AIDSWEEKLY Plus; Monday, June 18, 2001
Staff Medical Writers

NewsRx - The World Health Organization (WHO) during May 2001 stopped short of approving radical proposals for wider international access to cheap HIV/AIDS drugs.

Those proposals, raised by Brazil, had called for legislative protection of local production of cheaper generic drugs, a plan criticized by multinational producers of branded products. But a number of countries objected on the grounds that the WHO didn't have the authority or resources to take on such a role, and that trade and patent issues were best handled by the World Trade Organization, which sets global trade rules.

In a resolution adopted May 19, 2001, after two days of heated debate at WHO's annual assembly, the organization instead urged greater efforts toward tackling the epidemic. It asked WHO director-General Gro Harlem Brundtland to "maintain close collaboration with the international community and the private sector with the aim of improving the availability of medicines for HIV/AIDS, including antiretroviral therapy."

Health activists said the resolution doesn't go far enough and accused officials of putting commercial interests before people's lives.

The resolution "is something we could have done without. It doesn't add anything to what was adopted two years ago," said Ellen 't Hoen of the Doctors Without Borders campaign for access to essential medicines. "This is almost like a step backward. What I find very peculiar is that so many countries expressed their concerns about intellectual property, patents, and drug prices, but none of that is reflected in the resolution."

The debate on access to essential drugs has exploded in recent months. Some leading pharmaceutical companies have cut prices, sometimes under manufacturing cost level, to provide HIV/AIDS medication that few African countries could previously afford. But the drug companies also want to protect their patent rights against competition from cheaper generic versions.

Since AIDS was first identified 20 years ago, an estimated 60 million people have been infected, of whom some 22 million have died. The disease is expected to slash life expectancy in the worst hit African countries to 45 years in the coming years.

"AIDS is a crisis of unprecedented proportions that threatens development, social cohesion, political stability, life expectancy, and places a devastating burden on many countries and regions," the resolution said.

The resolution was adopted by consensus, according to WHO tradition. It was drawn up jointly by the European Union and Brazil, which was forced to drop its original, more radical proposals.

In its original proposals, Brazil also demanded that WHO take a more active role in promoting access to AIDS/HIV drugs and set up a price databank that would allow countries to shop around more easily among different pharmaceutical companies.

The United States has filed a complaint on Brazil's drug policy with the World Trade Organization, saying Brazil unfairly favors local producers and violates patent rules. The Bush administration has put Brazil on notice that it could face American trade sanctions.

Brazil says its strategy of universal access to treatment with locally made HIV/AIDS drugs, combined with a strong prevention and care program, has dramatically slowed the spread of the disease. The South American nation has an estimated 550,000 cases - compared with predictions made by the World Bank in 1994 of some 1.2 million infections in Brazil by this year.

U.N. secretary-general Kofi Annan recently set up a Global Health Fund, seeking the help of rich nations in providing $7 billion to $10 billion to tackle HIV/AIDS, tuberculosis, and malaria. So far, only the United States has donated $200 million.

This article was prepared by AIDS Weekly editors from staff and other reports.

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