E-DRUG: Press on AIDS Drug Victory
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[collation of press analysis of the SA court victory.
If you want to quickly review press coverage of a topic,
visit www.wn.com
More than 200 press articles on the court case if you search
for "South Africa court". NN]
The Independent (London)
April 20, 2001, FridayWhy Moral Victory is not Enough for Africa
By Alex Duval Smith
THE DRUG companies' climbdown in Pretoria represents a moral victory for
the Third World. But economists stressed yesterday that African countries
- home to 90 per cent of the world's 36 million HIV carriers - will not be
able to afford Aids drugs, brand-names or copies, without help from
taxpayers in the northern hemisphere.In the face of this, Kenya and South Africa are attempting to develop
vaccines - specific to Africa's HIV strains - and Jeffrey Sachs, the
Harvard development economist, earlier this month handed the Bush
administration a blueprint of a plan to get Aids drugs into African hands.Mr Sachs, supported by 127 other Harvard economists, argued that a global
trust fund must be established to combat the pandemic. "What is missing
right now is the international donor funding," he said.Mr Sachs's blueprint would initially help around one million patients at a
cost of $ 1.1bn and seek to triple numbers by 2006.He said: "The US is a $ 10 trillion economy, so $ 1bn is about one cent
out of every $ 100 in our economy. To save five million lives a year and a
continent that is dying, that is an incredibly modest effort."
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Business Week
April 23, 2001
ECONOMIC VIEWPOINT
How to Get AIDS Drugs to Africa
By Gary S. Becker; Gary S. Becker, the 1992 Nobel laureate, teaches at the
University of Chicago and is a Fellow of the Hoover Institution.The number of persons in Africa infected with the AIDS virus is of
disastrous proportions. The incidence of the virus is also growing rapidly
in India, Brazil, and other poor nations. This epidemic will rival some of
the most devastating ones of past centuries unless more affordable and
effective policies are developed soon.A recent U.N. report details the magnitude of the AIDS problem. Almost 30
million adults and 1 million children globally were infected with the AIDS
virus by the end of 1997. Two-thirds of those infected are in Africa, and
the infection rates on that continent are expected to grow even more
rapidly during the next several decades.Death rates reflect the rate of HIV infections with about an 8- to 10-year
lag, since there is no effective treatment once an infection evolves into
AIDS. About 12 million people worldwide already have died from AIDS, and
the number of deaths will grow rapidly. Eight million succumbed in Africa
alone between 1995 and 2000, and the U.N. estimates that deaths there from
AIDS will increase to 24 million during this decade. This would constitute
almost 40% of all deaths expected on that continent, where AIDS has
sharply reversed what had been impressive declines in mortality rates
during the past 40 years.The AIDS ''cocktails'' that combine various drugs often slow down the
progression from HIV positive to symptomatic AIDS. These cocktails have
reduced AIDS death rates in the U.S. and other rich nations, but they have
been much too expensive elsewhere. This is why pharmaceutical companies
have come under enormous international pressure to supply their drugs to
poor nations at a small fraction of the cost in the West. Some of these
countries have also begun to permit cheap generic copies that violate
international patent agreements. As a result, most pharmaceutical
companies have recently caved in on pricing. HUGE OUTLAYS. Over a longer
run, this policy could have a negative effect on Africa and other poor
nations because it could discourage the costly development of drugs to
fight malaria and other world diseases that are mainly due to poverty and
climate. Profit-oriented companies will not invest the half-billion
dollars and more required to research and develop effective drugs for
major diseases if they cannot price them sufficiently high to recoup their
investments.These financial considerations explain why drug companies already
concentrate most of their research on cancer, heart disease, and other
diseases that are common in richer nations, which can pay enough to
support large development costs.For this reason, a better strategy than pressuring companies to
essentially give away their drugs is for international organizations such
as the World Bank to negotiate with drug companies to buy large quantities
of the AIDS cocktails. They would arrange to have them resold cheaply to
persons who are HIV positive in Africa and other poor nations. This
approach would provide adequate compensation to drug companies, but it
needs to be carefully policed. Otherwise, some individuals and government
officials in poor nations who obtain drugs through these programs will
ship them instead to the ''gray'' markets of Western nations to profit
from the much higher prices there. EDUCATION IS KEY. Given the severity of
the consequences, it is puzzling that so many young African men and women
risk becoming infected with the AIDS virus through unprotected sex or the
use of contaminated needles to inject drugs. Presumably many are either
unaware of the consequences or they are unwilling to pay for condoms and
clean needles. To combat these forces, a second international program
should both subsidize condoms and clean needles and spread better
information about the dangers of unsafe sex and drugs.International efforts to reduce the incidence of AIDS are justified not
only by humanitarian considerations but also because they would reduce the
spread of a deadly contagious disease that has worldwide consequences.In addition, these efforts would encourage greater investments in human
capital in Africa and other poor nations with an AIDS epidemic. Since the
typical young person who contracts the AIDS virus lives only for 8 to 10
years, such people have less incentive to invest their time and money in
education and training that leads to higher earnings in the future. The
heavy incidence of the AIDS virus in many African nations is surely one
factor behind their dismal economic performance in recent decades.International organizations can take steps to reduce the high rates of HIV
infections on the African continent and to slow down the progress of this
virus among those infected. Successful efforts would dispel some of the
prevailing pessimism about prospects for combatting the AIDS epidemic in
Africa and in poor countries around the world.
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The Economist
April 21, 2001Drug-induced dilemma
POWERFUL medicines can have powerful side-effects, sometimes clouding
judgment or blunting reactions. As the public debate over how to get
expensive rich-world medicines to poor countries shows, this is as true
for those who make the drugs as for those who take them.The latest case in point is a South African trial, in which 39
multinational pharmaceutical firms sued the country's government. At issue
was a 1997 South African law that allows the government to obtain cheaper
versions of expensive, branded drugs--particularly those to treat
AIDS--from sources other than the patent-holders. The drug companies have
argued that the law is unconstitutional and violates their
intellectual-property rights; South Africa's health ministry charges that
millions of people are dying because the anti-retroviral drugs sold by
such firms are too costly, and says it is obliged to seek alternatives in
the interest of public health.The hearings were scheduled to start on April 18th after an adjournment
last month, but were called off after the drug firms decided to back down
and agreed to pay the South African government's legal costs. In the court
of public opinion, however, the companies lost this battle long ago. To
much of the international press, this has been a clear-cut case of nasty
profiteers clinging to their patents for dear life while the sick in poor
nations suffer.The truth is not quite so simple. That poor people lack access to
expensive medicines is the fault not just of high drug prices, but also of
poor-country governments, that fail to invest much in health care, and
rich-country donors, that until recently devoted little of their overseas
aid budgets to such problems. Indeed, in the past year, drug firms such as
Merck have drastically cut the price of their anti-retroviral medicines to
rival those of generic manufacturers; some, such as Boehringer Ingelheim,
have offered to give theirs away.Rather than earning the companies international admiration, however, such
largesse looks to many like the panic reaction of an industry on the
defensive, pressured into making concessions. Drug companies may not yet
be as reviled as tobacco firms and arms manufacturers, but they have not
done well out of this fray. How did the industry get itself into such a
mess?To an extent it was caught unawares, as its focus has long been on Europe
and America, which account for two-thirds of the world's $363 billion drug
market, rather than on developing countries. Aside from a few
philanthropic initiatives, how to make drugs available to poor countries
was simply not on the corporate agenda.As a result, companies have tended to take the same hard line on patents
and pricing in poor countries as they have in the rich world, without
acknowledging that there are places where rich-world rules should not
apply, says Ben Plumley, formerly with GlaxoSmithKline and now a policy
adviser to UNAIDS. Behind this tough approach lies a desire to protect
their lucrative, rich-world markets at all cost. Opposition to the
proposed South African law, for example, stemmed not so much from what
will be lost in Africa but what might happen if other, more affluent
countries decide to follow suit.Drug firms have also underestimated the power of interest groups to
mobilise support from the public and politicians. This week, for instance,
Medecins Sans Frontieres, an aid agency, presented the companies in the
South African trial with a petition containing 250,000 signatures to drop
the case. In February, Oxfam, an overseas development charity, launched a
campaign to pressure GlaxoSmithKline into changing its policy on patent
enforcement in poor countries. Heavy lobbying has also pushed the issue on
to the political agenda, especially in Europe--though it has not yet led
shareholders to ask tough questions of company executives.Drug companies have also assumed, wrongly, that the very nature of their
business--making life-saving medicines, rather than toxic chemicals--would
ensure public approval, according to Peter Zollinger of SustainAbility, a
consultancy. But many of them have failed to acknowledge that the issue is
not just the price of drugs, but fuzzier things such as social
responsibility and accountability.Mr Zollinger argues that many drug firms have failed to address this
broader issue of good governance, instead treating drug access as a
public-relations problem that can be patched over with a few more price
discounts or one-off drug donations. But this does little to satisfy
groups such as Oxfam, which want longer-term solutions, such as freeing up
poor-country markets to generic competition. Despite their capitulation in
the South African courts this week, drug companies have a long way to go
to satisfy their critics.
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The Guardian (London)
April 20, 2001We have a deal
Jean-pierre Garnier A Drug Company Boss Explains The Climbdown In South
AfricaThe settlement of the court case in South Africa has to be welcomed by all
sides. The terms of the settlement meet the goals of both industry and the
South African government and will enable us to work together in addressing
the healthcare needs of South Africa.No one would deny that the barriers which prevent patient access to
medicines in the developing world must be broken down. The pharmaceutical
industry has a fundamental long-term role to play in this, through the
discovery and development of innovative medicines to combat diseases not
yet eradicated. Effective intellectual property protection underpins this
continued research and development.It has been widely commented that the court case was about the industry
using its patents to block access to medicines and to keep up high prices.
Nothing could be further from the truth. Even now, non patented medicines
are not available in Africa.The key concern for the industry was that the South African legislation
was vague and ambiguous and in particular, the law appeared to give the
government freedom to override patents of any medicine at their
discretion. This would have undermined the industry's ability to provide
new and better medicines.Under the terms of the settlement the South African government has
confirmed that its new law will be implemented in a way compliant with the
international Trade-Related Intellectual Property Rights Agreement
(Trips). In doing so, it has af firmed the need for strong intellectual
property protection consistent with international agreements and the
underlying importance of intellectual property protection as an incentive
to innovation. Put simply, intellectual property is not an obstacle to
access.Kofi Annan, the United Nations secretary general, who played a key role in
bringing about yesterday's settlement, said only a few weeks ago:
Intellectual property protection is key to bringing forward new medicines,
vaccines and diagnostics urgently needed for the health of the world's
poorest people. The United Nations fully supports the Trips agreement -
including the safeguards incorporated within it.'In this context the settlement agreed with the South African government
has to be embraced by the industry. The opportunity to input on the
regulations that will implement the act and the government's willingness
to consult with the industry on this are further significant steps towards
a new spirit of partnership and cooperation.In the heated debate around the court case it has been difficult to convey
the overwhelming truth that the most significant barriers to comprehensive
treatment for HIV/Aids in the developing world are lack of funding and
public healthcare infrastructure. Now is the time for everyone who has a
role to play in alleviating the human and economic tragedy of HIV/Aids in
southern Africa to come together in the spirit of partnership exemplified
by the settlement of the court case. GlaxoSmithKline - by providing
heavily discounted Aids medicines and being the only company with
experimental vaccines in Aids and malaria already being tested in people -
will continue to give its full commitment to this endeavour.Jean-Pierre Garnier is chief executive of GlaxoSmithKline.
_________________________
The New York Times
April 20, 2001Editorial Desk
South Africa's AIDS VictoryThe withdrawal of the pharmaceutical industry's lawsuit against South
Africa is the latest in a series of deserved setbacks for the drug
industry on the issue of AIDS in the third world. Yesterday's settlement
is a long-overdue bow to both public health needs and common sense.The drug industry had been challenging a South Africa law that allows the
importation of brand-name drugs from nations where they are sold more
cheaply than in South Africa. When the legal action was filed in 1997, few
people were paying attention to the problem of high drug prices in poor
countries. But public attention soared in the last year, and the suit --
which formally listed Nelson Mandela as its first named plaintiff --
became a symbol of the industry's insensitivity to the health crisis in
Africa.The drug industry's defeat in South Africa should serve as a warning to
pharmaceutical companies not to start new efforts to block access to
cheaper drugs in other nations. It will embolden other poor countries and
feed a growing consensus worldwide that medicines, especially medicines to
treat AIDS, need to be available in nations that cannot afford to pay
world market prices. That can only happen if prices drop and rich nations
help subsidize purchases for poor nations.Inside South Africa, the end of the lawsuit puts the burden squarely on
the strangely inert government to make progress on getting AIDS medicine
to the suffering. The drug companies' case concerned only brand-name
drugs. It was not blocking South Africa from importing cheap generic
versions of AIDS drugs -- which can be legal under world trade rules. But
South Africa has so far declined. Until last year, this was in part
because of trade pressures from Washington and European governments at the
behest of the pharmaceutical industry. Those pressures have, mercifully,
ended.Today, one in four adult South Africans has the AIDS virus, and the
country is capable of providing effective AIDS treatment to much of its
urban population. Yet the government has been inexplicably passive -- even
hostile -- to treating the disease. It is only now beginning to administer
a simple, cheap drug to prevent mother-to-child transmission. Although
several companies have made offers of low-priced generic AIDS drugs, South
Africa has not yet said it will begin importing these medicines.One reason for the delay is that buying the drugs would balloon the
nation's health budget. But failure to treat patients early carries an
even higher future cost in hospitalizations and deaths of people in their
most productive years. South Africa, like other poor nations, needs help
from wealthy nations to pay for these drugs. But the country itself must
make a greater commitment to treating its millions of citizens infected
with the AIDS virus.
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