AIDS Culprits


The numbers beat out a dirge: Twenty-two million people to date worldwide have died from AIDS. Thirty-six million are infected. Twenty-five million of these live in Sub-Saharan Africa. Last year, the number of HIV positive people in Russia and Eastern Europe nearly doubled.

In the West, for those who can afford proper medication, AIDS is no longer a certain death sentence. In developing countries, it usually is.

"A fifteen-year-old in South Africa has a better than even chance of dying of AIDS," reported The New York Times Magazine on January 28. "One in five adults is infected with HIV. Hospitals are filled with babies so shriveled by AIDS that nurses must shave their heads to find veins for intravenous tubes."

In Africa, "fewer than 25,000--one-tenth of 1 percent--receive the therapy that could avert their deaths," reported The Washington Post in a remarkable four-part series in late December. "At current levels of intervention, the number of Africans dead of AIDS in ten years will probably surpass the population of France."

Precious little has been done about this plague, in part because multinational drug companies hold a patent on, and overprice, the antiretroviral medications that, when taken in triple combination, could keep millions alive.

The drug companies knew they could discount the drugs drastically for use in Africa, but they worried that a secondary market would develop, whereby people in Africa would buy the drugs cheaply and resell them at a mark-up in the West. The companies feared "killing the golden goose in the United States, Canada, Germany, France, Britain, Italy, and Japan," Post reporter Barton Gellman wrote on December 27.

"Corporate boards and regional operating companies weighed the costs and benefits of pricing AIDS medicines within reach of most of the dying," wrote Gellman. "With the tacit and sometimes explicit assent of public authorities, the companies decided the costs were too great."

Then, in counterpoint, comes the aggressively cheerful noise of P.R. In 1999 and 2000, Bristol-Myers Squibb--which calls itself "a $20 billion diversified, global health and personal care company whose mission is to extend and enhance human life"--and four other giant pharmaceutical companies announced a series of grants that were, among other things, supposed to make free or greatly discounted drugs available in Africa. For instance, the company announced a project in South Africa: "As active partners, Bristol-Myers Squibb and the government will make a significant impact on the lives of women and children affected by HIV/AIDS," said vice chairman Kenneth E. Weg, according to a company press release.

But the offer does much more to improve the reputations of the drug companies than it does to save lives. "Nothing fundamental has changed in the calculus of access to AIDS treatment," wrote Gellman.

"If it's relatively cheap to manufacture [AIDS] drugs, it makes no moral sense to let thirty-six million people die," says James Love, director of the Consumer Project on Technology, an organization started by Ralph Nader.

Love points to one positive development: the agreement whereby Cipla Ltd., a Bombay drug manufacturer, will make generic AIDS drugs that it will market for $350 per year per patient to the organization Doctors Without Borders, which will then distribute the medications for free. At Western prices, the brand-name versions of the drugs would sell for $10,000 to $15,000 per person per year.

Love's group, along with the Paris and Philadelphia chapters of the AIDS Coalition to Unleash Power and Doctors Without Borders, worked for six months to bring about the Cipla deal. They regard it as "the big breakthrough," says Love, who personally negotiated the price. "A dollar a day for a three-drug cocktail. That's a life-or-death issue in South Africa right now."

"We've been pursuing cheaper sources for medicines now since 1996, with the Vancouver AIDS conference, when it became clear that the triple combination therapy was helping people with AIDS live longer, more productive lives," says Eric Sawyer, a founding member of the New York chapter of the AIDS Coalition to Unleash Power. …

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