Wall Street Journal - April 20, 2001
Robert Block, Staff Reporter

JOHANNESBURG, South Africa -- Minutes after the world's biggest drug makers abandoned a legal battle to stop South Africa from importing cheap generic AIDS drugs, South Africa's health minister stood before a packed conference room and dropped a bombshell.

South Africa, said Manto Tshabalala-Msimang, had no immediate plans to use the landmark legal victory to obtain AIDS drugs known as anti-retrovirals, the leading treatment for the disease in the developed world.

"We never said we want to use anti-retrovirals," she told the audience, which went from singing and clapping to silence in minutes. "But we have to place our options on the table to see what we will use."

The moment marked the beginning of the next battle over AIDS treatment in South Africa: the struggle between activists and the government (allies in the fight against drug companies that ended Thursday) over how, or even whether, the drugs will be distributed and administered.

Claiming victory for supporters of the South African government in its battle against the drug companies, Kevin Watkins, a policy adviser to the British charity Oxfam, warned: "If the government doesn't grasp this opportunity, this struggle would have been wasted."

Zackie Achmat, chairman of the South African Treatment Campaign, himself infected with the virus that causes AIDS, announced after the health minister's remarks that activists would work to persuade the government to change its position on anti-retroviral drugs.

While the case was technically about patent rights, and not AIDS medication per se, AIDS activists effectively used the high cost of the drug cocktails used to prolong AIDS patients' lives as a potent symbol of barriers preventing poor Africans from getting treatment.

The South African health ministry, which only a year before was pilloried for AIDS policies that questioned the link between HIV and AIDS, allied itself with AIDS activists during the case.

That raised expectations the government would make anti-retroviral drugs a major focus of its treatment strategy if the case was won.

Dr. Tshabalala-Msimang said the drugs are still too expensive, too dangerous and too difficult to manage for the government to incorporate them into its AIDS-fighting plans.

Instead, the government backed nutrition programs and better treatment of infections, she said. "I think we are doing very well," she said.

For their part, drug companies say more-affordable AIDS drugs are only a small part of the effort to fight AIDS in poor countries.

In an interview, Jean-Pierre Garnier, chief executive of GlaxoSmithKline PLC, noted that Boehringer Ingelheim GmBh's AIDS drug has been available for almost a year and many African nations, including South Africa, don't employ it.

"That's the ultimate proof the issue of pricing could have been a hurdle, but is irrelevant in the grand scheme of things," he said.

Jeffrey Sturchio, spokesman for Merck & Co., said the settlement "underscores ... the importance of intellectual-property protection and the need to balance intellectual-property protection with the health needs of South Africans."

-- Gardiner Harris in New York contributed to this article.

Write to Robert Block at bobby.block@wsj.com

010420
WJ010408

Copyright © 2001 - The Wall Street Journal. Reproduction of this article (other than one copy for personal reference) must be cleared through the WSJ Permissions Desk.

ÆGiS is made possible through unrestricted grants from Boehringer Ingelheim, iMetrikus, Inc., the National Library of Medicine, and donations from users like you. Always watch for outdated information. This article first appeared in 2001. This material is designed to support, not replace, the relationship that exists between you and your doctor.

ÆGiS presents published material, reprinted with permission and neither endorses nor opposes any material. All information contained on this website, including information relating to health conditions, products, and treatments, is for informational purposes only. It is often presented in summary or aggregate form. It is not meant to be a substitute for the advice provided by your own physician or other medical professionals. Always discuss treatment options with a doctor who specializes in treating HIV.

Copyright ©1990, 2000. ÆGiS & the Sisters of Saint Elizabeth of Hungary. All materials appearing on ÆGiS are protected by copyright as a collective work or compilation under U.S. copyright and other laws and are the property of ÆGIS and the Sisters of Saint. Elizabeth of Hungary, or the party credited as the provider of the content.