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by Thalif Deen
(IPS) UNITED NATIONS --
international medical aid agency has expressed strong reservations over a joint public/private sector agreement to provide inexpensive drugs and health care to the millions of people suffering from the acquired immune deficiency syndrome (AIDS).
The concept of dramatically reducing the prices of drugs by as much as 85 to 90 percent is a good one, says the Nobel Prize-winning group Doctors Without Borders. "However, missing are concrete commitments from drug companies, national governments and international donors."
"This agreement does nothing to stimulate countries' rights to produce or import inexpensive high-quality generic drugs, a key component to long-term, sustainable solutions for improving access to essential medicines," it said.
The aid agency was responding to an announcement by UNAIDS, the joint UN anti-AIDS program, that a new dialogue has been initiated between the UN and five pharmaceutical companies to explore ways to accelerate and improve the provision of drugs and health care to AIDS victims.
The five companies are Boehringer Ingelheim, Bristol-Myers Squibb, Glaxo Wellcome, Merck and Co Inc., and F. Hoffmann-La Roche.
"The fact that a serious discussion has begun among drug companies on dramatically reducing the price of AIDS drugs is a victory, but a small one, and much like an elephant giving birth to a mouse," Bernard Pecoul, of Doctors Without Borders, said today.
"The reality is that despite this initiative, AIDS drugs will still be unaffordable for the vast majority of those in need in the poorest countries," he adds.
The aid agency said that the net effect of implementing this type of program could lead to a further consolidation of the AIDS drug market in the hands of a small number of multinational drug companies, and will also discourage the growth of manufacturing capacity in developing nations.
Meanwhile, other AIDS activists who campaign for affordable access to life-extending treatments, expressed "deep skepticism" about the new agreement.
"The pharmaceutical kingpins are attempting to prohibit African nations from creating self-sufficient solutions to the AIDS crisis," says Sharon Ann Lynch of ACT UP. "The strings attached to this price reduction amount to a noose."
ACT UP said that prohibition against compulsory licensing ties the hands of poor nations seeking self-sufficiency, and imposes a remedy dependent on the generosity of multinational corporations.
In exchange for a moderate price reduction, it said, pharmaceutical interests have attached a conditionality that prevents poor nations from exercising the legal means to manufacture generic versions of expensive patented medicines.
May 10, Pres. Clinton issued an executive order declaring that the U.S. government will not interfere with countries, specifically in sub-Saharan Africa, that may violate American patent law in providing AIDS drugs at lower prices.
Although these practices may be challenged under U.S. patent law, African nations could now either license local companies to produce generic versions or even import drugs from countries where they were available at cheaper prices.
While the Executive Order was described as a step in the right direction, Doctors Without Borders said it was concerned that the beneficiaries were restricted to sub-Saharan Africa.
This falls short of a pledge made by Clinton last December when he said that the United States will "henceforward implement its health care and trade policies in a manner that ensures that people in the poorest countries won't have to go without medicine they so desperately need."
Secretary-General Kofi Annan welcomed the new developments pointing out that the fact that drugs will be available is a positive and really strong indication to the patients that they are not being abandoned. "But let's not kid ourselves," he added, "drugs alone will not do it."
Annan said that any reduction in the prices of drugs will have to be combined with improving health systems and delivery capabilities and follow-up on patients. "So there is a whole range of activities which will need to be brought on board," he added.
Pointing out that UNAIDS has been working with quite a lot of governments to deal with the disease, he said there has been a controversy for some time as to whether or not African countries are going through the AIDS epidemic and who has the capacity to produce locally, some of these drugs.
Annan specifically referred to "generic versions" of anti-AIDS drugs which should be made available at a much cheaper cost, and more importantly, as to who will be allowed to do that.
"So I think the executive order is an important step in the fights against AIDS. It will help with treatment, and I think we are working on two fronts -- prevention and treatment," Annan added.
Meanwhile, Doctors Without Borders has urged UNAIDS to explore more widespread use of generic competition.
The example of Brazil, it said, was "poignant." By using more cost-effective locally produced generic drugs by the end of this year, Brazil will be able to offer combination anti-retroviral therapy at about $1,000 per year compared to a global price of about $10,000 to $15,000.
"Political commitment plus high quality local production has already led to a dramatic increase in access to AIDS drugs in Brazil," the aid agency said.
May 15, 2000 (http://www.monitor.net/monitor) All Rights Reserved. Contact firstname.lastname@example.org for permission to use in any format.
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