Daily Mail & Guardian - Johannesburg, South Africa. May 12 2000
Andrew Clark, Sarah Boseley and Larry Elliott

With one in four people infected in some of the worst hit African countries, and life expectancy tumbling by up to 10 years, one western pharmaceutical giant said it would cut the price of treatment from $16 a day to about $2.

The Clinton administration - under pressure from gay activists, the World Bank and the United Nations - also announced that it would drop its threat to use trade sanctions against countries such as South Africa planning to produce cheap generic copies of existing western medicines.

Aids activists and development experts hailed yesterday's news as a landmark in the fight against the disease in some of the world's poorest countries.

"It's the first time the companies are collectively willing to discuss a truly significant decline in prices," said Peter Piot, director of the UN Aids programme (UNaids). "It is something many of us have long hoped for."

The five drug companies involved are Glaxo Wellcome, Boehringer Ingelheim, Bristol-Myers Squibb, Roche, and Merck. Glaxo's chairman, Sir Richard Sykes, said the spread of Aids, particularly in sub-Saharan Africa, "threatens to wipe out the development and economic gains made in the second half of the last century".

Chris Lovelace, the director of health, nutrition and population at the World Bank, said the move was "very promising and very important but not a panacea. Only 3% of those who are HIV positive go into clinics because it is still a taboo subject. However it is a big step forward." Aids experts warn that with most of sub-Saharan Africa's population subsisting on less than $2 a day, even the promised price cuts will not be sufficient to make the drugs affordable. Many of those infected do not even know they have the disease.

"We have created an environment within which drug companies are prepared to start dropping their price. That's great, but I doubt that will be enough to bring the baseline price down to the sort of level that is meaningful for the majority of the 40m with HIV who need treatment," said David Nabarro, an executive director of the WHO.

Of more than 13m Aids deaths to date, 11m have been in sub-Saharan Africa. A further 23m Africans are infected with the virus, two-thirds of all cases worldwide.

One of the latest treatments for Aids is Glaxo's Combivir - launched in the US and Europe in 1998 - which brings together a cocktail of drugs in two daily doses.

President Clinton's intervention yesterday will allow sub-Saharan Africa to buy cheaper generic versions of the drugs, being manufactured in Brazil, Thailand and India. He lifted tough US patent restrictions in favour of World Trade Organisation rules, which allow exemptions for countries in dire need of drugs.

Drugs companies with large portfolios of HIV medicines have found the market for full-priced products in developed countries is relatively limited. The spread of the virus has slowed, particularly in the US, and competition has reduced companies' profit margins.
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