Associated Press - Sunday November 19, 2000
Theo Emery, Associated Press Writer

But the work of two Cambridge groups has changed their course, and that of dozens of AIDS medications like them, to Haiti, where the drugs are priceless.

"If I can't use them, somebody else can. There's a lot of stuff out there that's just being dumped," said Alicea, 36.

For the past year, Cambridge Cares About AIDS has been collecting the pills, most of them left over when a person switches drug regimens because of debilitating side effects.

So far, the group has delivered some $200,000 worth of medications to Partners in Health, a Boston-based organization with a clinic in Haiti that distributes the drugs to people with AIDS and HIV. Between 50 and 100 people who would otherwise never receive treatment are regularly receiving the medications there.

At the root of the salvage effort is the vast gulf between availability of the medications in affluent countries like the United States and developing countries like Haiti.

Some 95 percent of the more than 33 million people with HIV and AIDS in the world are in poor countries, according to the World Health Organization . In Haiti, considered the hemisphere's poorest country, just over 5 percent of the adult population is living with HIV.

In poor countries, the so-called drug "cocktails" - which can cost upward of $20,000 per year in the United States - are about 30 times the average monthly income, according to the group Doctors Without Borders. Partners in Health executive director Dr. Jim Yong Kim said there's an enormous unmet need that his group's effort cannot even begin to solve without global attention - and a global solution - to the drug crisis, he said.

"This is now an absolute disaster and an absolute crisis," Kim said. "It's a moral problem, but it's also an economic and political problem." Only a handful of groups send unused AIDS drugs overseas. There is no agency overseeing the practice, no way of knowing how common it is or whether groups are adhering to WHO guidelines for drug donations, said Michael R. Reich, acting chairman of the Department of Population and International Health at the Harvard School of Public Health.

But he said that while donations will never fill the need for drugs in poor countries, the effort highlights the problem.

"Troubling questions arise from gaps in access," he said. "Haiti is a country with extraordinary needs for good drugs, and donations provide a mechanism for trying to address the gap."

James Russo, spokesman for the Partnership for Quality Medical Donations, an organization made up of drug companies and non-governmental groups that distribute free drugs overseas, said it is a "perfectly reasonable and understandable and decent thing to do."

Such donations may not technically be legal, because the recipient is not the person for whom the drugs were prescribed, he said. But if the drugs are properly used and distributed, then public health benefits override such legal issues.

"The fact that it needs doing is, to me, a tragic observation about the state of public health policy," he said. "Nothing but good can come from something like this."

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On the Web:

World Health Organization: http://www.who.int/

Doctors Without Borders: http://www.msf.org/

Partners in Health: http://www.pih.org/

Partnership for Quality Medical Donations:

http://www.pqmd.org/announcement1.html
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