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Subject:
From:
Jabou Joh <[log in to unmask]>
Reply To:
The Gambia and related-issues mailing list <[log in to unmask]>
Date:
Sun, 14 Mar 2004 09:46:05 EST
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African Aids drug plan faces collapse 
Alison Langley in Geneva
Sunday March 14, 2004
The Observer

A United Nations plan to provide three million HIV-infected patients in
Africa with anti-retroviral drugs by 2005 is in danger of collapsing owing
to lack of funds, UN and World Health Organisation officials said. 

Some countries, particularly the United States, are balking at supporting
the project, Aids workers say, partly because the plan intends to use a form
of medicine called fixed-dose combination antiretroviral drugs whose use is
opposed by large pharmaceutical companies. 

Only $2.3 billion has been secured for the $5.5bn WHO project, dubbed 'Three
by Five' because it hopes to provide drugs to three million people by 2005.
Only the UK, Sweden and Spain have provided money to date, officials said. 

'If Three by Five fails, as it surely will without the dollars, then there
are no excuses left, no rationalisations to hide behind. There will only be
the mass graves of the betrayed,' said Stephen Lewis, the UN
Secretary-General's special envoy for HIV/Aids in Africa. 

The WHO urgently needs $200m in the next few months to upgrade health
systems' infrastructures in 14 African states, Lewis said. 

Aids activists say money isn't forthcoming because of WHO support of the use
of combination medicines. Called fixed-dose medicines, these drugs combine
two or more active ingredients in one pill, thereby reducing the number of
tablets an AIDS patient must swallow each day. 

Fixed-dose drugs are also cheaper. Taking two fixed-dose combination pills a
day for a year costs $140 per patient, compared to about $600 per year for
six pills per day. 

A fixed-dose combination pill 'has completely revolutionised people's
lives', said Ellen 'T Hoes, director of Mèdecins Sans Frontiéres' Access to
Essential Medicines programme. 

The US, by far the largest donor with a $15bn plan launched last year, has
been reluctant to endorse the fixed-dose combination pills, saying they are
not yet convinced the medicines are safe.

In order to make the combination drugs, generic manufacturers use active
ingredients that were discovered by different pharmaceutical companies and
are under patent in wealthy countries. 

'We need to have principles - standards by which the purchase decisions can
be made,' said Randall Tobias, the US Global Aids coordinator, in recent
testimony before the US Congress. Ambassador Tobias is the retired chairman
of Eli Lilly, one of the world's biggest pharmaceutical concerns. 

WHO and Aids workers say the principles and guidelines are already in place
because the medicines must meet extensive guidelines by the World Health
Organisation before being approved for use. 

The US is sponsoring a two-day conference starting on 29 March in Botswana
to discuss the principles of regulation of these generic medicines. 

The fixed-dose pills approved for use by the World Health Organisation are
produced by three generic drug makers in India, which does not yet recognise
patent laws. Exceptions to the patent system allow local manufacturers in
poor countries to produce life-saving generic medicines and export them only
under certain limited circumstances to other poor nations. 

This means Indian manufacturers will agree to sell their wares in the 14
poorest African nations. Mèdiciens Sans Frontiére's 'T Hoen believes the US
stance is not motivated by safety. 'The US's position is to buy drugs only
approved by the (Federal Drug Administration),' she said. 'The fixed dose
can't be approved by the FDA because of patent problems, not because of
their safety or efficacy.' 


Guardian Unlimited © Guardian Newspapers Limited 2004

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