Inter Press Service - May 10, 2000
Gumisai Mutume

"The executive order directs the US government to refrain from seeking, through negotiation or otherwise, the revocation or revision of any law or policy imposed by a beneficiary sub-Saharan government that promotes access to HIV/AIDS pharmaceuticals and medical technologies," says Democratic senator Dianne Feinstein.

Feinstein has been pushing similar policy provisions under the African Growth and Opportunity Act (AGOA) which, together with the Caribbean Basin Initiative is part of the proposed Trade and Development Act 2000 which aims to give Sub-Saharan Africa and the Caribbean greater access to the US market. It has passed through the House of Representatives and may be approved by the Senate as early as this week.

Under Feinstein's provisions, African countries would be able to manufacture, sell or import cheap, generic AIDS drugs despite patents held on them by major pharmaceutical companies. However, they were dropped from the Act mainly due to fierce lobbying by large pharmaceutical companies.

While 'compulsory licensing' and 'parallel importing' are consistent with World Trade Organisation (WTO) regulations allowing countries flexibility in addressing public health issues, US pharmaceutical companies think otherwise.

"At the behest of the pharmaceutical lobby Senate Majority Leader Trent Lott and House Speaker Denny Hastert stripped senate language from the bill that would have increased availability of affordable generic versions of expensive patented AIDS medication for Africa," says Paul Davis of the AIDS activist group Act Up. "An executive order, unfortunately can be overturned by an incoming presidential administration that is acting as the pharmaceutical industry's puppet," says Davis in a statement.

The Clinton administration has generally sympathised with the pharmaceutical sector's position which is that the industry is simply trying to adhere to intellectual property rights regulations enabling researchers to continue developing new drugs.

Sub-Saharan Africa, with an estimated 34 million people infected with HIV - more than 80 percent of the world total -- has however continued to suffer, unable to benefit from cheap generic drugs made in countries such as India.

In 1997, South Africa enacted a law allowing government to licence manufacturers to make AIDS drugs cheaply and to import generic versions. However, US drug companies such as Bristol-Myers Squibb and Merck strongly objected. The Pharmaceutical Research and Manufacturers Association of America led efforts to nullify the South African laws.

The new order, however, recognises that it is "in the interests of the United States to take all reasonable steps to prevent further spread of infectious disease, particularly HIV/AIDS".

South Africa is one of the countries worst affected by the HIV epidemic with estimated infection rates put at 1,600 every day.

Clinton's executive order says there is a critical need for effective incentives to develop new drugs, vaccines and therapies.

Recently Clinton asked Congress to approve a tax incentive for pharmaceutical companies of 1 billion dollars over a 10-year period, to develop a vaccine for HIV/AIDS and other diseases devastating poorer regions of the world.

The executive order, however, does not prohibit the US government from evaluating, determining or expressing concern about whether policies in Africa really promote access to HIV/AIDS pharmaceuticals or whether these countries provide adequate and effective intellectual protection.

"At the same time the order ensures that fundamental intellectual property rights of US businesses and investors are protected by requiring sub-Saharan governments to provide adequate and effective intellectual property protection consistent with World Trade Organisation rules," President Clinton said in a letter to Feinstein released to the media.

Earlier this month the US government formerly declared AIDS a national security threat. US concern over AIDS in Africa grew during the 1980s and Congress earmarked funds for a worldwide campaign against the disease in 1987. Between July 1999 and the end of this year, the United States projects that 170 million dollars will have been spent in the anti-AIDS fight in Africa.

USAID estimates that Kenya's Gross National Product will be 14.4 percent smaller in 2005 than it would have been without AIDS. In South Africa, Tanzania, Namibia Zimbabwe, the disease is expected to hinder economic growth.

While governments, donors and non-governmental organisations have responded to AIDS in Africa by attempting to reduce the number of new infections, another possible response, treatment of people with medicines that can result in long-term survival have been ignored largely due to cost, notes a paper by the Congressional Research Service.

The use of highly effective anti-retroviral therapy (HAART) has proven highly effective in developed countries such as the United States. Advocates of making HAART widely available in Africa argue that it would keep patients alive, slow the growth in the number of orphans, keep workers alive and reduce the economic impact of AIDS.

Estimates, some as high as 20,000 dollars per person, have been published as estimates of the annual cost of these combination therapies in Africa yet according to the World Bank, no sub- Saharan African country spent more than 400 dollars per person per year on health during 1990 to 1995.

The Congressional Research Service paper titled "AIDS in Africa" says that one view being mooted is that some combination of subsidies, price reduction and local manufacturing can be found which would make the drugs more widely available while maintaining drug company revenues through the sheer volume of African sales. (END/IPS/DV/HE/gm/da/00)
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