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Bush won’t fight price break for AIDS treatment

by Jim Lobe

Washington, 22 Feb (IPS) -- In a major victory for AIDS and Africa activists here, the new administration of President George W.  Bush has decided to keep in place an executive order by his predecessor, Bill Clinton, that was designed to make it easier for African countries to obtain anti-AIDS drugs inexpensively.

The new administration’s decision marks a blow to US pharmaceutical companies, which strongly opposed Clinton’s order and contributed heavily to Bush’s presidential election campaign.

The Pharmaceutical Research and Manufacturers of America (PHARMA) issued no substantive reaction to the administration’s decision, noting only that it expects the US Trade Representative (USTR), Robert Zoellick, to support industry efforts to persuade foreign countries to comply with international intellectual property laws.

“We believe countries still have to comply with (global trade agreements), and we would expect the USTR to support this,” a spokesman said. The announcement came in the form of a statement issued earlier this week by the USTR’s office. The administration, it said, “is not considering a change in the present flexible policy”.

“Consistent with our overall effort to protect America’s investment in intellectual property,” it added, “(the USTR) will seek to contribute to administration efforts to work with countries that develop serious programmes to prevent and treat this horrible disease.”

“This is an important victory,” said Salih Booker, director of the Africa Policy Information Center (APIC), which had taken a lead role in mobilizing pressure on the administration not to reverse the policy.  “This shows we can’t be ignored.”

Since its emergence in the mid-1980s, HIV/AIDS has spread through Africa at a devastating rate; its impact in some sub-regions is comparable to the Black Death that decimated Europe’s population in the 14th century.

Some 70% of the roughly 36 million people infected with HIV or AIDS worldwide is in Africa, according to the United Nations. In parts of southern Africa, which has been hardest hit, one in three adults have been infected.

The virus’ impact has not been limited to the health system by any means. Because HIV/AIDS attacks and kills people in their most productive working years, it also has severely set back development prospects in some of the world’s poorest nations. The same countries also cannot afford the kind of social safety net needed to cope with the millions of children who have been orphaned by the virus.

Until a decade ago, infection was literally a death sentence for the victim, whether in the United States or in Africa. But AIDS researchers have since developed treatments using anti-retroviral drugs, which inhibit the development of HIV into AIDS. The result is that, for those patients who can afford it, HIV/AIDS has become a chronic condition.

The problem, however, is the expense. In the United States, treatment with brand-name drugs costs $10,000-15,000 a year - far beyond the reach of all but a relative handful of people in Africa, where a large portion of the population earns less than one dollar a day.

The actual cost of producing the drugs, however, is far less. For example, in Brazil, which in 1996 passed a law authorising domestic generic production of key anti-retroviral drugs, the actual annual cost of production is currently about $3,000 per year and could fall to as little as $700 a year.

In India, another generic drug producer, the cost of production is estimated at only $600, and two companies have said in recent weeks that they are prepared to sell the drugs to certain non-governmental organisations in Africa for as little as $350.

The impact in Brazil, whose government provides the treatment free of charge to needy patients, has been spectacular. Combined with an active prevention programme, the country has cut the AIDS death rate by 50% in the past three years.

Moreover, free treatments have cut the time AIDS patients spend in the hospital by 75% on average, demonstrating the degree to which they can continue leading economically productive lives and save the government tens of millions of dollars in hospital costs.

Brazil has accomplished this primarily by defying pressure from Western drug manufacturers who hold the patents to these medicines.

While the companies acknowledged the desperate need for cheaper, anti-AIDS drugs, they also have charged that Brazil and other generic producers, including India and Thailand, are essentially stealing their intellectual property.

They have also pressed their governments to use their diplomatic clout, including the threat of trade sanctions and legal action at the World Trade Organisation (WTO), to force foreign generic producers to respect their patents.

Until last year, the Clinton administration did precisely as the companies wanted. But, under pressure from AIDS and Africa activists, Clinton issued an executive order banning all US government agencies from doing anything - including threatening WTO actions - to discourage African countries from acquiring or producing generic drugs.

Because Congress approved the order, however, it could have been cancelled or modified by the incoming Bush administration. The fact that Bush had accepted so much money from the pharmaceutical companies - and that, at several points in the campaign, he asserted that Washington had no major interests in Africa - spurred concern by many activists here that he would lift the order. Adding to that fear was an early decision to eliminate a special White House office on AIDS set up by Clinton.

Even while the activist and public-health community mobilised, however, several voices within the administration also spoke out against reviewing Clinton’s order. Bush’s political advisers argued that it would be seen as a betrayal of the “compassionate conservatism” on which he had run and as a gratuitous slap in the face of African Americans and the Congressional Black Caucus who were already furious over Bush’s controversial election victory.

Secretary of State Colin Powell, an African American himself, also spoke out strongly against reviewing the order. In a nationally televised interview in early February, he said that he, like the Clinton administration, considered AIDS a “national security problem”.

“I will do everything I can to continue getting that support from Congress to fight this pandemic,” he said, “and I think we all need to do more.”

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