|
|
| by Christopher
Spencer |
Former Senior
Advisor International Organizations,
Canadian Department of
Foreign Affairs and International Trade |
| Updated: 20 JUN
08 | |
(A) COST/PATENT DILEMMA; GLOBAL REACTION
(B) INFECTION RATES; SOCIO-ECONOMIC ISSUES
(C) MEDICAL DEVELOPMENTS AND CHALLENGES
(D) POLICY ISSUES AND CONFERENCES
(A) AIDS: THIRD WORLD: COST-PATENT DILEMMA; GLOBAL REACTION
Donald G.McNeil Jr."Drug Companies and the Third World: A Case Study in Neglect"in New York
Times 21 May 1999:-this substantial report deals with an extremely serious global issue. Major
pharmaceutical firms are deeply dependent upon stockholders/markets for their competitive
survival and the huge investments (billions of dollars and years of work)now required to do the
R&D necessary for developing new drugs. They therefore concentrate on drugs which, if
successful, will have a very large market(i.e. the rich world), insulate their investments with
patents, and charge the highest possible (monopoly?) prices while the patents last. The
appalling result is that very little commercial R&D or production is allocated to cures, treatments,
or techniques mainly or wholly relevant to the bulk of the world that is poor(i.e. offers a small
market), while those with global relevance are available at a cost often far beyond the reach of
poor peoples. The author uses sleeping sickness as a tragic case study but this dilemma lies
behind the AIDS crisis. Barbara Crossette,"Gore Presides Over Security Council Debate on
AIDS"NYT 11 Jan 2000:-US Vice-President Gore, chairing a UNSC session on the AIDS crisis in
Africa, pledged $150m to help combat AIDS and other infectious diseases in the poorest
countries, plus funds to share US expertise on controlling AIDS in the military with African
nations. The debate recognized the epidemic as an international security issue since it could
"decimate the economic, political and military establishments in many countries[and]is being
more effective than war in destabilizing[them]". Peter Piot(UNAIDS)said he needed $1-3b a year
in Sub-Saharan Africa alone. The Economist 29 Apr 00"Africa’s Twin Scourges"(17-8);"Aid for
AIDS"(76):-these articles are valuable in going beyond the schemes to fund urgent research on
cures for Third World diseases(as pharmaceutical companies see no profit),to also consider
market costs. Already AIDS kills 2.5m and malaria 2m annually, mostly in Africa and climbing
fast. The economic impact is huge. Malaria's cost is over 1% of GNP. Since AIDS weakens/kills
prime workers, skills and productivity are hit hard. Moreover, in any given country a year of basic
HIV medical treatment for one now costs 2-3 times per capita GNP, and once the adult infection
rate reaches 8%(the case in 21 countries), per capita growth is lowered .4%(Africa recently
averaged only 1.2%). Yet global AIDS vaccine research in 1999 drew only $300m, of which a tiny
fraction was specifically for LDCs. Since any successful vaccines must be marketed very
cheaply there, the authors urge that donors heavily subsidize both research and distribution. The
costs of tackling malaria are estimated at $1b annually, but this could benefit sub-Saharan
Africa’s combined GNP $3-12b. Neil A. Lewis"Clinton Tries to Expedite AIDS Drugs Into
Africa"NYT 11 May:- article reports that, in spite of strong opposition from the pharmaceutical
industry, President issued an executive order on 10 May declaring US government will not seek
to interfere with any countries in sub-Saharan Africa that may violate American patent law in
order to provide AIDS drugs at lower prices. (An identical Congressional proposal was
withdrawn because of industry opposition.) The order would allow African states to licence local
companies to produce cheap generic versions or import the drugs cheaply from third countries
without paying US prices kept high by patents. Reuters"Roche Says to Slash AIDS Drugs
Prices"11 May:-Swiss pharmaceuticals giant Roche announced it would slash prices of AIDS
drugs for LDCs, and offer free logistics support, under a UN initiative responding to the African
crisis. Arrangement also involves four other companies, but the timing and prices are”subject
to negotiations”. McNeil"Companies to Cut Cost of AIDS Drugs for Poor Nations"NYT 12 May:-the next day five major pharmaceutical companies offered to negotiate, with WHO and other aid
groups, steep cuts in the price of their patented AIDS drugs for Africa and other poor regions.
UNAIDS acknowledged a“promising step in a long-term process [but] only one critical factor
in what must become a much broader and more urgent effort". The allusion is to the additional
need globally for much more Third World-relevant medical research and much better AIDS-related education and health systems in the Third World(see Economist 14 Aug 99, 29 Apr 00,
Olson op.cit.). McNeil"Prices for Medicine Are Exorbitant in Africa, Study Says"NYT 17 Jun:-article reports huge anomalies in the prices of vital drugs. One study found "the price of life-saving medicine in Africa, where the need is greatest and the poverty is worst, is often higher
than in Europe and North America... [T]he medicine...patients need for AIDS...are often available
only at exorbitant prices”(by any standards)-particularly in South Africa. A UNAIDS study of
prices in Brazil, which like India ignores Western patents and makes cheap copies of new drugs,
found them very low compared with Africa or US, but also unreliable. Many poor countries use
a low-price WHO bulk-purchasing system, but have high loss rates. Kenyan Health Minister
summed up the basic problem:”How can we be denied access to drugs that prolong life when
people are dying?” Reuters,“SADC(Southern African Development Community) Ministers Unable
to Respond to AIDS Drugs Offer”NYT 17 Jun:-five leading drug companies offered to cut the
prices of HIV/AIDS therapies by up to 80% for poor countries as part of a UN deal, but the SADC
concluded they still had neither the funds nor infrastructure to afford the offer. McNeil“Writing
the Bill for Global AIDS”NYT 02 Jul:-an AIDS expert explains that in the Third World the
epidemic is”really a welfare and education issue rather than a medical one”. The $2b estimated
in a UNAIDS report as the annual cost of providing Africa with ”minimum prevention and
care”would have to go almost entirely for preventive measures even if cheap drugs were
available. Of the 34m HIV-infected people worldwide, at least 30m are so desperately poor that
most have to be simply“written off”so limited funds available/realistic can be invested in
prevention, not treatment. Financial triage. Lawrence Goldyn“Africa Can’t Just Take a Pill for
AIDS”NYT 06 Jul:-President Mbeki of South Africa has been justly criticized for doubting the
(proven) value of AZT and the (clear) sequence from HIV to AIDS, but he was right in claiming
that the pharmaceutical-based model of HIV care in the West is not applicable to(South)Africa.
“Cost is the obvious barrier to drug therapy”; even if subsidized to 10% of their cost in the West,
they would be well beyond African means. But "the lack of social, economic and medical
structures to support drug treatment"means that even if cheap“drugs arrived by the shipload” -
as proven by past TB programs, the problem is getting people to take them.”What Africa most
needs is an HIV vaccine” - but potential African returns are not so far worth massive research
investment by drug companies. Moreover, controlling HIV in(South)Africa would require a huge
international investment, not merely sufficient to create incentives to produce drugs, but also
to distribute them, and to provide clean water, sanitation, clinics, health education, refuge for
women, and care for children. Lawrence K. Altman“A Call for Fair Access to Future AIDS
Vaccine”NYT 07 Jul:- reports on a “blueprint” proposed by the International AIDS Vaccine
Initiative, a research consortium that works closely with UNAIDS. This addresses exactly the
dual economic and infrastructure challenges just outlined. The consortium urges that:”Though
a vaccine to prevent AIDS is years away, steps should be taken now to enable a vaccine to be
distributed widely in the third world as soon as it becomes available”. It admits both public and
private sectors must learn new ways of doing business to accomplish "sweeping changes in the
way vaccines are produced, licensed, priced, bought and distributed"-and offer special delivery
systems and counselling. There is usually a 15-year lag between availability of key vaccines in
rich and poor countries; but an avoidable 5-year lag in distributing an AIDS vaccine would
severely damage many African economies - and cost at least 20m lives! Existing WHO programs
can be exploited, but pricing structure is WTO business. Reuters “Botswana Pres.: Nation Faces
Extinction From AIDS”NYT 08 Jul:-”AIDS has put the people of Botswana, probably more than
any other, on a knife-edge between prosperity and poverty”. Perhaps the most democratic and
prosperous state in Africa now has the highest rate of HIV/AIDS infection in the world - mainly
spread by the sex trade. One in three adults is already infected, and advanced AIDS will not peak
for 5-10 years, so President Mogae was not being rhetorical when he told the Reuters journalist
a country of 1.6m people“faces extinction from the disease”. No antiretroviral drugs are
available: even at reduced prices, they are simply too expensive even for“successful”African
states to buy, distribute and administer. Reuters“Gates, Merck to Give Botswana $100m AIDS
Help”NYT 10 Jul:-in direct response to Mogae’s statement to Reuters, the Gates Foundation and
Merck and Co. will contribute $100m over five years in cash, expertise, antiretroviral drugs, etc.
to”help Botswana strengthen its primary health care system. German/British/Dutch firms will
also donate medication and expertise. McNeil“As Devastating Epidemics Increase, Nations Take
On Drug Companies”NYT 09 Jul:- an extraordinary article containing extraordinary information.
It relates to attempts by Pfizer, supported by the US government, to defend its patent, and high
prices, for fluconazole, an effective anti-fungal treatment for cryptococcal meningitis, an AIDS
complication that blinds and then kills within two weeks, and attacks about 9% of all AIDS
patients(20+% in Thailand). Fluconazole’s cost in Kenya is $18 per pill. Treatment requires two
a day for 8 weeks($1,080), then one a day for the rest of the patient’s life($540 a month). Good
Kenyan earnings would be $40-45 a month; the national health budget averages $5 per person
per year. Local doctors at a foreign aid agency are"so furious at Pfizer’s pricing policy"they
illegally smuggle generic Thai fluconazole pills(60 cents)into Kenya -"part of the titanic
struggle...between pharmaceutical companies and public health advocates over the cost of
drugs like fluconazole and who has the right to produce and market them". Thai action is based
on 1994 World Treaty on Intellectual Property(TRIPS)that allows countries to manufacture or
import generic drugs to avert national disaster(AIDS) -“compulsory licensing”. When South
Africa first proposed to use this clause, both Pfizer and the US government threatened severe
sanctions, but when it became a presidential campaign issue, the US changed its position. Pfizer
will now provide fluconazole free to any South African with AIDS who could not afford it; the
offer might eventually be extended to all Africa. Associated Press“US Hopes To Raise Anti-AIDS
Funding”NYT 11 Jul:-article reports that US government is raising its budget to stop the spread
and effects of AIDS to more than $200m, double the 1999 amount, but hopes for similar
increases from other donor countries. Head of the White House AIDS office stressed that,“With
no vaccine or cure in sight, we are at the beginning of an epidemic, not at the end”. Reuters“HIV
Drugs for All Would Cost $60 Billion - Report”NYT 11 Jul:-Panos Institute(London) report
estimates at least 12m with HIV worldwide(40% of those infected)need antiretroviral therapy at
a cost of $60b a year at current prices. Building national health systems and providing skilled
personnel ”would cost additional billions”, so prices must fall by 95% for the drugs to be
available to the majority of people infected. Hence, Panos recommends “compulsory licencing”
which grants the right to manufacture and sell locally at low prices. Since most drug companies
oppose this, debt relief is another possible solution. Joseph Kahn“U.S. Offers Africa Billions to
Fight AIDS”NYT 19 Jul:-the US Export-Import Bank will offer Sub-Saharan Africa $1b in loans
annually to finance the purchase of American AIDS drugs and medical services. Most of the new
loans would be provided at commercial interest rates(now about 7%)but at long(5-year)terms,
although a few “might be at a lower concessional rate”. This decision follows the agreement by
five multinational drug companies to cut the prices they charge African states for drugs to
combat AIDS, since these will still be expensive at prices discounted 80-90%. Some argue that
the straight donation of drugs is necessary; others that debt forgiveness of as much as $100m
globally would be a better way to free up funds. The UN estimates the cost of fighting AIDS in
Africa at”$3b annually if the nations hardest hit are to make significant progress in education,
prevention and care”. It is exploring the possibility of Africa buying generic drugs from Brazil
and India at even lower than 90% discounted prices (still $2000 per patient per year).
Reuters“Australia Hikes Overseas Spending on HIV/AIDS”onhealth.com, 27 Jul:-FM Downer
announced at a regional conference that the Australian pledge for ODA on world AIDS
assistance had been raised from A$130m to A$200m. Most will be allocated to the Asia-Pacific
region which has been relatively successful in holding the HIV epidemic at bay. Only three Asian
countries have infection rates above 1% among 15-49 year olds according to UNAIDS. These are
Cambodia, Myanmar and Thailand, and Thailand has been praised for instituting a successful
program to control an already serious outbreak. While the Australian six-year overseas initiative
already is committed to projects in Indonesia and Papua New Guinea, much funding is available
for new projects. This may be fortunate: the low UNAIDS rates are known to miss huge numbers
of already infected Asians. In India, 3.7m are known/admit to be infected already; in China, .5m -
mainly drug users - are(officially?)estimated to have HIV/AIDS. XINHUA“SADC Calls for Cheaper
Anti-AIDS Drugs” onhealth.com, 07 Aug:-the SADC Council of Ministers, with UN cooperation,
met the pharmaceutical companies’ unrealistic offer of discounted anti-AIDS drugs alone with
the reasonable counter-proposal that if very poor countries are expected to accept(and pay
for)the drugs package, it must be“as comprehensive as possible” and provide not only
medicines but “the whole range of services needed to make these interventions effective”.
Rachel L. Swarns, “Loans to Buy AIDS Drugs Are Rejected by Africans”NYT 22 Aug:-US Export-Import Bank offered 24 African countries $1b in annual loans(at commercial rates: 7%)to finance
purchase of anti-AIDS drugs - but none has accepted or is likely to, however desperate their
health situations. Those officials consulted for the article(South African, Namibian, AIDS experts
at the 14-member SADC)all said poor African countries are“already burdened by debt. Making
drugs affordable is the solution rather than offering loans that have interest”. Ironically, the West
is currently planning to forgive as much as $100b of poor countries’ debt precisely to free scarce
funds for health etc., and UNAIDS is seeking a steep drop in prices of costly anti-AIDS therapies
from drug firms for poor regions stricken by the pandemic. Further, South Africa and Thailand
recently authorized seizure of patents for AIDS drugs(with full US government approval)and
India, Bangladesh and Brazil simply ignore drug patent treaties in such circumstances and
produce generic drugs. Marc Lacey“President Urges Nigeria to Fight Tyranny of AIDS”NYT 28
Aug:-Clinton, on Nigerian visit, rightly urged elimination of AIDS-associated taboos:“we need
to fight AIDS, not people with AIDS”. He offered no new funds but promised duty-free status to
Nigerian exports and noted AIDS education is part of the military course US troops offer Nigerian
peacekeepers. President Obasanjo gives AIDS priority, but pointedly stressed:”We don’t see it
as a Nigerian disease. We see it as a world disease that is ravaging Africa most”. The Economist
30 Sep“Generic Genius: Indian Pharmaceuticals”(66-9);“A Problem of Patents”(69):-related
articles illustrate the fact that the global pharmaceutical industry is in a period of rapid and
important change: more/critical discoveries; huge/desperate needs; evolving
manufacturing/trade; bitter conflicts over patents; wildly divergent prices for some life-saving
drugs. More specifically the first reveals: drugs with sales of $40b are likely to lose patent
protection in the next three years; some Third World countries are major producers of cheap
generic drugs(some before patents run out); and some of India’s 20,000 drug makers in
particular are trying to break into rich world markets. The second article sees such low-cost
producers as a possible means of getting more expensive new drugs to the poor. Fluconazole,
protected by patents, now costs $10 a pill wholesale in the US, but only 25 cents in India where
its patent is not recognized and there are no R&D costs to recoup. Medecins Sans Frontieres
want to expand sales of affordable drugs from capable generic companies in Brazil, India,
Thailand in other poor countries. However, the latter also must have a “loose”patent policy.
Those with tough patent laws(e.g. South Africa)have to apply for special dispensation from the
patent holder, or invoke the TRIPS “national disaster”clause(see above) - and all countries are
now under obligation from WTO to implement strong TRIPS-type laws. AIDS is getting even
costlier for the poor.
(HENCEFORTH, I’m afraid coverage of items will have to be shorter, or it will simply not be
possible to keep up with the media. The gist of articles can be derived from their titles, UNLESS
titles are so ambiguous/ uninformative that brief notations are necessary. Unless it is otherwise
indicated, all articles were published for, or at least in, New York Times(NYT). Authors' names
are identified fully only the first time they are listed. After that, they may be identified only by
surnames. Dates are identified by: two-digit day-number, followed by first three letters of month.
All four (or last two) numbers of year ONLY IF AMBIGUOUS/NEW.)
A1. SOURCE/LEVEL OF DRUG PRICES IN NEEDY
COUNTRIES(COST)
McNeil“Selling Cheap‘Generic’ Drugs, India Copycats Irk Industry”01 Dec 00. Indian patent law
allows for generic drugs to be produced in the country, angering many pharmaceutical
companies. Tina Rosenberg“Look at Brazil” 27 Jan 2001:-Indian/Brazilian examples of how the
AIDS cost-patent crisis may be soluble: Third World generic production and sale. Reuters"Brazil
May Defy U.S. and Make More AIDS Drugs”03 Feb:-Brazilian patent law which enables patients
to take free antiretroviral drugs is being criticized by the US due to intellectual property rights.
AP“Drug Co. Offers Cheap AIDS Drugs”07 Feb:- company, Cipla Ltd, to sell AIDS drugs for $350
a year rather than $10 000. Reuters“Indian Firm Offers AIDS Cocktail for $1 a Day”07 Feb:-Cipla
Ltd. will sell cheap triple-cocktail of AIDS drugs to developing nations. McNeil“Indian Company
Offers to Supply AIDS Drugs at Low Cost in Africa”07 Feb:-Cipla Ltd. to sell their generic drugs
at $350 a year. AP“OXFAM Takes Aim at Pharmaceuticals” 11 Feb:-Oxfam is urging the WTO to
renew its position towards patent laws so that poor nations can receive generic versions of
AIDS drugs. Sara Chartrand“ Patents: In Health Emergencies, Brazil Allows the Copying of
Drugs”19 Feb. Reuters“ S.Africa Okays Pfizer AIDS Drug Distribution”21 Feb:-US pharmaceutical
Pfizer to give its AIDS drug Diflucan for free distribution within hospitals in order to prevent
resale of the drug. AP“South Africa to Get Free AIDS Drug”21 Feb:-same coverage as above.
Reuters“CIPLA to Meet With WHO on Discounted AIDS Drugs”26 Feb:-:Cipla’s offer to the charity
is aimed primarily at Africa, where antiretroviral drugs used in the West are out of reach of
virtually all the 25.3 million people on the continent who are infected with the HIV virus”.
Reuters“Firm Creates Africa AIDS Fund to Deliver Free Drugs”28 Feb:-small US firm Phyto-Riker
creates $250m fund to buy and distribute AIDS drugs free in Africa. Reuters“Merck Leads New
Round of AIDS Drug Price Cuts”07 Mar:-US pharmaceutical Merck and Co Inc. says it will
distribute their AIDS drugs in poor nations at cheaper price even though the company will
receive no profit on their sale. Reuters “AIDS Drugs Land in South Africa Amid Patent Dispute”08
Mar. Pharmaceutical Manufacturers Association of South Africa (PMA)is in a legal dispute with
the S. African government over the free distribution of AIDS drugs donated by US. Sheryl Gay
Stolberg“AIDS Drugs in Africa: If Cedes to When”10 Mar:-PMA who represents 39 drug
companies have sued S. African government over distribution of free AIDS drugs while
protesters demand price cuts in region. McNeil“Yale Pressed to Help Cut Drug Costs in
Africa”12 Mar:-legal battle among university students and the university’s patent contract
agreement with Bristol-Myers Squibb over the distribution of the AIDS drug d4T to Africa.
AP“Romania to Get HIV Drug Price Cut”12 Mar:-Merck & Co. to provide reduced prices on their
AIDS drugs due to “only 40 percent of AIDS and HIV infected patients receive drug therapy”.
AP“Studies: HIV Drugs a Good Buy”14 Mar:-US study shows AIDS drugs are of better value at
extending patients’ life than drugs for other illnesses. Petersen and McNeil“Maker Yielding
Patent in Africa for AIDS Drug”15 Mar:-US pharmaceutical Bristol-Myers Squibb will no longer
try to stop cheap generic versions of AIDS drugs “d4T”, since they are distributed to many
infected people in Africa. AP “Abbott Cuts African AIDS Drug Prices”27 Mar:-US drug maker
Abbott Laboratories will sell their AIDS drugs “Kaletra” and “Norvir” at extremely cheap prices
to African nations. Reuters“Brazil Wins Fight Over Prices of Merck AIDS Drugs”29 Mar:-due to
pressure from the Brazilian government, US drug manufacturer Merck and Co. will reduce the
price of its two AIDS drugs “Indinavir” and “Efavirenz” in the country. Petersen and Larry
Rohter“Maker Agrees to Cut Price of 2 AIDS Drugs in Brazil”31 Mar:-Swiss pharmaceutical
Hoffman-La Roche is also pressured by the Brazilian government to slash the price of their AIDS
drug “nelfinavir”. Bloomsberg News“ F.T.C. Accuses Drug Makers of Collusion to Delay
Generics”03 Apr:-Federal Trade Commission has discovered a $90m payment by many big
pharmaceutical companies to small generic drug maker firms in order to delay the distribution
of low-cost AIDS drugs. Reuters“6 Companies in New AIDS Pact”06 Apr:-UNSG Annan wins
agreement from major drug companies to continue cutting prices of AIDS drugs to poor nations.
Petersen “Consumer Groups Unite To Fight For Generic Drug” 08 Apr:-US consumer groups
have filed a lawsuit to Bristol-Myers Squibb because the company is trying to block other cheap
generic versions of their drugs available to the public. AP“Bush Plan Cuts Drug
Reimportation”09 Apr:-Bush administration will not allow cheap, re-imported US-made drugs
to be distributed within the country. AP“South Africa Drug Suit Postponed”18 Apr:-lawsuit by
pharmaceutical companies to the S. African government over patent rights on the distribution
of AIDS drugs, is receiving wide criticism by AIDS activists and labour unions and demand the
lawsuit to be removed. Rachel L. Swarns“Drug Companies Begin Talks With South Africa”18
Apr:-amidst popular and international dissent over the lawsuit by the 39 pharmaceutical
companies, the drug companies are negotiating with the S. African government over importing
generic drugs. Swarns“Drug Firms Drop South African AIDS Case”19 Apr:-the attempt to stop
S. Africa importing/producing cheaper anti-AIDS medication ends. Andrew Pollack“New
Analysis: Defensive Drug Industry Fuels Fight Over Patents”20 Apr:-editorial dealing with
pharmaceutical companies and their protection of patent laws are under attack due to the high
cost of the drugs in which people in poor nations cannot afford to buy. AP“Profits Still Plague
AIDS Drug Cos.”21 Apr:-closer look as to how several major drug companies are concerned over
patent laws and the rise of public opinion weakening its importance. Petersen“Lifting the Curtain
on the Real Costs of Making AIDS Drugs”24 Apr:-generic drug-makers talk about the low cost
of producing generic AIDS drugs and how if benefits the survival of many HIV infected victims.
Reuters“Global AIDS Fund To Push Drug Firms To Cut Prices”01 May:-British ministers propose
rich nations to contribute money to the UN’s Global AIDS Fund in order to pressure
pharmaceutical companies to lower their prices of AIDS drugs. Barbara Crossette“Brazil’s AIDS
Chief Denounces Bush Position On Drug Patents”03 May:-Bush accused in being tough on
Brazilian generic AIDS drugs. AP“Drug Companies Cut Africa Prices”03 May:-many
pharmaceutical companies considerably reducing the price of their AIDS drugs, among these
companies Swiss-based Novartis. WHO and Medecins Sans Frontieres are grateful for the offers.
Terence Neilan “President Pledges $200 Million to New Fund To Fight AIDS”11 May:-money to
be given to developing nations especially Africa. AP“WHO Adopts Weakened AIDS Statement”19
May:-US and European states dismiss any authority the WHO has over the patent laws, which
they claim the WTO is responsible. Reuters“Glaxo to Cut Cost of AIDS Drugs for Kenya”24 May:-major AIDS drug maker will reduce price after Kenyan threat to acquire cheaper drugs. AP
“Pfizer expands Free AIDS Drug Plan”06 Jun:-US company will lower price of AIDS drugs to 50
poor nations. Crossette“AIDS Fungus Drug Offered to Poor Nations”07 Jun:-same story. Andrew
Ross Sorkin “Bristol-Myers Squibb to Acquire DuPont Unit”08 Jun:-$7.8b paid for drug unit in
order to compete in world market. AP“Swiss Insurer Gives to UN AIDS Fund”08 Jun:-the first
corporate donation of $1m by Winterthur Insurance to the UN AIDS Fund. Don Colarusso“Hope
for AIDS Vaccine Fuels a Stock’s Ascent”10 Jun:-Vaxgen a small US pharmaceutical company
has been using human test subjects for their newly developed AIDS drug “AIDS vax” which has
proven to be effective, giving them a rise on the company’s stock price, many researchers are
skeptical of the effectiveness of the drug. Robert Pear “Measure Easing Imports Passes in
House”12 Jul:-US House of Representatives allowed for public to import cheap generic drugs
for personal use, angering many pharmaceutical companies. AP“Gates Donates $100M to U.N.
for AIDS”19 Jun. AP“Coca-Cola to Help Africa AIDS Fight”20 Jun:-among other MNCs allowing
for transport t/distribution of AIDS drugs in many AIDS-stricken regions of the continent
particularly S. Africa. McNeil “U.S. at Odds With Europe Over Rules on World Drug Pricing”20
Jul:-Bush and the EU debating as to how to better distribute AIDS drugs to developing nations.
The US president stance is to protect patent rights of the AIDS drugs while the EU is pushing
for more generic drugs to be allowed in poor countries. Christopher S.Wren “Holbrooke Has New
Role: Leading Fight Against AIDS”20 Jun:-former US ambassador to UN pressing MNCs to
contribute to AIDS costs in LDCs. AP“U.N. Welcomes Corporate AIDS Funds”21 Jun:-Due to
many MNC’s such as Coca Cola and Chrysler contributing by giving donations for the fight
against AIDS, UN is encouraging them to give to the Global AIDS fund as well . Crossette “U.S.
Drops Case Over AIDS Drugs in Brazil”26 Jun:-US allows patent case to be settled out of court.
Peterson”Drug Maker Is Set to Ship Generic Prozac”02 Aug. US company awaiting the Food and
Drug Association (FDA)approval in order to ship their product all over the world. Reuters
”Central America Teams Up to Buy AIDS Drugs”11 Aug:-six countries to buy drugs at bulk-price
from major companies. AP“Brazil to Strip Patent on AIDS Drug”23 Aug:-claiming national
emergency, Brazil removes patents on AIDS drugs distributed by Roche pharmaceuticals.
AP“HIV Vaccine Creators Share Patents”24 Aug .US and British drug manufacturers have signed
a three year agreement on the ownership of their AIDS vaccine which is in a testing phase.
Peterson “Roche Asks for Meeting With Brazil Health Minister”24 Aug. Reuters “Brazil and
Roche Agree on AIDS Drug Price Cut”31 Aug:-Brazil persuaded Roche to lower price since its
government will allow for the production of the“nelfinavir”a generic AIDS drug that Roche
manufactures. Mcneil“A Rush for Cipro, and the Global Ripples”17 Oct:-As the US is desperate
to buy Cipro, an antibiotic designated to cure against Anthrax, from cheaper generic companies,
the developing nations will copy the US’s move for the purchase. Pollack“Drug Makers Wrestle
With World’s New Rules”21 Oct:-major drug companies claim that their production of antibiotics
such as Anthrax is due to US demand for countering bioterrorism but their real priority reflects
the US government’s creation of a rich market for Anthrax cures. Edmund L.Andrews“Bayer
Reaches Deal on Cipro to Protect Patent in Canada”23 Oct. Keith Bradsher with Edmund
L.Andrews “U.S. Says Bayer Will Cut Cost of Its Anthrax Drug”24 Oct:-A price concession
between the Bush administration and Bayer has been made in order for the US to buy Cipro at
a patent price. AP “Smallpox Vaccine Makers Watch Feds”25 Oct:-Pharmaceutical industries are
worried that the US will not purchase their vaccine drugs but rather generic. Economist“Dealing
with anthrax: Patent problems pending”25 Oct:-Article discusses how developed nations are
able to break patent laws while developing nations cannot. Bradsher “Bayer Halves Price for
Cipro, but Rivals Offer Drugs Free”26 Oct:-Keith Bradsher with Melody Peterson “Drug
Companies Aim to Please”27 Oct:-Major drug companies are looking to maintain their patent
laws through public relations and their contribution to bio-terrorism in the US. Daniel Akst “It’s
Time for Teamwork on New Drugs”04 Nov:-an editorial commenting the problems of patent laws
and its effect on poorer nations who cannot afford to buy AIDS drugs. Leslie Wayne and Melody
Petersen“A Muscular Lobby Tries to Shape Nation’s Bioterror Plan”04 Nov:-Major
pharmaceutical companies winning concessions to maintain their patent laws in the US while
maintaining a close relationship with the Bush administration. McNeil“Patens or Poverty? A New
Debate Over Poor AIDS Care in Africa”05 Nov. Milt Freudenheim“ Court Reverses U.S. Approval
of Generic”07 Nov:-US federal court overturned the government’s approval for the distribution
of a generic pill. Amy Harmon“Suddenly , ‘Idea Wars’ Take on a New Global Urgency”11 Nov:-As
the meeting for global trade in Doha, Qatar is near, many questions by developing nations
emerge over the US handling of patent laws. Reuters“Trade Round Hopes Rise After WTO Deal
on Drugs”12 Nov:-An agreement over the sale of generic drugs to developing nations has
emerged during the Doha Round conference. McNeil“Tuberculosis Group Tries to Spur Research
for New Antibiotics”15 Nov:-Pharmaceutical companies research for cure that bring in $1billion
yield of return, many diseases such as tuberculosis do not get the proper research due to the
lack of financial incentive. Louis Uchitelle “U.S. Industries Largely Favor Decision on Global
Trade”15 Nov:-Generic medicine can be made in developing nations for the treatment of AIDS
and other lethal epidemics. Celia W.Dugger “A Catch-22 on Drugs for the World’s Poor”16 Nov:-Poor countries do not have the essential resources for the possibility of producing generic
medicine for the treatment of AIDS. Jennifer L.Rich“Brazil Welcomes Global Move on Drug
Patents”16 Nov. AP“Activists Slam Drug Dev. Cost Study”30 Nov:-A study shows that
pharmaceutical companies’ claim for the cost of their medicine is deliberately overpriced.
AP“Profits From AIDS Drug Help Samoans”14 Dec:-The healing knowledge of a particular tree
in Honolulu might bring a cure for AIDS. Larry Rohter“Brazil Sees Promise in Jungle Plants, but
Tribes See Peril”23 Dec:-By having “nearly one-quarter of the world’s plant species”, Brazil is
pushing for restrictions that will allow these plants to be researched for medicinal purposes
only. McNeil “New List of Safe AIDS Drugs, Despite Industry Lobby”21 Mar 2002:-WHO
listed/approved generic drugs thus angering multinationals. AP “AIDS Group Battles
GlaxoSmithKline”27 May:-Activists are arguing that the British pharmaceutical is still overpricing
its product. Economist “The bitter pills”05 Jun:-Bristol Meyer, US drug company, being sued
over its prevention of not allowing for generic medicine. Reed Abelson“Glaxo Freezes Prices
AIDS Drugs in U.S.”21 Jun. Elizabeth Olson“U.S. Backs New Trade Rules on Drugs”25 Jun:-US
agrees on the sale of generic drugs against AIDS to be available in poorer nations. Reuters
“AIDS Conference Opens Amid Controversy”07 Jul:-Barcelona international AIDS conference
was overshadowed due to AIDS activists demanding for cheaper drugs to be sold to poorer
nations. NYT“Brazil to Share AIDS Drugs”09 Jul. Reuters“AIDS Activists Trash EU Commission
Stand at Meeting”10 Jun:-AIDS activists in Spain want the EU to contribute to the AIDS effort.
Economist“AIDS: Hope for the best, Prepare for the worst”11 Jul:-A concise article dealing with
the positive results from the AIDS conference in Spain. Howard W. French“Whistling Past the
Global Graveyard”14 Jul:-Richer nations reluctant to contribute to AIDS fund due to their focus
on terrorism or the gulf war. Economist“Generic drugs: A good week for copycats”01 Aug:-Generic manufacturers receive legislative support in producing their medicine. Henri E.
Cauvin“Mining Company to Offer H.I.V. Drugs to Employees”07 Aug:-A company in South Africa
is supplying AIDS drugs to its employees. Economist“Business and AIDS: Digging Deep”08
Aug:-South African miners receive AIDS drugs from its employer. Economist“AIDS and South
African business: Strategic Caring” 03 Oct:-Many companies in South Africa are initializing new
policies to stop the spreading of AIDS. AP“FDA to Review New AIDS Drug Fuzeon”11 Oct:-An
expensive AIDS drug has been discovered in which its approval process will be shortened.
NYT“Annan Warns China of an AIDS Epidemic”15 Oct:-Gregory Crouch“Europeans Investigate
Resale of AIDS Drugs”29 Oct:-Trafficking of AIDS drugs which were meant to be sold to poorer
nations are being sold in the European market. Economist“Face value: The acceptance face of
capitalism?”12 Dec:-Drug companies’ bosses need an exceptional public relations image in
order for their companies to be seen credible. Economist“Drugs and Developing Countries: Pill
Paupers”19 Dec:-Report on the WTO pushing for a concession between drug companies and
the generic manufacturing of their product. Elizabeth Becker“U.S. Official to Discuss Trade as
Africa Hopes to Talk AIDS”11 Jan 2003:-Elizabeth Becker and Edmund L.Andrews“Performing
a Free Trade Juggling Act, Offstage”08 Feb:-US trade representative will decide if generic drugs
should be sold to sub-Saharan Africa. Economist 22 May“The Cost of AIDS: An Imprecise
Catastrophe”(68-71):-"The most dreadful cost of AIDS is in lives lost. A second cost, shared by
those not infected, is economic. However, estimating the damage done by the disease, especially
in southern Africa’s mostly feeble economies, is an inexact exercise even by the standards of
economics, because AIDS has struck hardest in areas where data are least accurate:
subsistence farming, casual labour markets, rural barter and so forth”; Amelia Gentleman & Hari
Kumar“AIDS Groups in India Sue to Halt Patent for U.S. Drug”NYT 11 May 2006:-“AIDS groups
this week brought important test of India’s new patent law, which restricts ability of Indian
companies to produce low-cost generic drugs. Two patients-rights groups sued to stop Gilead
Sciences, California biopharmaceutical company, from patenting the antiretroviral drug Viread -
company’s brand-name version of tenofovir, which is available [in India] as a generic drug. If it
is patented, the groups contend, making the cheaper versions will become illegal, and the drug
will become too expensive for patients...in developing countries... Doctors Without Borders
[stated:] ‘People in Africa and Caribbean are relying on India to produce these drugs. Quality
matches that of US-manufactured drugs, but prices affordable’. Lawyers for two [Indian]
groups... presented arguments contending tenofovir not new drug, but modified version of
earlier drug, and therefore not eligible for new patent under India’s new law. Those backing legal
challenge hoping to gain legal precedent for use in other patent applications... WHO recently
recommended tenofovir for patients just starting treatment for AIDS and those who have been
receiving antiretroviral treatment therapy but resistant to other treatments. In [rich] countries,
Gilead’s tenofovir costs $5,718/person/year. Cipla, one of largest companies in India, marketing
version called Tenvir, at cost of $700/person/year in India. Chairman Cipla said drug eventually
available in Africa for about half that price. But Tenvir would have to be withdrawn if Gilead were
given patent,.. in effect for 12 years. Gilead Sciences said... ‘[W]e believe Viread represents
innovation and parentable under Indian law. We will use this patent responsibly, and not block
access to our medication in India or other resource-limited countries where HIV epidemic hit
hardest’. Company... ‘pursuing broad policy of nonexclusive voluntary licensing under patent
to generic manufacturers in India for local Indian market as well as provision for manufacturers
to export product to 97 developing-world countries included in Gilead’s access program’”;
A2. EFFECT/ADJUSTMENT OF DRUG PRICES IN
NEEDY COUNTRIES
Jennifer L. Rich“Explosion of Generics About to Occur in Brazil”23 Nov 2000:-joint venture
between Teva, generics manufacturer, and local Loboratorios Biostetica, makes more generics
available. Reuters“Chirac Says EU Not Doing Enough to Combat Aids”01 Dec:-French President
claims EU should increase anti-AIDS work in Africa. Swarns“South Africa to Distribute $50
Million in Donated AIDS Drugs”02 Dec. AP“U.N. Steps up AIDS Fight in Africa”07 Dec:-UNSG
Annan and African leaders pledge to unite political-economic resources to conquer AIDS.
AP“U.S. to Help Fight AIDS in Botswana”12 Dec. McNeil“Romania’s AIDS Children: A Lifetime
Lost”07 Jan 2001. Reuters “Bill Gates Gives $100 Million for AIDS Vaccine”27 Jan.
Reuters“Economic Leadership Lacking in Global AIDS Epidemic”05 Feb:-Dr. Jeffrey D. Sachs
claims economic response to AIDS pandemic ‘utterly inadequate’. McNeil“Oxfam Presses to
Make Drugs Cheaper for Poor Countries”13 Feb. Reuters“UN Agency Urges Drug
Cooperation”16 Feb:-head of Joint UN Program on HIV/AIDS(UNAIDS)urges cooperation among
activists, pharmaceutical firms, governments. Economist “Science and Profit”17 Feb:-Editorial
argues drug companies must cover R&D costs somewhere. They would be willing to increase
their sales in poor countries through extremely low prices there - if they could maintain their
profits in the West. “The case for much more generous provision of life-saving drugs to the
developing countries is irresistible both morally and as a matter of economics. But it is naive,
wrong, and in the long run counter-productive, to expect the cost of this aid to be met out of
drug-company profits.” Reuters“AIDS Drug Costs Must Fall in Poor Nations: UN”21 Feb:-UNSG
Annan’s report to UNGA states: "people in developing countries are dying needlessly for lack
of appropriate care”; hence drug companies and governments must do more”through all
possible means”to bring down the cost of AIDS therapies so patients in poor nations can gain
access. AP“Priest To Import AIDS Drug to Kenya”21 Feb:-US priest working with HIV-positive
orphans in Kenya plans to import cheap generic drugs from India. McNeil“Bush Keeps Clinton
Policy on Poor Lands’ Need for AIDS Drug”22 Feb. AP“Aid Agency To Distribute AIDS Drugs”24
Feb:-Doctors Without Borders will buy anti-AIDS cocktail from Indian company Cipla for 10 poor
countries. Reuters “Protests As Drug Firms Take on S.African Govt”05 Mar. AP“South Africa
Fights Over Aids Drugs”05 Mar. Reuters“South African AIDS Drug Case Postponed Until April”06
Mar. AP“Botswana Firm Subsidizes AIDS Drugs”07 Mar:-DeBeers (diamonds)will subsidize anti-AIDS drugs. AP“S.Africa: AIDS Drug Need Is Heeded”08 Mar:-Merck and Co plans to sell two key
AIDS drug to poor countries at 1/10 normal price, while Indian-based Cipla offers to sell cheap
generics. Swarns“South Africa May Cite Crisis to Lower Cost of AIDS Drugs”12 Mar:-government
considering declaration of national emergency to eliminate legal obstacles to
importing/producing cheap generic HIV/AIDS drugs. AP“No State of Emergency in S. Africa”14
Mar:-President Mbeki refuses to declare state of emergency over AIDS epidemic. Swarns “No
National Emergency, South African Leader Says”15 Mar. AP“Ivory Coast Winning AIDS Drug
War”19 Mar:-Ivory Coast quietly importing generic AIDS drugs for years without problems.
Swarns“AIDS Obstacles Overwhelm a Small South African Town”29 Mar:-in Hlabisa, single
doctor must dispense all desperately-needed anti-AIDS drugs. Reuters“South Africa Says Key
AIDS Drugs Still Too Costly”06 Apr. AP“Mali Gets Deal on Western HIV Drugs”08 Apr:-Mali to
obtain cut-rate HIV drugs from four major firms. AP“Few Benefit From African HIV Deals”11 Apr:-six sub-Saharan countries strike deals with major Western drug firms but only few thousand
expected to benefit. Reuters“South Africa Confident of Winning Drug Court Case”12 Apr:-government(sic) expects to win landmark patent case against world’s most powerful drug firms.
Economist “Economics Focus: Markets for Ideas”12 Apr:-discusses the economic arguments
pro and con intellectual property rights, concluding that since ideas are not reduced through
use, “Poor countries have every reason to question the [intellectual property-related] trade-policy bargain”. Reuters“Mandela Slams Drug Makers, Chides S. African Government”20 Apr:-former president castigates 39 major drug firms for taking South Africa to court to prevent
import/manufacture of cheap AIDS drugs. AP“Africa Ministers OK AIDS Drug Plan”25 Apr:-agree
on joint declaration to import generic AIDS drugs, and boost spending dramatically on AIDS
programs. Reuters“A Call for AIDS Superfund”26 Apr:-UNSG Annan proposes global superfund
to halt/reverse pandemic which kills 2.8 million annually. AP“African Leaders Discuss AIDS
Drugs”27 Apr. NYT “Africans Unite in Seeking More Funds to Halt Spread of AIDS”28 Apr.
Joseph Kahn“Rich Nations Consider Fund of Billions to Fight AIDS”29 Apr. Crossette “Experts
Say That Cheaper Drug Treatments Alone Are Not Enough”30 Apr:-claim need more effective
education/prevention, better clinics, more trained health care workers, imaginative development
projects to tackle AIDS epidemic. Reuters“Annan Calls on Foundations to Back AIDS War
Chest”30 Apr:-UNSG calls on US foundations to throw financial weight behind new global AIDS
fund. Crossette“U.N. Chief Asks for New Funds to Fight AIDS”09 May:-Annan asks Bush
Administration to give more for Africa. Reuters“Glaxo To Cut Cost Of AIDS Drugs For Kenya”24
May. Reuters“UN’s Annan Warns AIDS Wrecks World Economic Growth”01 Jun:-Annan tells US
Chamber of Commerce,”As AIDS creates more poverty and deepens inequalities, it fuels the
growing public backlash against globalization.” Economist“Aid and AIDS: Gambling with
Lives”31 May:-an independent global fund to pay for ending global diseases is attainable
through voluntary donations. Among donors: UN, rich and poor countries, NGOs. Reuters“South
Africa Seeks Cheaper Drugs After Court Win”04 Jun:-gains legal victory over companies trying
to stop import of generic AIDS drugs. AP“Pfizer Expands Free AIDS Drug Plan”06 Jun.
Crossette“AIDS Fungus Drug Offered To Poor Nations”07 Jun:-Pfizer offers 50+ poor nations
unlimited free supply of AIDS-related drug. Reuters “African Ministers Say AIDS Drugs Too
Costly”08 Jun. AP“Swiss Insurer Gives To UN AIDS Fund”08 Jun:-Winterthur Insurance first
corporate donor to new UN AIDS fund. Don Colarusso“Hope For AIDS Vaccine Fuels A Stock’s
Ascent”10 Jun:-despite skepticism, shares of biotech company Vaxgen soar. AP“In Africa, HIV
Treatment Erratic”18 Jun:-widespread poverty makes chances of treatment very uncertain.
AP“Gates Donates $100M To UN For AIDS”19 Jun. Christopher S. Wren “Holbrooke Has New
Role: Leading Fight Against AIDS” 20 Jun:-ex-US Amb. to UN returns to international arena.
Robert Pear“Measure Easing Drug Imports Passes in House”12 Jul. AP“Study: Fighting AIDS
May Cost $9B”18 Jul. AP“Health Experts Ask G8 for AIDS Money”18 Jul. Reuters“G8 to Launch
AIDS Fund, But Short of U.N. Target”20 Jul. AP“Coca-Cola to Help Africa AIDS Fight”20 Jul.
McNeil“US at Odds With Europe Over Rules On World Drug Pricing”20 Jul. AP“UN Welcomes
Corporate AIDS Funds”21 Jul. Crossette“US Drops Case Over AIDS Drugs in Brazil”26 Jul:-US
unexpectedly withdraws patent complaint and agrees to settle out of court. Petersen“Drug Maker
is Set to Ship Generic Prozac”02 Aug. Reuters“Central America Teams Up to Buy AIDS Drugs”23
Aug:-six nations buy AIDS drugs in bulk in attempt to negotiate lower prices. AP“Brazil To Strip
Patent on AIDS Drug”23 Aug. AP“HIV Vaccine Creators Share Patents”24 Aug. Petersen and
Rich“Roche Asks for Meeting With Brazil Health Minister”24 Aug:-Brazil may break Roche patent
in order to produce generic AIDS drugs. Reuters“Brazil and Roche Agree On AIDS Drug Price
Cut”31 Aug. AP“S.Africa Official: AIDS Drugs Costly”13 Sep:-while drug companies have cut
price of medications, country still cannot afford to provide them. Agence France-Presse“Nigeria
Buying Generic Drugs for an AIDS Treatment Trial”30 Sept:-will begin trial program in order to
receive cheap imported generic drugs. Marc Lacey“Kenya Losing Needed M.D.’s as Low Pay
Causes Flight”07 Oct:- Many Kenyan doctors are leaving for Southern parts of Africa due to
better working conditions/wages. AP“Generic AIDS Drug in South Africa”07 Oct:-S. African drug
manufacturer will be allowed to produce and sell three key AIDS medicines in region.
McNeil“Patents or Poverty? A New Debate Over Poor AIDS Care in Africa”05 Nov. AP “Study:
Cycling Drugs May Curb AIDS”03 Dec:-AIDS patients take drug combination for week and then
stop for week. May be able to control HIV, reduce side effects and cut costs in half. Daniel
Altman “Diagnosis of World’s Health Focuses on Economic Benefit”21 Dec:-WHO claims foreign
aid plus poor governments’ own funds could improve health of people. Report states how money
from donor states could tackle AIDS, malaria, tuberculosis and diseases common to Third World.
AP“Generic AIDS Drugs Come to S. Africa”29 Jan 2002:-humanitarian aid organization importing
three AIDS medicines into S. Africa due to country’s refusal to legalize these cheap copies of
patented AIDS drugs. Reuters“Global Anti-AIDS Fund Swings Into Action”29 Jan:-Geneva-based
UN organization, Global Fund, calling all countries to suggest projects to contain spread of
AIDS, tuberculosis and malaria, and generate funds from donor states. Reuters“W. Bank Sets
$500 Million Anti-Aids Loan for Africa”07 Feb:-total World Bank anti-AIDS assistance is $1 billion
in financial year, “helping African countries act with much greater speed and flexibility against
HIV”. Sheryl Gay Stolberg“AIDS Fund Falls Short of Goal and U.S. Is Given Some Blame”13 Feb:-Annan urges donors to contribute $7 billion a year in fight against AIDS. US pledge of only $200
million sets poor example. Kahn“A Star Close to the Heart of Aid Policy”15 Mar:-Bono, lead
singer of band U2, has lobbied White House to contribute more to fight AIDS. McNeil“New List
of Safe AIDS Drugs, Despite Industry Lobby”21 Mar:-WHO releases list of manufacturers of
safe/cheap AIDS drugs, challenging pharmaceutical multinationals -who want only patent-holders to decide what discounts to offer on products. Reuters“Calls for Help Exceed Global
AIDS Fund Resources”25 Mar:-large number of requests by poor nations, particularly African,
seeking $1.15 billion this year to fight AIDS, tuberculosis and malaria. Global Fund states amount
is 50% more than it has available. Adam Clymer“Helms Reverses Opposition to Help on AIDS”26
Mar:-former US senator Jesse Helms has changed his negative view on AIDS funding, by
pushing for $500 million to be put towards $27 billion requested. AP“Cheap AIDS Drugs Not
Getting to Africa”28 Mar:-25,000 of 2.5 million people infected by AIDS are receiving drugs.
Causes: high cost of daily treatments and price of medicine in Africa. NYT“Demand For AIDS
Funds Exceeds Supply”28 Mar:-poor nations seek $1.7b, more than half Global Fund has been
able to collect from donors. AP“U.S. to Help Caribbean Fight AIDS”21 Apr:-US agrees to send
health experts to Caribbean and pledges to give $500m this year, and proposes to give $1.1b
next year to fight AIDS. McNeil“W.H.O. Moves to Make AIDS Drugs More Accessible to Poor
Worldwide”23 Apr:-WHO releases guidelines on which AIDS drugs poor nations should use,
while allowing competition between patent-based and generic-drug manufacturers. AP “AIDS
Fund Issues $378M in Grants”25 Apr:-Africa will receive 52% of money with rest to be distributed
to other poor nations. Economist“How to live with it, not die of it”05 May:-Africans infected with
AIDS could later create negative economic impact due to rise in orphaned children, halting
much-needed development. Economist“AIDS in southern Africa: Fighting back”05 May:-southern
region of Africa, especially Botswana and Mozambique, with world’s highest rate of HIV
infection, could create 1m orphans, poverty, and violence in region. Stolberg“Unlikely Coalition
Stirs Congress in AIDS Battle”12 May:-Republican reps in US are pushing to add $200m towards
Global AIDS Fund. AP“Zimbabwe Lifts Import Restriction on AIDS Drugs”28 May. Henri E.
Cauvin“Zimbabwe Acts to Obtain AIDS Drugs at Low Prices”01 Jun:-HIV has become national
emergency in Zimbabwe, allowing it to obtain generic drugs at low prices. AP“Bush Proposes
Spending $500 Million on AIDS”19 Jun:-money intended only to stop transmission of virus from
mother to child during pregnancy and after birth. Stolberg “Bush Offers Plan to Help Mothers
Avoid Passing H.I.V. to Babies”20 Jun:-provides treatment for 2m mothers in Africa and
Caribbean over each of next 5 years. Altman“Modest Anti-AIDS Efforts Offer Huge Payoff,
Studies Say”05 Jul:-research provided by variety of government and private groups shows that
proper measures(e.g. condom distribution, improved status of women, voluntary
counselling)would save 29m from AIDS. AP“Caribbeans to Buy AIDS Drugs at Discounts”07 Jul:-6 AIDS drugs manufacturers allow sales at lower prices. Reuters“AIDS Conference Opens with
Call for Drugs for Poor”07 Jul:- 14th International AIDS Conference in Barcelona: activists and
top officials demand AIDS drugs at lower prices in countries where most needed. NYT“Brazil to
Share AIDS Drugs”09 Jul:-through donation of generic drugs, plus knowledge of drugs.
Reuters“AIDS Activists Trash EU Commission Stand at Meeting”10 Jul:- activists push EU to
donate more towards Global Fund against AIDS. AP “Health Gap in Rich, Poor Countries”11 Jul:-
AIDS Conference illustrates need for wealthier nations to contribute more for AIDS epidemic.
Projects life expectancy of 30 years in many AIDS-stricken regions of Africa. Economist “AIDS:
Hope for the best, Prepare for the worst”11 Jul:- AIDS Conference has allowed positive changes
to take effect: better treatment for infected; cheaper AIDS drugs for poor nations.
Economist“AIDS: The long war”11 Jul:-as number of people dying reaches 9,000 a day, crucial
need for donor nations to provide more to stop virus. Reuters“Clinton to Tell West to Pay Up for
AIDS Treatment”11 Jul:-Being the co-founder of the International AIDS Trust, Clinton sees AIDS
as the most troublesome issue in world. Altman“ Former Presidents Urge Leadership on
AIDS”13 Jul:-Nelson Mandela and Bill Clinton urged heads of state and business executives to
take a stand against AIDS. Howard W. French “Whistling Past the Global Graveyard”14 Jul:-
AIDS epidemic is slowly affecting other nations who were not affected by the disease, such as
Russia and China. Experts argue that in future all countries in world will be affected by disease.
Reuters“S.Africa Health Minister Slams AIDS Global Fund”21 Jul. AP“African AIDS Activists
Unite”22 Aug:-the movement organized in South Africa are pushing for easier accessibility of
AIDS medicine. Agence France-Presse“China Raises Estimates of HIV Cases and Warns of
Increases”06 Sep. Elisabeth Rosenthal “China Now Set to Make Copies of AIDS Drugs”07 Sep.
Economist“China: Owning up to AIDS A “state secret” is revealed”12 Sep:-Chinese government
has allowed for AIDS drugs which have expired patents across world, are permitted to be
produced. Economist“Intellectual property: Patently problematic”12 Sep:-Intellectual-Property
Rights (IPR) known for its patent and copyright laws have modified their views on the need for
AIDS medicine to be copied from existing drugs. Economist“Intellectual property: Imitation v
inspiration”12 Sep:-A debate among pro/anti patent supporters when dealing with developing
nations. AP“China OKs Generic Anti-AIDS Drug”16 Sep. AP“AIDS Group Files Drug Price
Complaint”19 Sep:-AIDS activists are pushing for two companies to drop the price on their anti-AIDS drug. Reuters“Cheap Vaccine Sought for Africa”20Sep:-Aid agencies are urging drug
companies to make cheaper drugs against a new strain of meningitis in Africa. Geoff Dyer“UN-backed Aids fund approves generic drugs”12 Oct:-Global AIDS fund is issuing a list from WHO
which indicates generic AIDS drugs at cheaper price. McNeil“U.N. Disease Fund Opens Way to
Generics”16 Oct:-Global Aids Fund to fight AIDS will encourage poor countries to buy cheap
generic medicines. Gregory Crouch“ Europeans Investigate Resale of AIDS Drugs”29 Oct.
Reuters”World Trade Talks Struggle Over Cheap Drugs Access”25 Nov:-25 WTO members
debate in a conference in Geneva as to which developing nations are able to receive cheap AIDS
generic drugs or should there be any restrictions. Reuters “Trade Talks Fail to Break Deadlock
Over Cheap Drugs”27 Nov. Agence France-Presse“Limits Proposed on Low-Cost Drug
Program”29 Nov:-Drug manufacturers arguing that cheap medicine should only be available to
countries that are suffering major epidemics and not for other less dangerous diseases”
AP“Diplomats Prod U.S. on Affordable Drugs”17 Dec:-Members who participated in Geneva
Conference are blaming Bush administration for not allowing cheaper medicines to be attainable
for poor countries. Elizabeth Becker“U.S. Official to Discuss Trade as Africa Hopes to Talk
AIDS”11 Jan 2003:-Social unrest as US ambassador is travelling to discuss his country’s
decision to block trade deals to import generic drugs into poor countries. AP“Chinese Co.
Distributes Anti - AIDS Drug”28 Jan. Economist “AIDS: The other war”30 Jan:-With Bush
promising to pledge $15 billion over 5 years in the fight against AIDS, questions arise as to how
the money should be spent. James Lamont“UN Fund to Fight Aids in Jeopardy”30 Jan:-Global
Fund to fight Aids agency has declared that it will run out of money and not be able to afford new
projects. Rachel L. Swarns“Free AIDS Drugs in Africa Offer Dose of Life”08 Feb:- Outlook of
town in South Africa that suffers from AIDS victims and its government’s perception. Richard
W.Stevenson“Bush to Allow AIDS Money to Supporters of Abortion”16 Feb:-US president will
give donations to countries who have organizations which allow for abortions under some
certain conditions. Stolberg“Redeeming a $2 billion Pledge for Global AIDS”23 Feb:-AIDS
activists are criticizing Bush administration for lowering promised donation amount for fight
against the disease. NYT“Lawmakers Agree on AIDS Bill Details”17 Mar:-Members of US House
of Representatives are pushing for Bush’s promised donations to become larger.
Stolberg“Politics of Abortion Delays $15 Billion to Fight Global AIDS”06 Mar:-Debate between
Bush administration and opposition on allocation of promised funds by president: on the exact
amount and which poor country will receive money. Economist“The World Health Report: Battle
Ready”15 May 2004:-Article states this year’s WHO report concentrates on “3 by 5”anti-AID
initiative that agency and several collaborators announced and whose aim is to provide anti-AIDS drugs to 3m people in poor countries by end of 2005. Marc Santora & Lawrence
K.Altman"Rare and Aggressive H.I.V. Reported in New York"New York Times 12 Feb 2005:-disturbing report introduces a potentially very serious medical development in the global threat
of HIV/AIDS. Item states:"Rare strain of HIV, highly resistant to virtually all anti-retroviral drugs
and appears to lead to rapid onset of AIDS, detected in New York City man...It was first time
strain of HIV had been found that both showed resistance to multiple drugs and led to AIDS so
quickly, the officials said. While extent of disease's spread unknown, officials...say that situation
alarming...Virus found in...man in mid-40's who engaged in unprotected anal sex...with hundreds
of partners...While HIV strains resistant to some anti-retroviral drugs have been on rise in recent
years,...new case worrisome. Viral strain in unnamed patient resistant to 3 of 4 classes of drugs
used". The potential seriousness of this pandemic report justifies printing here a collection of
recent/unusually-striking articles on the truly global crisis of infectious diseases - which convey
both encouraging and shocking facts, and are relevant to the health/life of every human being -
whether we want to know about them or not. One very serious survey of the global situation is
found in major source that is op.cit.: Laurie Garrett Betrayal of Trust: The Collapse of Global
Public Health. Another broad global survey is found in Dennis Pirages"Containing Infectious
Disease". His 17-page essay contributes to serious broad subject addressed in the annual:
Worldwatch Institute State of the World 2005: Redefining Global Security, also op.cit.. Its careful
research on global issues is summarized/sub-titled:"Reducing worldwide death toll from
infectious disease should receive the highest priority". The Dynamics of Disease Outbreaks.
Environmental change can upset established equilibriums between people and pathogens,
facilitating new disease outbreaks. Each year more than 2.3m people, primarily in poor countries,
die from eight diseases that could easily be prevented by vaccination. Widespread and often
indiscriminate use of antibiotics and other anti-bacterial agents is creating families of drug-resistant microbes. The Current State of"Microsecurity". Table 3-1. Deaths from Major
Communicable Diseases, 2000 and 2002. Most worrisome near-term threat from traditional
diseases is posed by influenza. Table 3-2. Healthy Life Expectancy in Selected Countries, 2002.
Economic Consequences of Infectious Diseases. Ranks of the most productive people in some
of the world's poorest countries are being systematically depleted by HIV/AIDS. Table 3-3.Countries Most Affected by HIV/AIDS. Managing Future Disease Outbreaks. Box 3-1 HIV/AIDS
in the Military. Box 3-2 Biowarfare. Number of countries in which polio is endemic has declined
from 125 to just 6 - Afghanistan, Egypt, India, Niger, Nigeria, Pakistan. There is pressing need
to create innovative mechanisms to provide affordable drugs to disease victims in poor
countries. The rest of this concentrated item includes serious and related subjects found over
just a few weeks. Associated Press"Religious Leaders Talk AIDS Prevention"NYT 13 Dec 2004:-More than 80 religious leaders, Muslim and Christian, met at UN-sponsored Cairo conference
on HIV/AIDS."[D]ebated methods to halt spread of AIDS - usually taboo subject in conservative
Arab world - but stopped short of agreeing to recommend use of contraceptives to prevent the
disease". Community made move from only supporting abstinence/fidelity to a new message of
compassion/helping ill people/fighting discrimination. Donald G.McNeil Jr."Furor in Africa Over
Drug for Women With H.I.V."NYT 21 Dec :- "A series of articles critical of past trials of an
important AIDS drug has created a furor in Africa, causing many public health experts to worry
that some countries will stop using the drug, which prevents mothers from infecting their babies
with virus that causes AIDS." Nevirapine long been part of arsenal of antiretrovirals. NYT article
reports both medical and political positions relevant in (South)Africa and US. Nicholas D.Kristof
"It's Time to Spray DDT"Op-Ed Columnist in NYT 08 Jan 2005:-argues that West's refusal to
provide DDT to malaria-ravaged countries has contributed to surge of the disease - probably
killing 2m-3m people/year. "Instead, UN/Western donors encourage use of insecticide-treated
bed nets/medicine to cure malaria", but they are not enough."Existing anti-malaria strategy is
an underfinanced failure." While harm DDT can cause in environment recognized,"overall, one
of the best ways to protect people is to spray inside of a hut, about once a year, with DDT." This
uses tiny amounts, and is acceptable/essential. Donald G.McNeil Jr."A Path to Cheaper AIDS
Drugs for Poor Nations"NYT 26 Jan 05:-US"Food and Drug Administration has approved first
generic triple-therapy AIDS cocktail, opening way for US taxpayer dollars to be used to buy
cheaper medicines for use in poor countries." South African-made drugs are priced 1/3-1/2 of
brand-name ones. WHO already endorses dozens of generic AIDS drugs. AP"Number of People
Using HIV Drugs Improves"NYT 26 Jan 05:-"Though numbers... using HIV/AIDS drugs in
developing world, including Africa and Asia, nearly doubled in 2004, more work needed to
meet...goals of 3m getting treatment by end of 2005",warned WHO/Joint UN Program on
HIV/AIDS heads. Needed: better access to cheaper drugs and help to ensure preventative
education; 72% still missing drugs in Africa."About 40m worldwide infected with AIDS virus, and
5m new cases recorded annually. [E]pidemic now pushing deep into Asia." Sharon
LaFraniere"Poor Lands Treating Far More AIDS Patients"NYT 27 Jan 05:-"AIDS patients receiving
life-saving drug treatment in poor/middle-income nations rose 60% in past 6 months, WHO
said...,largely because of huge influx of international aid funds and a growing determination by
governments to confront the pandemic...Still, anti-retroviral treatment reaches only one in eight
needy people in developing world, leaving estimated 5.1m without such protection. Last year,
disease took more than 3m lives, 75% of them in sub-Saharan Africa."The Economist 29 Jan
05"The Gates Foundation: Missionary Zeal"(Edit.10); "Global Health: Foundation"(76-7):-major
essay tells much about global action against tropical diseases. Focus:Bill Gates' second gift of
$750m to Global Alliance for Vaccines and Immunisation (GAVI) which is aimed at giving
comprehensive vaccine protection to 90% of newly born children - and is more demanding of
donor governments to help meet its $8-12b need by 10 years. Gates' total foundation is richest
charity in world, with endowment worth $28b. Its most ambitious aim is"to free the world - and,
in particular, those regions of it that are poor - of ill health.It has formed largest non-governmental gifts to the Global Fund to Fight AIDS, Tuberculosis and Malaria, set up by UNSG
Kofi Annan. Economist 02 Jul 05"G8: Helping Africa Help Itself"(Edit.11):-Lots more money for
Africa will not make poverty history. But it might just do some good";"Aid to Africa: The $25
Billion Question"(Special Report 24-6):-"Years of mistakes have taught donors a bit about how
to spend aid money better"; "Lexington: Evangelicals and Aid: Right On" (34):-"Bob Geldof and
Bono have some unlikely friends in America... During discussion of a plan to spend $15 billion
fighting AIDS, [US President Bush] turned to his silver-penned speech writer... 'Mr President',
came the reply, 'if this is possible , and we don't do it, we will never be forgiven'"; "AIDS In
South-East Asia: There's Good News and Bad News"(38-9):-"Good prevention work has tamed
the AIDS epidemic in some countries, yet it is getting much worse in others"; "The Grand
Challenges in Global Health: 43 Ways To Save the World"(69-70):-"The Gates Foundation's latest
largesse has just been announced. It will pay for some intriguing and original research. But will
it translate into healthier people? [References to several AIDS research projects]; "AIDS: Moving
Targets" (70):-"Progress, and problems, in treating AIDS around the world". Economist 08 Oct
05 "Pharmaceuticals in South Africa: Aspen's Upward Slope"(74):-item asks: "Can South Africa's
generics manufacturer become a global giant?.. Number of South Africans with HIV-AIDS tragic
and alarming. [O]ver 800,000 people need treatment -but only about 100,000 are getting it...
Aspen Pharmacare is local firm doing most to supply the market with the generic drugs South
Africa will need. It now has ambitions to do the same for rest of Africa - and then to expand into
market for generic HIV-AIDS drugs in US and Europe... Both government and health insurers -
keen to keep medical costs down - have pushed for generics against the more expensive patent-protected drugs. As result, over 40% of prescribed drugs in South Africa are now generics.
Government and local pressure groups have arm-wrestled with pharmaceutical multinationals
over anti-retrovirals (ARVS) - the drugs used to fight HIV-AIDS. As result, companies such as
Merck and Eli Lilly have licensed local manufacturers to produce their patent-protected drugs...
Aspen now offers six different ARVS"; Donald G.McNeil Jr."Clinton in Deal to Cut AIDS
Treatment Costs"NYT 12 Jan 2006:-"Former [US] President Bill Clinton plans to announce today
that his foundation has negotiated lower prices on AIDS tests and on two important AIDS drugs.
Four companies, from US, India and China, will offer rapid HIV tests for 49 cents to 65 cents,
which will reduce typical cost of a test in poor countries by half, Clinton said in written
statement. Another four companies - three from India and one from South Africa - will make
antiretroviral drug efavirenz for as little as $240 per patient per year. One of Indian companies,
Cipla, will also make the antiretroviral abacavir for $447"; Donald G.McNeil Jr."Bristol-Myers
Allows Powerful AIDS Drug to Be Sold Cheaply"NYT 15 Feb 06:-"One of the newest and most
powerful AIDS drugs will be licensed to generic drug makers in India and South Africa so that
it can be made inexpensively for patients in many poor countries. Drug is atanazavir, made by
the Bristol-Myers Squibb Co. under the brand name Reyataz and introduced only last year in
many wealthy countries. It is a protease inhibitor, which is useful in second-line treatments for
patients who have developed resistance to their first antiretroviral cocktails. It will be licensed,
without charge, to Emcure Pharmaceuticals Ltd. of India and Aspen PharmaCare of South Africa.
Under the deal, the generic companies will set the pricing for atanazavir in Africa and India. At
moment, second-line treatments in Africa cost $3,000 to $6,000 a year for each patient, compared
to about $200 for first-line treatments... However, guidelines from WHO require that protease
inhibitors be given with what is called a booster drug - usually ritonavir, sold under brand name
Norvir [, which] must be refrigerated, especially in hot climates. As a result, move by Bristol-Myers puts pressure on Abbott Laboratories, maker of ritonavir, to make a heat-stable version";
AP"Clinton Urges Help for Kids With AIDS"NYT 18 Feb 06:-"Former [US] President urged
governments and public foundations to buy anti-AIDS drugs from low-cost manufacturers so
more children can receive treatment for the disease. Clinton... said last month that Cipla and 3
other Indian pharmaceuticals would offer antiretroviral drugs at prices up to 30% cheaper than
current market rate... Since his Clinton Foundation's 2002 HIV/AIDS initiative began, foundation
has concentrated on making affordable drugs available, buying second line AIDS drugs from
generic drug makers for 21 countries in Asia, Africa and the Caribbean, he said. His foundation
planned to get anti-AIDS drugs to 60,000 children in worst-affected countries this year... 'We've
had a 3-year partnership with Cipla, and because of them an enormous number of HIV/AIDS-infected people are alive', he said. India has 5.13m cases of the illness, second largest number
of people infected with HIV after South Africa. Indian government claims its anti-AIDS campaign
has stabilized the epidemic and says there has been a sharp decline in the number of new HIV
cases"; Reuters"Clinton Group, India to Train Nurses in AIDS Care"NYT 19 Feb 06:-"Former US
President and Indian government announced a joint plan to train nurses in AIDS care in a
country which has world's second-largest number of HIV/AIDS cases... Partnership between
National AIDS Control Organization of India (NACO) and Clinton Foundation, aims to develop
training material and program for nurses... 'Nurses not only deliver clinical care, needed to keep
people alive, but they also act as counselors and play an important role in reducing the myths,
stigma, and discrimination surrounding this disease', [Clinton said]"; Reuters "Relief Group
Seeks Access to New HIV Drug in Africa"NYT 15 Mar 06:-"A humanitarian group urged US
drugmaker Abbot Laboratories Inc. on [15 Mar] to make a new HIV drug accessible in developing
countries, especially Africa. Relief organization Medecins Sans Frontieres said a new
formulation of Abbot's lopinavir/ritonavir drug had critical advantages for patients in poor
countries, including lower daily pill count, storage without refrigeration and no dietary
restrictions... Sub-Saharan Africa has about 10% of world's population but 60% of people living
with HIV/AIDS... More than 3m Africans became infected with HIV in 2005, representing 64% of
all new infections globally and more than in any previous year for the impoverished continent,
according to UNAIDS. MSF provides anti-retroviral drugs for over 60,000 patients in nine
countries in Africa, Asia and Latin America. It said it urgently needed the new drug because
refrigeration is unavailable to many people in poor countries. The new formulation, marketed
under the name Kaletra, is in tablet form and does not melt at high temperatures unlike the old
version which is in capsules. MSF said the new version of Kaletra, which was approved by US
Food and Drugs Administration [Oct 05], was not available in any developing country. It urged
Abbot to register the new version in developing countries, sell it at less than $500 per patient per
year and remove patent barriers to allow production of generic versions... Abbott said it was
pursuing registration for the new formulation in developing countries as rapidly as possible. It
also said it was making its HIV medicines available in 69 of the world's poorest countries...
Kaledra is a 'second line' drug which can be used when standard anti-retroviral drugs stop
working... One MSF program found that after four years of ARV treatment, 16% of patients
needed second-line drugs"; Economist 01 Apr 06"Treating AIDS: A Missed Target"(64-5):-"World
Health Organization(WHO)'s attempt to roll out AIDS drugs in poor countries has missed its
target. A shame, but not a disaster[op.cit. AP 28 Mar]. The '3 by 5' initiative to get 3m HIV-positive
people in poor/middle-income countries on to anti-retroviral drugs by end of 2005 has got less
than halfway there. [WHO/UNAIDS reported] a mere 1.3m of those infected in target countries
are on courses of drugs. [Yet shift from pure prevention to care offered incentives for] those who
might...be infected[: new] reason to find out the truth [and encourage modified behaviour to
reduce transmission. Also, even 3+ times the previous number under treatment] averted about
250,000 premature deaths in 2005. One problem [was] that in most countries the [essential]
infrastructure... did not exist. [Hence] the initiative may have been more successful than [new]
figure suggests, since part money has gone on infrastructure [and] this sort of work has spin-offs beyond the treatment of AIDS. Expense of treatment also tackled[:] big change...in market
for AIDS drugs. Clinton Foundation HIV/AIDS Initiative has helped to defragment market for
generic anti-retroviral drugs by signing contracts... in India and South Africa that guarantee large
order-volumes and reliable payment. As result, price in some cases... below $150 per person per
year.. Progress, then, being made. [Possible] 3m figure by end of 06"; AP"AIDS Conference Ends
With Appeals"NYT 26 Apr 06:-"International AIDS conference [in Cape Town, of 1,000 scientists/
researchers,] ended [26 Apr] with impassioned appeals to political/pharmaceutical industry
leaders to fund development of a virus-killing [vaginal] gel to protect women from the disease
and so save millions of lives. Peter Piot, head of UNAIDS,.. said safe/effective microbicides could
be ready in 5-7 years, with only minimal additional funding, and thus turn the dream of saving
millions of lives into reality... In the hard hit African countries, women account for nearly 60% of
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