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AIDS and Profits | The Nation

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AIDS and Profits

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This is not about profits and
patents; it's about poverty and a devastating disease." That
statement did not come from AIDS activists struggling to provide
sub-Saharan Africa's 25 million HIV-positive people with access to
life-extending medications. It came from the executive vice president
of Bristol-Myers Squibb, which recently announced it would slash
prices on its two AIDS drugs and forgo patents on one of them. A week
earlier, Merck & Co. said it would lower prices on its two AIDS
drugs not just in Africa but, pending review, in other heavily
affected countries as well.

What's going on is not a
change of heart on the part of "Big Pharma"--which John le
Carré describes in this issue as a group of
"multibillion-dollar multinational corporations that view the
exploitation of the world's sick and dying as a sacred duty to their
shareholders." Far from being a humanitarian action, the price
reductions represent an attempt to preserve patent rights by
diffusing international pressure for generic manufacturing.
Revealingly, neither BMS nor Merck has withdrawn from a suit against
the South African government brought by thirty-nine pharmaceuticals
seeking to prohibit importation of generic drugs, which they claim
would violate their patents.

The Indian generic
manufacturer Cipla announced in February that it would sell the
entire AIDS triple-therapy combination at $350 per person, per year,
and other generic manufacturers, in Thailand and Brazil, currently
offer AIDS drugs at a fraction of multinational prices. By
comparison, the Wall Street Journal reported that a
combination of AIDS drugs from BMS and Merck would cost between $865
and $965 per person, per year. If those prices were multiplied by the
number of AIDS patients in, say, Zimbabwe, a relatively prosperous
country by African standards, the total would come to about 20
percent of its GDP. And that sum doesn't include the investments in
healthcare infrastructure needed to distribute and monitor the drugs'
use.

But even if poor African countries could somehow find
the money to pay the high patent-protected prices of the drug giants
(the $26.6 billion a year it would cost to provide all Africa with
AIDS drugs is no more than about a third of what Bush's tax plan
would give to America's wealthiest 1 percent), that would not be the
end of their problems. Rather, such a course would lock them into
exclusive trade agreements with multinationals and put them at the
continual mercy of Western foreign aid budgets. As new treatments are
developed, Africa would have to negotiate new price reductions,
country by country, company by company.

If the solutions
lie with generic manufacturing (not just for AIDS medications but for
a slew of vital drugs for malaria and other ills), then circumventing
existing international patent regulations is a necessity. The trial
in South Africa over compulsory licensing is one crucial test of the
viability of this option. Another potential plan would be for the
National Institutes of Health to give patents owned by the US
government on publicly funded AIDS drugs to the World Health
Organization, thereby licensing it to oversee generic manufacturing.
Why not, in fact, let governments underwrite the entire cost of drug
research--rather than, as now, underwriting substantial amounts of
the research, which drug companies then exploit--and do away with
patents altogether?

Whatever the recourse, and despite the
well-publicized gestures by multinational pharmaceutical companies,
the solutions to Africa's AIDS epidemic lie in sustainable
competitive drug production, not momentary self-interested
charity.

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