AIDS TREATMENT NEWS Issue #389, March 14, 2003
John S. James
On February 10, 2003, President William Jefferson Clinton gave the keynote speech at the 10th Conference on Retroviruses and Opportunistic Infections in Boston. As an example of the lack of systems in place dealing with AIDS, he noted that his team working in the Caribbean had in one week drastically lowered the price the Bahamas paid for drugs:
"The week after we started working in the Bahamas we found out that the government was buying, not from a big drug company, but from a generic source, but through an agent or two, AIDS drugs at $3,600 a year. Generically produced AIDS drugs at $3,600 a year. Our people on the ground there, said, "This is nuts." They went back and cut the deal directly with the manufacturer, and in one week they went from paying $3,600 a year to $500 a year per person, which means they're now serving more than seven times as many people for the same amount of money, and another 1,000 people will live because of it. That's the good news. It's a nice story, isn't it?
"It's horrible! Why does somebody have to drop in from another country to figure out how to save 1,000 lives with the money you're already spending? Why isn't somebody worldwide in charge of this? When the South African drug case was settled, it turned out to be largely a bust, because no one was put in charge of figuring out how many people needed the medicine in which countries, how much they could get it for, how much could they pay, and who would close the gap. There has never been a system to drive this.... We know that, without systems, madness like this will happen. And since there are lots of countries that cannot afford the $3,600 a year, there are a lot of people that don't have medicine they would otherwise have. Nobody is in charge of this deal. No one is in charge.
"So we're going to do what we can to make sure, in the countries we touch, we give them a maximum chance to save more lives more quickly. I hope that we can make a difference. I believe we can tone up these systems very quickly, and move quickly from treating scores of people to treating thousands of people."
Other activists could not expect such quick results. Besides being a former president, Clinton's team had been invited to help with AIDS in the Caribbean, and had signed a memorandum of understanding with 15 governments there.
Today many people in poor countries still must pay several times as much for generic antiretrovirals on the private market as what the manufacturer sells them for. There is no rational economic reason for such a large price increase -- thousands of dollars per person per year to distribute a product that costs so little to transport and store. Clearly the problems differ in various countries and regions. Activists must look for ways to overcome particular barriers, while also working toward workable worldwide systems for distributing live-saving medicine.
Note: The full text of President Clinton's speech is at: http://www.clintonpresidentialcenter.com/retroviral_2003.html
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