Report from AIDS Conference
High drug prices undercut medical gains
By Julie
Fry
Durban, South Africa
During the week ending July 14, the 13th International
AIDS Conference was held here in the province of
Kwazulu/Natal, where the proportion of HIV-positive adults
has reached nearly 30 percent. South Africa as a whole now
has a total of 4.2 million people living with HIV/AIDS--the
highest number in the world.
According to the Joint United Nations Program on AIDS
(UNAIDS), 18.8 million people in sub-SarahanAfrica, including
3.8 million children, have already died of the disease. Some
34.3 million currently live with HIV. Last year alone, 5.4
million were newly infected.
Dozens of breakthroughs in vaccines and anti-retroviral
therapies were discussed at the conference. For those who can
afford it, the possibility of living a long and healthy life
with HIV has already increased enormously and continues to
grow.
But that is cold comfort for the working class in
oppressed countries like this, where AIDS still means a
relatively fast death.
The average HIV-positive person in South Africa and most
other countries has no access to treatment of any kind.
Further, this lack of access to medicine, and to the AIDS
drug AZT in particular, contributes directly to the
increasing infection rate among newborn children.
AZT can prevent HIV transmission from mother to child
during birth. But because of the lack of AZT in South Africa,
over 60,000 babies there are now infected with HIV.
The lack of medicines was the subject of a rally July 9
outside the conference on the opening day. "The fight against
AIDS begins with the fight against the drug companies!"
proclaimed Winnie Mandela to the roaring crowd of 3,000
demonstrators.
The demonstration was called by the Treatment Action
Campaign, a coalition of several South African organizations
that includes the Congress of South African Trade Unions and
the South African Communist Party.
TAC organized the rally to expose the multinational
pharmaceutical companies that are withholding life-saving
medicines from working and poor people around the world.
Speakers from all over Africa and other parts of the world
spoke about the global crisis being created by the obscenely
high cost of HIV treatment.
Where are the drugs?
The costs poor nations face for HIV treatments are
grotesque. UN figures show that anti-retroviral therapy alone
would cost countries like Bangladesh, Nigeria, Uganda and
Zambia approximately 30 percent of their respective Gross
National Products.
In South Africa, the government estimates that it would
take its entire health budget to provide AZT to all
HIV-positive pregnant women.
Pharmaceutical companies are making huge profits by
charging desperately ill people criminally high prices for
medicine. A telling example is fluconazole, known by its
brand name Diflucan. Fluconazole is used to treat some common
opportunistic infections in HIV patients, including oral
thrush and a fatal infection called cryptococcal
meningitis.
According to UNAIDS, "Cryptococcal meningitis is the most
frequent systemic fungal infection in the HIV-infected
persons. Without treatment, life expectancy is probably less
than a month..."
This disease is easily treatable with fluconazole. One of
the largest pharmaceutical companies in the world, Pfizer,
manufactures the drug and sells it all over the world. In
U.S. dollars, Pfizer charges $9.34 per 200-mg capsule in
South Africa, $10.50 per capsule in Kenya, and $27.60 per
capsule in Guatemala.
The same drug is manufactured generically in Thailand for
60 cents per capsule--less than 7 percent of the price Pfizer
charges South Africa.
Pharmaceutical companies argue that their high prices are
used to cover the costs for the many years of research and
development that go into producing new drugs. However, the
overwhelming majority of these costs have actually been paid
through public funds. The development of HIV drugs in
particular has had little if anything to do with investments
from drug corporations.
According to the Wall Street Journal, U.S. government
funding for HIV/AIDS treatments increased five times between
1987 and 1996, to $1.65 billion. This period was critical in
the development of anti-retroviral therapies. The increase in
funding was the direct result of the powerful movement that
developed in the lesbian, gay, bi and trans communities and
other at-risk communities to demand treatment for AIDS.
Credit for the development of HIV medications available
today belongs to AIDS activists, not to pharmaceutical
companies or the U.S. government. They were content to watch
people of color, the poor, and gay and bisexual men die as a
result of AIDS.
However, the fact that they did not create these drugs
does not stop companies like Pfizer from buying the exclusive
rights to manufacture them and make huge profits.
Why can't people
buy cheaper drugs?
If drugs like fluconazole are available for less money in
other parts of the world, why don't countries like South
Africa buy them? The answer is that South Africa, along with
136 other countries, belongs to the World Trade Organization.
And the WTO guarantees drug corporations an instant global
monopoly on the sale of medicine.
The WTO protects this monopoly through the agreement on
trade-related aspects of intellectual property rights
(TRIPS). In the U.S., the government and the media usually
refer to intellectual property rights in the context of the
entertainment or designer clothes industries.
During the WTO meeting in Seattle this past December, Bill
Clinton continually talked about the importance of enforcing
intellectual property rights, or TRIPS.
The TRIPS agreement also applies, however, to
pharmaceutical companies. They enjoy universal patent
protection from all the WTO member countries. The U.S. has
the largest pharmaceutical industry in the world. Only nine
other countries--eight in Europe plus Japan--have any
significant pharmaceutical development capacity.
This means that, through the WTO, the U.S. and other
imperialist countries can dictate the cost of health care to
the rest of the world.
TRIPS prevents countries from importing medicines from
cheaper sources or from producing them themselves. Exceptions
to the agreement are supposed to be made in cases of public
interest, but any country that dares defy TRIPS finds itself
under attack by U.S. imperialism.
That happened in 1998, when the South African government
passed legislation that would allow it to find cheaper ways
of accessing medicine, regardless of patents. The major
pharmaceutical companies immediately filed a lawsuit against
South Africa for violating the TRIPS language. The
legislation today is inactive, subject to the ruling of the
U.S. government-controlled WTO.
Other countries that defied these agreements have been
subject to trade sanctions or withdrawal of their already
meager U.S. foreign aid.
The WTO is not the only tool that U.S. capitalists use to
protect their profits. In 1997, the United Nations launched
the UNAIDS Drug Initiative with the Ivory Coast and Uganda,
two countries that are among the hardest hit by the
epidemic.
The UN told the Ivory Coast and Ugandan governments that
it would help lower the cost of HIV medication through
negotiations with pharmaceutical companies in return for an
agreement from the two countries to buy exclusively from
those companies.
Three years and thousands of deaths later, prices for
medications in the Ivory Coast and Uganda have not decreased
at all. In some cases, they have even gone up. Faced with an
exploding number of deaths, the Ivory Coast government
bravely decided to ignore the UN and find affordable ways to
get treatment.
Just before the conference, Uganda's government announced
it would do the same.
Poverty behind health crisis
The blame for the AIDS epidemic falls not only on the drug
companies but on the capitalist system as a whole. Years of
imperialist exploitation in the Third World have caused a
public health crisis that hits HIV-infected people the
hardest. Critical to their health, as well as to anyone else,
is access to clean water and good nutrition.
Yet 50 percent of the people in sub-Saharan Africa do not
have clean water and 32 percent of children under 5 years old
are malnourished.
Dirty water and inadequate, crowded housing make poorer
HIV-infected people much more susceptible to deadly
opportunistic infections. In addition, lack of proper
nutrition weakens the immune system dramatically.
In South Africa, the few poor people who manage to gain
access to some treatment through the limited government drug
trials often have little food to take with their medication.
The drugs can make them so sick that they cannot go to work
or perform the daily tasks necessary for the survival of
their families and themselves. They are forced to choose
between surviving day to day or fighting their disease.
The blame for this poverty lies with the legacy of
colonialism and apartheid, followed by the economic
encroachment of U.S. imperialism, which insures a system of
low wages and brutal exploitation for the entire Third
World.
Resistance is growing
The TAC rally was endorsed by over 160 organizations from
35 different countries. This is evidence of the growing
global movement against the capitalist drug industry.
Throughout the conference, activists continued to put the
drug companies and the companies that support them on
trial.
On July 11, TAC and the U.S. AIDS activist group ACT UP
held a demonstration outside a World Health Organization
press conference. They exposed the UN/WHO as well as the
pharmaceutical companies for lying when they announced they
would lower the price of HIV drugs.
All the speakers at the TAC rally, from COSATU members to
members of the National Association of People Living with
AIDS, spoke of the need to get rid of the profit-driven
medical industry. They talked about the role of the U.S.
government and organizations like the World Trade
Organization in letting millions of poor people around the
world die while the companies they protect make billions in
profits.
This article is copyright under a Creative
Commons License.
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