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The Truth
12-13-2001, 09:54 PM
arlier this month was World AIDS Day. It focused on the role men in developing nations play in spreading HIV through rape, casual sex, and the failure to use condoms. UNAIDS, the sponsoring organization, released a sobering and stark account of how fear, ignorance, and brutality among men are the major reasons HIV has spread so rapidly throughout the world, and how prevention is critical to keeping the number of victims from growing from 40 million people to 60 million over the next few years.

But guess what? According to the media and most major AIDS organizations the real causes of the epidemic are high drug prices, and the patents that prop them up. In the recent round of trade talks in Doha, Qatar, designed to encourage free trade around the world, AIDS activists, African countries which have the most people infected with HIV (33 million) and anti-globalization groups pushed to revise international patent-protection rules to allow any country to seize any patent, or import any generic drug, so long as it claimed it had a public health crisis that could not be challenged in any forum. And they succeeded in getting the United States and Europe which wanted a deal to protect Western-nation farm subsidies that block developing world competition, and needed African and Indian complicity to get it to concede to just that, all in the name of helping to solve the HIV crisis.

But attacks on patents have nothing to do with saving the lives of Africans with HIV. When South Africa urged the World Trade Organization (WTO) to make AIDS drugs cheaper for the developing world, saying that the drug industry was putting patents before lives, its health minister called it a crime against humanity that poor people should die because life-saving medicines are too expensive. She also cited other methods for bringing down drug prices, including the use of generic substitutions of patented drugs, compulsory and voluntary licensing, and parallel importing (shopping around for cheaper drugs).

But it turns out that in all of Africa, there were an average of only three patented out of a total of 15 drugs used to treat the disease. In most countries, it is possible to produce a generic version of the triple cocktail of HIV drugs considered to be the best treatment for controlling replication of the AIDS virus. Yet no one has developed or manufactured such drugs, despite the freedom to do so. And even at the generic price ($360), the cocktail is still well out of the reach of many African health budgets.
Everyone grants that cutting the costs of drugs will reduce total treatment costs. But this has never been the major thrust of the activist argument. Hence, the same South African health minister who calls drug prices a crime against humanity also refuses to broadly distribute nevirapine a drug now available for free through its manufacturer, Boerhinger-Ingelheim. Nevirapine reduces transmission of the virus during labor by up to 50 percent (almost 23 percent of South Africa's pregnant women are HIV-positive). Meanwhile, the defense budget for South Africa is $5.5 billion compared to $430 million for AIDS. How exactly will a generic industry help dying infants where free drugs will not?