Mail & Guardian (Johannesburg) - July 13, 2001
Howard Barrell

The chorus has been particularly loud in the case of the HIV/Aids pandemic. Some have gone so far as to suggest that the HIV virus does not exist. They argue the virus is merely a demon dreamt up by the pharmaceutical companies as a marketing ploy -- to ensure that governments and ordinary people are panicked into spending billions of dollars on a new class of drug, the anti-retroviral.

Our own President, Thabo Mbeki, has implied on a number of occasions that he holds this view.

I disagree with him -- not because I have any special scientific knowledge. I don't. Rather, I've come to the conclusion that the pharmaceutical companies are pretty stupid. Their marketing strategists appear to be (as a particularly pretentious British academic I encountered used to say of many who studied under him) "intellectually sub-optimal".

If the pharmaceutical companies were clever enough to hoodwink us on the grand scale suggested, they would surely have had enough grey matter to develop a workable marketing strategy for anti-retrovirals in a country like South Africa. Other foreign interests and industries have found a way to sell us things we don't need at enormous costs to ourselves. So why should the pharmaceutical industry be any different? I've told you already: because its marketers are really quite dim.

I thought of selling the pharmaceuticals the marketing strategy I outline below. Had I done so, it could have earned me vast amounts of money. Why? Because it is guaranteed to work. But, probably because I too am a bit sub-optimal, I am going to disclose it free of charge as a public service.

I am even more disappointed in Zackie Achmat and the others at the Treatment Action Campaign than I am in the brain power of the big pharmaceutical manufacturers. Achmat holds, as do I, that the HI virus does exist and that it invariably leads to the collapse of the immune system and the fatal onset of opportunistic diseases unless this process is retarded by anti-retrovirals.

Achmat, moreover, is himself HIV-positive and deals daily with people for whom the Aids syndrome is all too real and the prospect of affordable anti-retroviral treatment all too distant.

Moreover, he is an African National Congress member. He knows how the ANC works. So why has he not found the key to unlock the government's heart and provide affordable anti-retroviral treatment to all who need it?

Zackie Achmat has got the whole thing wrong. He's been demanding that the pharmaceutical companies drop the prices of anti-retrovirals as an inducement to our government to make them available, when needed, to the one in seven South Africans now infected with the HI virus. Really, how naive can you be?

Some pharmaceutical companies have even fallen in with this gullible strategy by offering price cuts. But we know why that is. Because they are stupid.

Zackie, old chap, the way forward to combating the HIV/Aids pandemic is not to ask the pharmaceutical companies to drop the prices of anti-retrovirals. Here is how to do it:

* Get the big international pharmaceutical companies to raise the price of anti-retrovirals. They can call the extra margin a "special cost of doing business in South Africa";

* Then get the pharmaceuticals to use this extra margin to help finance the setting up of a few medicines manufacturing or wholesaling companies in South Africa in which various ANC-aligned figures (some perhaps with medical or chemistry qualifications) have directorship and substantial shareholdings;

* Give these politically wellconnected companies the sole rights to manufacture or wholesale particular brands of anti-retroviral and other anti-Aids medicines;

* The pharmaceutical companies should provide an added sweetener for co-operative government officials and business people:

* Mercedes quality belly lifts for the men and facelifts for the women, or vice versa, depending on need and desire. The surgery should be carried out in southern California;

* With little prompting, this programme should inspire the government to budget, say, R30-billion of taxpayers' money (escalating to about R50-billion in two years) to fund medicines for the war against HIV/Aids -- whether or not the government or the president believes the HI virus exists or that it causes Aids.

The principle here is clear. Give significant members in the ANC, or people aligned to it, a pecuniary interest in fighting a particular war and quite amazing reserves of government will and taxpayers' funds can be mobilised. It doesn't matter if that war is real, as is the war against HIV/Aids, or imaginary, as is the war that R50-billion in armaments are supposed to protect us against; the principle applies nonetheless.

Get real, Pfizer. Get with it, Glaxo-Wellcome. Come on, Zackie Achmat, the big arms manufacturers abroad know how to do it.
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