Copyright 1999 Star Tribune
Star Tribune
(Minneapolis, MN)
July 27, 1999, Tuesday, Metro Edition
SECTION: NEWS; Pg. 6A
LENGTH: 1156 words
HEADLINE:
The price of life;
AIDS in Third World sparks debate over
U.S. drug policy;
Poor countries in need of expensive drugs are calling on
U.S. policymakers to help them.
BYLINE: Greg Gordon;
Staff Writer
BODY:
Fighting back tears, Chatinka
Nkhoma told a House subcommittee that she was speaking on behalf of millions of
Africans who, like her, have AIDS.
"I'm their voice, and I'm here to cry for help," she
said at the hearing late last week. "We cannot be condemned to death because we
are poor."
Nkhoma, 37, said the AIDS
scourge sweeping her destitute homeland of Malawi already has killed her brother
and his wife (who left behind a 2-month-old baby), her sister (who had four
children), three brothers-in-law and 10 cousins. It also has killed many of her
friends and some of Malawi's politicians and entertainers.
"I'm supposed to have been dead by now," she said. "If
I had not been one of the fortunate people . . . who had God's blessing to be
able to access these drugs, I simply wouldn't be here."
Nkhoma got the drugs when she came to the United
States five months ago to study for a master's degree at George Washington
University. The treatment that she received, as well as other new treatments,
have cut the U.S. mortality rate from AIDS nearly in half from
1997 to 1998. But they can cost $12,000 to
$30,000 per year and are only a dream to most of the 22.5
million people who have the fatal virus in sub-Saharan Africa, where
AIDS already has killed 12 million people. Many Africans earn no more
than $500 a year and spend $5 to
$15 annually on health care.
The
hearing by a House Government Reform and Oversight committee underscored the
growing focus on the plight of AIDS patients in the Third
World. It also highlighted a debate over the role of the United States, Vice
President Al Gore and other administration policymakers, who have sided with
drugmakers in resisting some efforts to speed the flow of cheaper drugs.
The flap revolves around U.S. opposition to a
two-year-old South African law that would bypass drugmakers' patents and allow
local manufacturers to copy the breakthrough products. It pits humanitarian
concerns against drug companies' arguments that they must be allowed to profit
from high-risk research or they can't continue to finance medical discoveries.
.
Trade pressures
Gore, who chairs a U.S.-South
Africa Binational Commission, has become a lightning rod for
attacks from AIDS activists protesting U.S. opposition to the
South African Medicines Act of 1997. The law, blocked from implementation by a
constitutional challenge from more than 40 pharmaceutical firms, also would
permit drug importation from countries that offer lower prices, bypassing a
company's authorized distributors.
The United States
began exerting trade pressures on the Pretoria government in April 1998 on
grounds that the law would violate intellectual property
protections. Allowing other firms to manufacture products in which U.S.
drugmakers invested as much as $500 million to
$1 billion "takes away the life's blood of the industry," said
spokesman Jeff Trewhitt of the Pharmaceutical Research and Manufacturers of
America.
Tom Bombelles, assistant vice president for
international trade at the pharmacy group, said he and other industry
representatives haven't spoken with Gore, but met with his aides in spring 1998,
when the first trade pressures were exerted, and shortly before they were
removed a couple months ago.
Gore's foreign-policy
spokesman, Thomas Rosshirt, and Trewhitt said Gore rejected the industry's
attempts this spring to ratchet up the pressure on South Africa
to an outright threat of trade sanctions.
If Gore were
"in our back pocket," Trewhitt said, he would have pressured the Office of the
U.S. Trade Representative "and insisted that this be escalated."
But Gore, whose campaign fund-raisers reportedly have
been making the rounds among drug-company executives, irked some congressional
Democrats by stating in a letter in June that he supports South
Africa's efforts to care for its 3.2 million
AIDS patients "so long as they are carried out in a way that is
consistent with international agreements."
Critics
such as James Love, director of Ralph Nader's Consumer Project on Technology,
say international agreements adopted when the World Health Organization was
created give South Africa the right to breach patents during a
national emergency. If South African firms copied their patented products, he
said, the drug companies would be entitled to royalties but could not set
prices, which could fall by as much as 95 percent.
Besides, Love said, a number of the U.S.-patented
AIDS drugs were developed at the National Institutes of Health
or at research universities with federal grants, then were licensed to the
firms. The firms cannot reasonably expect huge profits from these drugs, he
said, and the government can issue additional licenses for their sale at lower
prices.
U.S. trade officials, however, say the
intellectual property protections in the international
agreements still require South Africa to meet certain
conditions if they breach the patents.
Rosshirt said
Gore "supports South Africa's efforts to make health care more
affordable to its people, and [that] he has worked with then-Deputy [Vice]
President Thabo Mbeki to resolve our trade differences."
Members of ACT UP, a group of AIDS
activists, have interrupted several of Gore's speaking and fund-raising
appearances to protest the U.S. positions. But some AIDS
activists and consumer-watchdog groups acknowledge that they have been focusing
on Gore mainly because his presidential candidacy strengthens their leverage for
influencing the administration's trade policies.
"Frankly, I think focusing too much attention on Gore
or any other politician distracts attention from the real culprits, which are
the drug companies," said Daniel Zingale, executive director of
AIDS Action, a national lobbying organization for
AIDS patients.
He called Gore's announcement
that the administration is proposing spending $100 million to
assist African AIDS patients "a good start."
With 33 million people infected with
AIDS worldwide, the global devastation is soon expected to
surpass that of the bubonic plague, which killed 20 million people in 1347.
"In many sub-Saharan Africa
countries, between one-fifth and one-third of all children have already been
orphaned by AIDS," Sandra Thurman, director of the Office of
National AIDS Policy, told the House panel. "And the worst is
yet to come. Within the next decade, more than 40 million children will have
lost one or both parents to AIDS."
Health experts in the United States and
Africa agree expediting shipments of drugs alone will not solve
the problem, because African health care systems lack the personnel to properly
administer them.
But Nkhoma said she knows people "who
will travel 10 miles every day if the doctor tells them to get an injection."
LOAD-DATE: July 29, 1999
