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Search Terms: compulsory licensing AND AIDS AND Africa, House or Senate or Joint

Document 10 of 17.

JULY 22, 1999, THURSDAY

SECTION: IN THE NEWS

LENGTH: 1639 words

HEADLINE: PREPARED TESTIMONY OF
ERIC SAWYER
DIRECTOR, HIV/AIDS HUMAN RIGHTS PROJECT
BEFORE THE HOUSE GOVERNMENT REFORM COMMITTEE
SUBCOMMITTEE ON CRIMINAL JUSTICE, DRUG POLICY AND HUMAN RESOURCES
SUBJECT - ROLE OF THE US GOVERNMENT IN COMBATING
THE GLOBAL AIDS CRISIS

BODY:

Mr. Chairman, Members of the Committee, Ladies and Gentlemen,
I have but a few minutes to speak about a global public health crisis that has been evolving for twenty years and is unprecedented in human history. At present 14 million people have died from AIDS -- more than died during the Black Plague or all the world wars of the last 100 years. And we are of course still counting, and will be for some time.
So allow me briefly to introduce myself and then focus my remarks on aspects of this crisis that may not yet have come to your attention.
My name is Eric Sawyer. I live in New York City and am Director of the HIV/AIDS Human Rights Project. I am also one of the founders of ACT UP New York: an AIDS activist coalition formed in 1987 to focus media attention on the lack of governmental action with respect to AIDS, and to advocate for access to medical treatments for AIDS and related opportunistic infections.
I am also a person who has been living with AIDS for nearly twenty years, thanks to my privileged access to a sophisticated and expensive regimen known as "salvage therapy". This regimen includes daily doses of five anti-retroviral drugs, including two protease inhibitors. At the present time my viral load is undetectable and my CD-4 count has risen to its highest level in a decade. I have not been this well in ten years, and I am happy to be alive, and happy to be here today.
But I am also extremely sad, because I represent less than two percent of those for whom HIV/AIDS has become a manageable disease. There are nearly forty million men, women, and children with HIV/AIDS in the world today, and for 98% percent of them this disease remains-- there is no other term for it-- a death sentence.
It certainly was a death sentence for one of my heroes Auxcillia Chimusoro. Auxcillia was a brilliant woman from Zimbabwe, full of life and energy. She had just found out she was HIV infected in 1991, when her husband and infant child died of AIDS. She quickly started the first support group in her country for women living with HIV, by coming out as HIV positive and opening her home to others. Her bravery was rewarded with a fire-bombing and the beating of her children at school. Auxcillia responded by starting a sewing project to give other AIDS widows in her village an alternative to the exchange of sex for income or food. She also went on to start a project to care for AIDS orphans.
To access health care Auxcillia traveled over night on three different buses to reach a doctor who could treat her. While Auxcillia discovered her HIV infection 10 years after I began showing symptoms, today she is dead and I am alive and that is wrong. Auxcillia Chimusoro deserves tobe alive and with us here today. The world is a poorer place because of her loss and the loss of millions of others like her.
And even if we were all-- governments, NGO's, researchers, activists, pharmaceutical companies-- to come together on this very day in pursuit of a common goal, their will be millions and millions more, like Auxcillia, who will die before their time. Make no mistake about it: we are witnessing a global crisis of unprecedented proportions, that will leave a fossil-like imprint on human civilization for decades to come. The very existence of this congressional committee hearing, therefore, is in my view of historic importance, and I urge you to consider all the testimony you hear today with the courage, compassion, and concern.
In the few minutes I have left, I wish to zero in on pricing issues specifically with regard to those drugs that treat AIDS-related opportunistic infections.
The point is this: the kinds of combination therapies I am privileged to have access to are far beyond the resources of most men, women, and children in developing countries and they are furthermore difficult to administer and supervise in developing world conditions.
But these treatments, in my view, are not the most important ones we should be looking at. The first priority for extending the lives of people living with HIV/AIDS in the developing world should be providing access to very inexpensive drugs that treat and prevent the development of opportunistic infections that that kill most people with AIDS.
In this regard I am especially troubled that the pharmaceutical companies are focusing the attention of the treatment access debate on their most over-priced and difficult-to-administer anti-retroviral drugs: their triple-therapy cash cows.
What would have far more important and immediate benefits to people with HIV and AIDS in the developing world would be access to the inexpensive drugs used to treat and prevent AIDS-related opportunistic infections.
A few brief examples: Most people with AIDS die of treatable and preventable infections such as tuberculosis, pneumonia, fungal infections, and dehydration due to diarrhea. Prior to the introduction of triple-therapy regimens, significant reductions in AIDS-related death rates were achieved here in the United States through the application of inexpensive drugs to these and other infections.
What are the actual costs today of some of these drugs?
--TB prophylaxis costs $15 per year in a WHO program in Uganda.
--PCP prophylaxis in HHS programs costs as little as $24 per year.
-- NTZ, a wide-spectrum anti-parasitic drug for diarrhea, and some of the older generic anti-fungal drugs cost less than the Uganda TB treatments.
Thus, for under $70 per year, many fatal AIDS related opportunisticinfections can be prevented, delaying the deaths of people with AIDS for several years. Generic production of these treatments and bulk buying can even further reduce costs.
In other words: a partial remedy to the global AIDS crisis-- in the form of prolonging the lives of millions of people while the search for a vaccine goes on and hopefully intensifies-- is already at hand. That is the importance of the implementation of trade policies such as compulsory licensing and parallel importing. These policies will drive price reductions by introducing generic equivalents into the market place.
At the same time while we gear up efforts to dramatically expand access to cheaper drugs for opportunistic infections we can start to look at trade policies like compulsory licensing and parallel importing, or two tiered pricing systems, to reduce the price of the more expensive and complex triple therapies. Such efforts are already underway in Indiaproof that it can (and must) be done. In India, generic versions of AZT cost $34.00 per month-- as compared to the $250.00 charged by GlaxoWellcome.

For too long, in my view, the US Government has allowed the commercial interests of the pharmaceutical industry to drive trade policy and has, frankly, avoided meaningful debate about what our public policy should be with respect to global public health issues such as AIDS. What is our responsibility as Americans, I would ask, to the health of our planet? Now that we have the global village, do we really understand what it means to live-- and far to often-- to die in it? What should our response be? Should it be one hundred million dollars, as Vice President Gore recently announced? This is a welcome initiative but it is also a drop in the vast ocean of suffering created by AIDS and other infectious diseases.
What is required of us, I believe, is a comprehensive and compassionate policy that is driven and informed by a vision of our responsibilities as Americans in a planetary society. It is time for us to realize that the public health of South Africa is also the public health of the United States. And it is time to act on this realization by challenging greed; promoting debate; and recognizing that when it comes to public health, it is never about "them". It is always about us. Health is a human right. This is the great lesson we can learn from AIDS in the world, and if we do, some redemption will emerge, I believe, from this global tragedy.
In conclusion, I would ask this committee to consider the following:
1. Call for Congressional Hearings on the real cost of drug development so as to identify who is actually paying for research and development of essential medicines. I believe you will find that in many cases it is the US taxpayer;
2. Call for Hearings on drug pricing practices and work to pass fair pricing legislation for essential drugs;
3. Pass legislation making it illegal for the US government to use trade sanctions to bullying developing countries into denying it'speople affordable access to essential medicines through legal trade practices like compulsory licensing and parallel importing; and
4. Ask the President to license all US taxpayer-funded medical inventions to organizations like the World Health Organizations or to a multi-national not-for-profit drug distribution venture to facilitate greater access to essential medicines.
My mentor and hero was Jonathan Mann, the architect of the World Health Organizations' Global program on AIDS. Jonathan and his wife, Mary Lou, were tragically killed last September 2 in the crash of Swissair 111, but he has left behind for the global AIDS family, and indeed for all of us a vision of the inextricable link between health and human rights.
I would like to end my remarks with this statement of Jonathan's made at last year's International AIDS Conference in Geneva:
"Our responsibility is historic. For when the history of AIDS and the global response is written, our most precious contribution may well be that at a time of plague we did not flee, we did not hide, we did no separate ourselves."
In this spirit, may we all not separate ourselves, but instead work together to provide every man, women and child with one of their most fundamental rights: health.
Thank you very much.
END

LOAD-DATE: July 28, 1999

Document 10 of 17.


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