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The Boston
Globe
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May 12, 2000, Friday ,THIRD EDITION
SECTION: NATIONAL/FOREIGN; Pg. A1
LENGTH: 1023 words
HEADLINE:
Globe UN correspondent Joe Lauria contributed to this report from New York.;
AIDS DRUG PRICES CUT FOR AFRICA
PHARMACEUTICAL COMPANIES YIELD TO PRESSURE FROM WHITE HOUSE
BYLINE: By Kurt Shillinger, Globe Correspondent
BODY:
JOHANNESBURG - Under increasing pressure from
the Clinton administration and African leaders, five of the world's largest
pharmaceutical companies yesterday announced that they would make their
AIDS drugs affordable for tens of millions of people across the
southern hemisphere.
Unveiling the joint agreement, the United Nations
in Geneva said the companies would slash the price of their
AIDS drugs by as much as 90 percent of what Americans
pay. Health officials in South Africa,
struggling to cope with one of the highest rates of HIV infection in the world,
reacted with cautious optimism to the announcement.
"I would welcome
anything that brings the price of these drugs down, but I would like to see more
details of their offer," said James McIntyre, the chief AIDS
researcher and medical doctor at Bharagwanath Hospital in Soweto, the sprawling
township south of Johannesburg. "If the companies are just doing this to protect
their intellectual property rights, it will be a waste of
time."
The announcement could mark the beginning of a rapprochement
between the drug firms and African governments long embittered by what they saw
as efforts by powerful Western multinationals to exploit
Africa's epidemic for profit.
About 23 million people
south of the Sahara Desert have the human immunodeficiency virus, according to
the United Nations, and AIDS kills more than 2 million Africans
annually. At current prices, anti retroviral treatments are prohibitively
expensive for even the best African budgets.
But even with lower costs,
regional experts said, much more was needed before the drugs could be made
widely available in poorer countries that lack the expertise and infrastructure
to administer complicated treatment regimens.
"We need significant new
funding that is on a level with the enormous human, social, and economic
challenges now being imposed by the epidemic," said Peter Piot, executive
director of UNAIDS, the joint UN program responding to the epidemic globally.
"Lowering the prices of medicines, however, is only one critical factor in what
must become a much broader and more urgent effort."
The five
pharmaceutical companies announcing the price cuts were Glaxo Wellcome of
Britain, Bristol-Myers Squibb of New York, Boehringer Ingelheim of Germany, the
Swiss firm Roche, and Merck and Co. of New Jersey.
Glaxo, which
manufactures the joint treatment of AZT and 3TC called Combivir, said it would
reduce the price of the daily regimen from $16.50, the cost in
the United States, to $2 in developing countries. Ugandans
currently pay about $6 per day for the treatment. AZT,
international studies show, can reduce the risk of infection from pregnant woman
to fetus by as much as 50 percent.
Devising a plan
The deal,
which follows an urgent appeal by UN Secretary General Kofi Annan last December,
involves the World Health Organization, the World Bank, the UN Children's Fund,
and the UN Population Fund. The next step, according to officials from these
agencies, is to work out a plan for how the drugs will be purchased,
distributed, and administered. That plan will be announced in July at the
international conference on AIDS in Durban, South
Africa.
One scenario, according to Christopher
Lovelace, director of health, nutrition, and population at the World Bank in
Washington, D.C., is for his organization to offer low-maintenance loans to
African countries. UNICEF would then purchase the drugs from the companies.
WHO might be involved in training health officials how to administer the
drugs, which can be dangerous or rendered ineffective if not taken correctly.
"If a country wishes to take advantage of these reduced prices, the bank
would certainly consider supporting those countries," Lovelace said. "It is hard
for us to imagine a situation where there was a well-conceived national
strategy, a government request to borrow, and we wouldn't support it."
Lovelace said a country with a per capita income of less than
$1,000 might receive no-interest loans.
With as much as
25 percent of their adult populations infected with HIV, African countries have
been struggling for years to find affordable responses to the
AIDS epidemic. Despite some recent concessions - Bristol-Myers
Squibb last year announced that it would donate $100 million
over five years to help African countries combat AIDS - the
pharmaceutical companies have not responded willingly to demands for lower
prices.
US issues executive order
On Wednesday, President
Clinton issued an executive order relaxing US protection of intellectual
property rights held by drug companies, thereby allowing African
governments more leeway in obtaining cheaper generic alternatives to the
name-brand drugs. Congress earlier rejected an almost identical provision from
an African trade bill, which pharmaceutical companies had fought strongly
against. Annan applauded Clinton's decision.
"There has been a
controversy for some time as to whether or not African countries who have the
capacity to produce locally generic versions of some of these drugs at a much
cheaper cost will be allowed to do that," he said. "I think the executive order
is an important step in the fight against AIDS . . . on two
fronts: prevention and treatment."
The battle for cheaper drugs has
angered African governments - none more than South Africa. Even
at $2 per day, anti retroviral treatments would be too costly
for most individual Africans to pay, AIDS specialists say,
leaving the burden on state budgets. The lower costs could, however, finally
make antiretroviral treatment cheaper than hospitalization.
But without
knowing the fine-print details of the new offer, South African health officials
remain wary.
"Even if the pharmaceuticals say they will reduce the cost,
before we can say yes, we must study the terms of the offer," said Confidence
Moloko, chairman of the national health committee of the ruling African National
Congress.
"We have to know what we're getting into. We can't get these
treatments at lower costs for three or four months, and then find out we've been
suckered."
LOAD-DATE: May 12, 2000
