's eight leading
countries to promise $500 million each toward the future cost of
delivering a vaccine to the poor world: This would give the drug
companies a powerful incentive to come up with one. But that excellent
scheme cannot save the millions likely to become infected over the next
half-decade. In sub-Saharan Africa, 10 people are infected every minute.
Since science is unlikely to provide a silver bullet in the medium term,
there is no option but to change human behavior. That sounds like a
hopeless task: There have been calls for safe sex in the developing
world for more than a decade, and yet the epidemic has progressed
monstrously. But changing behavior is not in fact impossible. The
countries that have tried it seriously have managed. Thailand, for
example, has succeeded in getting prostitutes to insist on condoms.
Senegal has kept the incidence of HIV infection below 2 percent.
Uganda's education campaign, focusing both on values and on practical
information, has persuaded its youth to delay the first sexual
experience by an average of two years; the infection rate among pregnant
women in towns fell from 37 percent to around 15 percent during the
1990s.
Other developing countries need to follow this example. To do this, they
need to go beyond spreading the simple facts of the disease: Study after
study in Africa has found that people know about AIDS but still do not
change their behavior. In order to make progress, governments need to
fight the presumption that multiple sexual conquests are a mark of manly
virtue: They could begin by prosecuting rapists seriously, including the
many teachers who routinely have sex with their pupils. At the same
time, governments need to treat decently those who are infected, so that
the stigma of AIDS weakens. So long as that stigma persists, people will
not admit to having the disease, and so will continue to spread it.
This set of policies will be expensive. The humane treatment of
sufferers is a monumental task in regions such as southern Africa, where
one in four adults are thought to carry HIV. In his speech before the
Security Council next week, Vice President Al Gore will do the world a
service by focusing attention on this era's plague. But he should also
spur the developed world to give more aid to developing countries with
serious AIDS policies. At present, the United States spends nearly $900
million a year on fighting the disease within the United States, and the
problem here is far from solved. All the sub-Saharan countries combined
have a mere $160 million to spend on their efforts--and the challenge
they face is much, much bigger.
--
James Love
http://www.cptech.org
mailto:love@cptech.org
voice 1.202.387.8030