The AIDS-Drug Warrior

Web magazine article

By: Daryl Lindsey

Date: June 1, 2001

Source: Lindsey, Daryl. Salon. "The AIDS-drug Warrior." June 1, 2001. <http://archive.salon.com/ news/feature/2001/06/18/love/print.html> (accessed May 30, 2006).

About the Author: Daryl Lindsey is the editor of the online English edition of Speigle, a German magazine. He has also contributed to the Guardian and other English-language newspapers. Founded in 1995, Salon has received several awards including "Best Online Magazine" by Yahoo Internet Life and "Best 50 Websites" by Time Life. Salon reaches more than 2.5 million visitors, most of who reside in the U.S.

INTRODUCTION

According to The World Bank, "Sub-Saharan Africa has just over ten percent of the world's population, but is home to more than sixty percent of all people living with HIV—25.8 million." The solution to managing the worldwide HIV/AIDS situation is complex, especially in developing nations. According to Africa Action, a Washington, D.C.-based organization that works for political, social, and economic justice in Africa,

an effective response to HIV/AIDS requires a more urgent and comprehensive approach from the U.S. and the international community. It requires greater funding, a scale-up of effective prevention, treatment, care and support programs, support for the rights and needs of women and girls, and new investments in Africa's human resources and health care infrastructure.

Large multinational pharmaceutical companies are under more scrutiny of late. Critics charge that drug makers focus more on diseases that affect the affluent rather than tropical diseases and other diseases that affect developing countries.

Historically, medical research of tropical diseases was driven by war and colonialism—the need to keep specific populations of people alive and healthy (i.e. soldiers and settlers). Today, the advancement of medical science has resulted in cures for many diseases, but affluent people in developed nations have the most access to lifesaving drugs and technology, while millions in the least developed countries continue to die. Lack of health care infrastructure, lack of affordable drugs, and lack of political stability deter access to treatment and worsen the HIV/AIDS crisis.

There are two sides to this debate. While critics argue drug makers can do more to help, pharmaceutical companies claim that reducing drug prices will significantly decrease profits that are funneled to research and development of new drugs. Critics say drug makers hinder progress by offering over-priced drugs and trying to block efforts to produce generic drugs. Frustrated by high pricing and corporate influence, countries like Brazil and South Africa sought to develop their own drugs or import cheaper versions from other countries. In response, the U.S. government petitioned the World Health Organization (WHO) to sanction both countries.

Critics point out that the U.S. government, backed by the pharmaceutical industry, has challenged international treaties aimed at providing poor countries access to affordable medicine and generic drugs. Many researchers, activists, and citizens assert that the right to health (including affordable medicines) is a human rights issue.

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SIGNIFICANCE

Since the inception of this debate, a number of new initiatives to encourage the delivery of drugs used in the treatment of AIDS to developing countries were begun, each with modest success. For example, the President's Emergency Plan for AIDS Relief (PREFAR) was drafted in 2003 with $15 billion to be distributed in five years. Critics argue that this initiative proposed by President Bush does not mesh well with current programs that have proven success and that it is under-funded. In fact, a recent UNAIDS report shows needed funding of more than $18 billion alone in 2007 to effectively combat the pandemic in developing countries. In addition, PREFAR adds more barriers to access of affordable drugs, as it relies on brand name formulations. The high cost of brand name drugs reduces the number of recipients.

Despite more international programs and more funding, the situation continues to escalate, especially in Africa. Researchers describe more than three million new cases of HIV in 2005 (and a total of twenty-six million people currently living with the disease in Africa alone). The 2006 World Health Organization Annual Report describes a coming shortage worldwide in trained health-care workers of "over four million, affecting fifty-seven countries, thirty-six of which are in sub-Saharan Africa." In response to these problems, in early 2006, the WHO Commission on Intellectual Property Rights, Innovation, and Public Health (CIPH) passed a new declaration proposed by Kenya and Brazil, which the U.S. supported. Daryl Lindsey, author of the primary source, who observed these negotiations, also wrote, "This initiative is important. If we can create a global framework that stimulates R&D [research and development] in areas of medical priority and also promotes access, we may be able to replace or de-emphasize global agreements that simply raise drug prices."

FURTHER RESOURCES

Books

Love, James. Remuneration Guidelines for Non-voluntary use of a Patent on Medical Technologies. TCM Series No. 18. World Health Organization, 2005.

UNAIDS. AIDS Epidemic Update—December, 2005. Geneva, Switzerland: UNAIDS, 2005.

World Bank and UNAIDS. Responding to HIV/AIDS Crisis: Lessons from Global Best Practices. Geneva, Switzerland: The World Bank, 2005.

World Health Organization. WorldHealthReport2006. Geneva, Switzerland: World Health Organization, 2006.

Periodicals

Berkman, A., et al. "A Critical Analysis of the Brazilian Response to HIV/AIDS: Lessons Learned for Controlling and Mitigating the Epidemic in Developing Countries." American Journal of Public Health. 95 (2005): 1162–1172.

Centers for Disease Control and Prevention. "HIV/AIDS Surveillance Report, 2004." U.S. Department of Health and Human Services, Centers for Disease Control and Prevention. 16 (2004).

de Carvalho Mesquita Ayres, J.R., et al. "Vulnerability, Human Rights, and Comprehensive Health Care Needs of Young People Living With HIV/AIDS." American Journal of Public Health. 96 (2006): 1001–1006.

Desvarieux, M., et al. "Antiretroviral Therapy in Resource-Poor Countries: Illusions and Realities." American Journal of Public Health. 95 (2005): 1117–1122.

Galvão, J. "Brazil and Access to HIV/AIDS Drugs: A Question of Human Rights and Public Health." American Journal of Public Health. 95 (2005): 1110–1116.

McCoy, D., et al. "Expanding Access to Antiretroviral Therapy in Sub-Saharan Africa: Avoiding the Pitfalls and Dangers, Capitalizing on the Opportunities." American Journal of Public Health. 95 (2005): 18–22.

Web sites

Africa Action. "Betraying Africa's Priorities: A Short Analysis of U.S. Policies on HIV/AIDS in Africa." May 22, 2006. <http://www.africaaction.org/newsroom/index/> (accessed May 30, 2006).

Consumer Project on Technology. "Drug Development Incentives to Improve Access to Essential Medicines." May 2006. <http://www.cptech.org/ip/health/rnd/love-who052006.pdf> (accessed May 31, 2006).

Oxfam GB. "Public Health at Risk." April 2006. <http:// www.oxfam.org.uk/what_we_do/issues/health/ papers.htm> (accessed May 14, 2006).

The World Bank. "HIV/AIDS in Africa—Regional Brief." <http://web.worldbank.org/WBSITE/EXTERNAL/ COUNTRIES/AFRICAEXT/ EXTAFRHEANUTPOP/ EXTAFRREGTOPHIVAIDS/0,contentMDK: 20411613~menu PK:717155~pagePK:34004173~ piPK:34003707~theSitePK:717148,00.html> (accessed May 31, 2006).