Bay Area Reporter - April 12, 2001
Liz Highleyman

According to Annan, "We affirmed to them that the intellectual property regime is essential if companies are going to have the incentive to do the research to produce effective medicines for these diseases. But at the same time we need to ensure that the needs of the poor are protected."

The companies that took part in the secret Amsterdam meeting were Abbott Laboratories, Bristol-Myers Squibb, Boehringer Ingelheim, Pfizer, Roche Holdings, and GlaxoSmithKline; global giant Merck and Company was notably absent.

The company heads agreed to set prices with the 50 least-developed countries as a group, rather than negotiate with each country separately; several of the companies have already agreed to price reductions on a country-by-country basis. Much attention has been focused in recent months on the need for AIDS drugs in African countries, but Annan insisted that developing nations outside Africa must also be included. The companies did not agree to specific prices at the meeting, citing antitrust concerns related to collaborative price-fixing.

Harvard proposal

The previous day, April 4, a group of Harvard University faculty members released an AIDS treatment proposal for sub-Saharan Africa that will be presented at a special meeting of the UN General Assembly on AIDS in June.

The authors estimated that the price for antiretroviral treatment for 1 million people with HIV/AIDS for three years would be $1.1 billion dollars, and proposed the establishment of a global trust to finance such treatment. Other AIDS relief - including prevention programs, non-antiretroviral treatments, and care for children orphaned due to the disease - would tack on another $3 billion. The statement was endorsed by 128 doctors, economists, policy experts, and researchers affiliated with Harvard.

Jeffrey Sachs of Harvard's Center for International Development, one of the report's authors, said that a comprehensive treatment and prevention plan for Africa was "overdue," and called on pharmaceutical companies to make AIDS drugs available at cost.

In the wake of the report's release, several philanthropists cautioned that funding for anti-HIV drugs was not sufficient, and that donors must also focus on prevention. "It's fantastic to see the AIDS crisis getting the increased visibility that it deserves," said Microsoft founder Bill Gates, but "prevention is tremendously under-funded." Gates's foundation has committed to spending $126 million on vaccine research and $133 million on other prevention initiatives.

Paul Davis of ACT UP/Philadelphia responded that prevention in the absence of adequate access to treatment is a failure, stating "if the only thing you get out of prevention is testing, stigma, and a death sentence, why would you like to listen to a prevention pitch?"

Also on April 5, the U.S. Senate passed a budget amendment that would allocate an additional $700 million for AIDS programs in developing nations, primarily in sub-Saharan Africa. The new amount would bring total U.S. funding for international AIDS initiatives to $1.1 billion. Under the Senate proposal, the additional funds would be phased in over two years, with the money coming from the U.S. budget surplus. The funds would be used to purchase anti-HIV drugs at discounted prices, as well as for prevention programs and health infrastructure such as clinics. Amendment sponsor Bill Frist (R-Tennessee) called AIDS funding "one of the most important moral, humanitarian and foreign policy decisions of the new century."

Harvard's Sachs said the Senate bill was "an important start but not yet enough," and suggested that the U.S. should commit at least $1.5 billion immediately, rising to $2.5 billion in five years. The amount proposed by Sachs works out to a cost of about $5 per U.S. resident.

Finally, on April 9 the World Health Organization and the World Trade Organization met in Norway to discuss improved drug access for developing countries. The WTO sets global trade policies that govern patents and intellectual property. The three-day meeting, which was continuing as the Bay Area Reporter went to press, was described as a brainstorming session. National trade officials, drug company representatives, and representatives of non-governmental organizations were expected to discuss how to prevent discounted drugs provided to poor countries from being sold on the black market to people in wealthy countries.

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