Africa shuns US move allowing access to cheaper AIDS drugs

Developing countries are not exactly queuing up at the US Trade Department to take advantage of flexible patent regulations allowing them to access cheaper AIDS drugs. The reason may be due to mixed signals coming out of Washington, says Gumisai Mutume.

WHILE the US government has been at pains to explain that unlike before, it will not harass sub-Saharan African governments over patent requirements on AIDS medicines, pharmaceutical companies say they are willing to fight.
The US government re-affirmed in the week of 24 July an earlier offer to sub-Saharan nations caught up in the claws of the deadly HIV/AIDS epidemic. The Clinton Administration says it has weakened the application of US trade laws relating to intellectual property to allow African nations to respond to the public health crisis.

'Since December, we have been explaining the new policy to other countries that if they can show that they have a serious health problem, we would consider it, 'says assistant US trade representative Joseph Papovich. 'By spring this year, no countries had come forward.'

For more than a decade, the United States has been pushing an aggressive TRIPS regime to pressure any government that violates US patents and copyrights.
TRIPS, the World Trade Organisation's (WTO) Trade-Related Aspects of Intellectual Property Rights Agreement, protects inventions under patent laws preventing any other company or country from producing the same product without a licence.
The United States had even threatened to take South Africa to the WTO over legislation that would have violated US patents but which at the same time would have strengthened the hand of that government to provide cheaper AIDS drugs to its people. An estimated 20% of South Africans are infected with HIV, the virus that causes AIDS.

Industry opposition

But the pharmaceutical industry has made it clear that it is opposed to an executive order issued by US President Bill Clinton in May, which loosened rigid enforcement of US intellectual property laws regarding AIDS drugs for sub-Saharan African nations.

'It sends the wrong signal,' says Shannon Herzfeld, senior vice president for international affairs at the Pharmaceutical Research and Manufacturer's Association (PHRMA). 'Yes, we would like it to be withdrawn.'

'Rules can be trade barriers in disguise. We need rules which are fair and transparent and rules which do not hamper our ability to sell our medicines because a local industry has failed to stay modern.'

The pharmaceutical industry says for every 15,000 chemical and molecular compounds it investigates, only three become suitable for human use and one becomes a profitable medicine. On average, this process takes 12 years.
The industry says it spends more than $26 billion annually on research and development. However, activists say only 2% of that figure is directed at diseases affecting 80% of the world's population, those living in developing countries.

An estimated 95% of the 34.4 million people infected with HIV/AIDS worldwide have no access to medication and more than 60% of infections are in sub-Saharan Africa.

Clinton's executive order says: 'Should a government determine to avail itself of the flexibility the TRIPS Agreement provides to address a health care crisis, the United States will raise no objection, provided the policy employed is consistent with the provisions of the WTO TRIPS Agreement.' It offers a lifeline to sub-Saharan African nations.

The flexibility has raised concerns in the US pharmaceutical industry that the order will essentially permit unauthorised copying of its products. According to Herzfeld: 'AIDS drugs are hard to make, easy to steal.'

Recently, five AIDS drug manufacturers agreed to lower the price of AIDS medication for Africa and the US Export-Import Bank extended a $1 billion annual loan facility to a number of sub-Saharan nations to import US-made AIDS drugs.

However, the move has been seen as an attempt to dilute attempts by African nations to resort to parallel importing and compulsory licensing. Parallel importing and compulsory licensing permit a country to either import generic versions of patented drugs or manufacture them.

Even with discounts of up to 90%, the drugs being offered by the pharmaceutical companies will still be about 10 times more expensive than the cheapest generic alternatives.

'Moral equivalent of war'

The International AIDS Conference in Durban, South Africa, held in July, heard how the world would need at least $60 billion to treat 12 million people at the current prices of AIDS medication. The figure represents about one-fifth of the annual US military budget, but it would bankrupt many developing nations.

'If there were a nuclear war, we wouldn't worry about whether people had their trigger mechanisms patented or not,' says Nils Daulaire, president of the Global Health Council. 'This is, I hate to use the term, the moral equivalent of war,' he says, referring to the AIDS crisis in Africa.

Daulaire says the challenge goes way beyond cheaper medication. He says Africa needs to build up ailing national health systems, and provide skilled personnel to make sure the complicated drug regimens are administered and monitored properly, which would cost additional billions.

'Even if AIDS drugs were free, no more than 10 to 20% of Africans would benefit as the health infrastructures do not exist to manage infections in each individual,' he says.

But many African communities feel that humanitarian concerns far outweigh the rights of patent holders and access to cheap medicines would give them the vital push.

Sophia Mukasa-Monico of The AIDS Support Organisation (TASO) of Uganda says while communities are driving the response to AIDS on the continent, they have limitations because 'we cannot access expensive drugs that mean the difference between life and death'. - IPS

(Aug-Sept 2000)