Copyright 2000 InterPress Service, all rights reserved.
Worldwide distribution via the APC networks.
*** 20-Jul-0* ***
Title: FINANCE: Cheaper AIDS Drugs for Africa?
by Gumisai Mutume
WASHINGTON, Jul 19 (IPS) p The US Export-Import Bank has
announced a 1 billion dollar programme to finance the purchase of
AIDS drugs for a number of sub-Saharan nations ravaged by the
HIV virus.
Under the programme, major US drug companies will offer their
products at a discount and the Export-Import Bank will finance
their export with five-year loans in a bid to reduce the price of
AIDS drugs in Sub-Saharan Africa.
The move, announced in Washington Wednesday comes on the
heels of an announcement by African nations at the just ended
World AIDS Conference in Durban, South Africa, that they would
explorecheaper ways of acquiring AIDS cocktails such as resorting
to importing generic drugs from other developing countries.
The US Export-Import Bank initiative will not help them in this
regard. "The Bank's authority is limited to extending loans for
the purchase of US products which include most leading HIV and
AIDS-related drugs," says Export-Import Bank chairman James
Harmon.
The programme will be available to 24 sub-Saharan African nations,
Benin, Botswana, Burkina Faso, Cameroon, Cape Verde Island,
Cote D'Ivoire, Gabon, the Gambia, Ghana, Kenya, Lesotho, Mali,
Mauritius, Mozambique, Namibia, Niger, Nigeria, Senegal,
Seychelles, South Africa, Swaziland, Tanzania, Uganda and
Zimbabwe.
However, there are doubts about how the bank's commercial-rate
loans will allow for the delivery of cheaper drugs.
In a few weeks' time five pharmaceutical companies involved in the
scheme will embark on a country-by-country assessment to
determine the depth of discounts they can offer. They are Merck &
Co., Glaxo Wellcome, Boehringer Ingelheim, Bristol-Myers Squibb
and F. Hoffman-La Roche.
In May the companies agreed to slash the price of their drugs to
below market prices for sub-Saharan Africa.
A year's supply of the three anti-AIDS cocktail drugs costs up to
12,000 dollars a year per patient. The Export-Import Bank loans
are expected to be given at commercial rates which average seven
percent in the United States, a figure many of the highly indebted
poor countries in Africa may not find appealing.
Even with discounts of up to 90 percent, the drugs would still
cost about 2,000 dollars a year, which is way above the average
per capita incomes of 500 dollars in many of the worst affected
countries.
Last year, world pharmaceutical sales were estimated at 200
billion dollars.
While commending the Export-Import Bank's efforts, the Ugandan
ambassador to the United States, Koby Koomson said the
pharmaceutical companies still need to "look at ways to make
these products more affordable to the people of Africa."
He says developed countries need to devote more financial
resources to Africa. He also calls for partnerships with African
countries aimed at "total patient care and educational programmes
to help prevent the spread of the disease".
There is an ongoing debate on how best to approach the treatment
of HIV/AIDS in developing countries especially in sub-Saharan
Africa where some 24 million people are said to be infected.
After the Durban AIDS conference, a number of sub-Saharan African
countries announced they would explore the possibility of using
cheaper generic drugs, which according to Medicins San Frontier
(MSF), could lower treatment to 200 dollars per person a year.
Brazil and Thailand have been successful in this regard. In Brazil
a staggering 80,000 people were treated through the use of
affordable generic drugs that brought triple-drug therapy down to
a cost of approximately 1,000 dollars a year. In Uganda, however,
where the government was working with brand-name drugs in a
UNAIDS initiative, less than 1,000 people were treated over the
same period.
US Pharmaceuticals have strongly resisted any moves by African
governments to lower the price of AIDS drugs. At one stage the US
based Pharmaceutical Research and Manufacturers Association
threatened to pull South Africa through the courts if it legislated
compulsory licensing.
Compulsory licensing refers to an order by a court or government
body that allows any person or government to use a patent legally
without permission from the patent holder in the public interest.
But as the epidemic rages, 95 percent of the 34.3 million people
worldwide with HIV/AIDS remain without access to treatment and
the spread of the epidemic has been exacerbated by this lack of
access to medicines.
"Many factors contribute to the problem of limited access to
essential medicines: the emerging global trade system, which sets
the rules for how products are sold within and between countries,
is one. This system treats medicines like other non-essential
products," notes the medical humanitarian organisation, MSF.
One-third of the world's population lacks access to essential
medicines. In the most impoverished parts of Africa and Asia that
number is more than 50 percent.
In one of the most affected countries, South Africa there are more
than 3.5 million people out of 43 million infected with HIV. The
Treatment Action Campaign which has been lobbying for cheaper
substitutes says it is inconceivable for the vast majority of the
population to afford the real thing.
The vast majority of people who have HIV are poor and black in
South Africa and young women are at greatest risk for infection in
a country where more than 60 percent of employed people earn less
than 250 dollars a month.
TRAC says the problem is wider than just affordable AIDS drugs as
even access to drugs for opportunistic infections are increasingly
limited. "This includes no treatment for retinitis, meningitis, or
even serious cases of candida," notes TRAC.
According to UNAIDS in order to make a dent in dealing with the
HIV/AIDS problem in Africa wealthy nations need to make firm
commitments to support national programmes at a tune of 3 billion
dollars annually p this is about 10 times the amount currently
being spent.
"We are a trade agency, not an aid agency," says Harmon. The
primary job of Export-Import Bank will be to provide
Congressionally-mandated financing for credit-worthy US exports
and to create US jobs.
Wendy Roseberry senior technical expert for Southern and Eastern
Africa says the initiative is welcome in that it affords African
governments one more option in their choice of a strategy to deal
with the crises.
She, however, says while the Durban conference put the spotlight
on the issue of how best to provide treatment, enough is still not
being done to tackle AIDS internationally. She also expresses
concern at whether impoverished nations will be able to afford
more loans to deal with HIV/AIDS.
"While we seem to be focusing on debt relief on one hand we are
talking about borrowing for AIDS on the other," she says. "These
are hard policy choices for sub-Saharan Africa".
Roseberry says some countries have no choice other than to
borrow to mitigate new infections that would cost more in the long
run.
The Export-Import financing route will not be cheaper than
importing generic drugs. It will certainly place a further debt
burden on poor African countries, 29 of which are seeking debt
relief under the Highly Indebted Poor Countries Initiative (HIPC).
(END/IPS/HE/EF/gm/da/00)
Origin: SJAAMEX/FINANCE/
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[c] 2000, InterPress Third World News Agency (IPS)
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