SOUTH AFRICA
Victory over U.S. drug giants, but struggle continues
By Key
Martin
Southern Africa is the cauldron in which the battle against
the AIDS epidemic is being forged and where the fate of
humanity in the face of this scourge may well be decided. It
was late afternoon on Sept. 17 in Washington when U.S. Trade
Representative Charlene Barshefsky announced the U.S.
concession to "support" South Africa's efforts to obtain
cheaper medicines to help combat the exploding AIDS epidemic in
the region.
This concession saved Washington the embarrassment of
confronting newly elected President Thabo Mbeki during his
mid-September appearances at the United Nations. Protests,
however, are expected to continue.
U.S. actions against South Africa blocked medical treatment
while the death toll mushroomed in the entire subcontinent. It
took months of protests by Act Up and the Health Gap Coalition
and others--in both the United States and South Africa--to
defeat the pharmaceutical companies and Vice President Al Gore.
Gore represented the Clinton administration in threatening
South Africa on these matters.
The drug companies took legal action in the South African
Constitutional Court. Washington started trade sanctions
against some South African products. Their goal was to stop
South Africa from implementing a new law that would lower drug
prices.
The South Africans face a devastatingly high rate of HIV
infection and the legacy of an apartheid-era health-care system
that left the poor largely without treatment.
The concession "temporarily" halted the legal action without
dropping it completely. The U.S. government withdrew sanctions
and agreed to take South Africa off the "watch list." This is a
list of countries against which some economic sanctions would
be considered when the list is redone later in the fall.
"We've acknowledged each other's policy decisions and the
South African government made it quite clear that it was never
our intention to infringe on the intellectual property rights
of any person or any company," said Minister of Trade and
Industry Alec Irwin during President Mbeki's New York
visit.
"What was at stake was the so-called parallel import issue.
The U.S. government, on behalf of the companies, took this
matter up very forcefully. So did the German government, the
United Kingdom, Switzerland. We had discussions with all those
governments and reached an understanding.
"We have not attempted to reach agreement on `exhaustion.'
That is a multi-national issue that will come up in the World
Trade Organization."
"Exhaustion" refers to the fact that a patent holder loses
the right to the patented product once it is sold. It can then
be resold without infringing on patent rights. "Parallel
importing" is the right to buy medicines at the cheapest price
from any source, not just from the drug monopolies at their
fixed prices.
"There is a separate issue that has also emerged within the
World Health Organization, and that is the affordability of
crucial drugs--not only AIDS drugs, but a range of drugs, from
malaria to tuberculosis. I think the WHO may be a much better
place to discuss this than the International Monetary
Fund--which has nothing to do with drugs and should stay out of
it. It's crucial for Africa," Irwin said.
Special Assistant to the Minister of Health Ian Roberts
helped write the new law in question. "When the ANC government
took power in South Africa and started the process of
transformation," said Roberts, "one of the earliest things the
government addressed was altering the legislation from an
apartheid-based structure to a democratic structure. And that
meant that we changed about 100 acts a year.
"One of the very crucial areas dealt with medicines and the
medical market place. We designed an act to address all the
critical transformation issues that surround medicines. The act
covered basically five main topics: rational prescribing,
altering the ethical base of the marketplace, affordability of
medicines, strengthening the regulatory process, and control of
the effects of medicines," he said.
While the pharmaceuticals focused their publicity on the
question of intellectual property, Roberts explained, in fact
they attacked the law in its entirety.
"That is one reason why the government is so resolute in
defending the act. For instance, generic substitution is
illegal in South Africa. An enormous market in America is
generics. The act was to address broadly the marketplace and
the way the pharmaceutical industry functioned and
behaved."
A U.S. journalist recently paid $45 in South Africa to
replace asthma medicine. The same medicine cost only $15 in the
United States.
President Mbeki addressed leaders from the African American
community in a meeting at the Schomberg Center in Harlem. He
said the matter has been "settled." But he also cited one of
the biggest problems in South Africa: The economy is still
owned by those who owned it under apartheid and little has
changed.
This is the context in which the struggle over the
pharmaceuticals is taking place.
The U.S. concession represents a major victory for South
Africa's people, and therefore for all of southern Africa and
its estimated 32 million people who are HIV-positive.
The high death rate from AIDS-related illnesses has
dramatically reduced average life expectancy in Zimbabwe from
58 to 39 years. The corn and cotton crops have plummeted to
less than 50 percent of previous production due to the AIDS
epidemic's impact on the work force.
There are many more victories needed. The drug industry must
open the doors to all medications, from those treating
tuberculosis to antibiotics, and all the treatments for
infections and diseases that become more common and deadly in
the world of HIV.
How this infection is handled in Africa may well determine
the fate of other oppressed people, from South Asia, Asia, and
Latin America, to here at home in the United States, where many
poor communities are ill-equipped to handle it.
"Those people in the United States who are protesting
against these pharmaceutical companies are engaged in one of
the most noble struggles to save humanity," said South African
Communist Party General Secretary Blade Nzimande. "No one
should be left off the hook so far as this is concerned."
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