Newsday - June 7, 2001
Laurie Garrett, Staff Writer

At a news conference at United Nations headquarters, Pfizer chief executive officer Hank McKinnell signaled his company is heeding United Nations Secretary General Kofi Annan's recent call for industry sacrifices to get vital drugs to poor nations hardest hit by HIV and AIDS.

The plan, hammered out after more than 20 months of negotiations with the South African government, will make fluconazole available immediately to South Africa and its neighbors, Botswana, Lesotho, Namibia and Malawi. Pfizer will assist in developing systems in the region for distribution of the medicine. In addition, the company yesterday vowed that any of the other 50 least-developed nations are eligible to receive the drug gratis.

Fluconazole, which is marketed under the name Diflucan, is a patented medication used for treatment of fungal infections. It is an indispensable component of successful treatment for AIDS patients because it is effective against cryptococcal meningitis and candida thrush. About 10 percent of all untreated AIDS patients in Africa contract the brain-damaging, usually fatal cryptococcal meningitis, and upwards of 40 percent develop thrush in their throats.

Activists and health leaders in poor countries have long sought discounts from Pfizer, and the company has come under increasing pressure from demonstrations in this country.

"Today is an important day for AIDS patients," McKinnell said. "I consulted with the White House and Health and Human Services Secretary Tommy Thompson and received their encouragement. Our goal is to provide Diflucan...in a manner that offers the least stress to these nations' public health systems."

The company's plan promises to provide millions of dollars worth of fluconazole and underwrite the cost of training doctors and nurses in diagnosing and treating the two fungal diseases. McKinnell declined to specify the size of the donation, nor would he state how much it costs Pfizer to make fluconazole in its Brooklyn factory.

Pfizer's Africa public affairs specialist, Konji Sebati, said in an interview that the South African portion of the program will be roughly equivalent to $25 million a year. Pfizer's commitment is for two years, with program reassessment in 2003.

In two years, Pfizer's patent on fluconazole expires.

Sebati said the cost of the giveaway program in South Africa was determined based on optimistic forecasts regarding the country's ability to use the drugs.

"So by the end of two years the health care system of South Africa will have 80 percent of its current 4.2 million people with HIV in treatment, and 10 percent of them will need fluconazole." The price tag, in South African rand at current market prices, would equal $50 million.

McKinnell said yesterday that "if we get into treatment 50,000 in all of Africa in the next two years...that would be significant." African leaders attending the press conference said offers like Pfizer's may prove an incentive for improvements to inadequate health care systems in other countries.

South Africa's ambassador to the United States, Sheila Sisulu, told Newsday her country plans to use the Pfizer agreement as the basis for future partnerships with other companies. The commitment to infrastructural support, she said, is a key element, as is regional distribution of drugs, because of the threat of mass immigrations of AIDS-sufferers from neighboring nations where such treatments aren't available.

The negotiations with Pfizer were tough, lasting nearly two years, Sisulu explained, because "unless there's a real partnership that recognizes that infrastructure is critical, that unless you actually have people who are able to administer and monitor the use of these medications and their effects on people, eventually you end up creating new, worse problems."

Pfizer also announced yesterday that it will be partially underwriting the Academic Alliance for AIDS Care and Prevention in Africa, based in Kampala, Uganda. In support of the Alliance, Pfizer is building a headquarters clinic in Kampala, which will collaborate with U.S. physicians and scientists to set standards for African AIDS treatment and physician training.

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