Wealthier countries, drug firms can save Africa

By Mark Mathabane

When I was growing up in a South African ghetto, my family couldn't afford medicines for such commonplace illnesses as colds, chicken pox and measles. I remember a bottle of aspirin costing my parents as much as it cost to feed our family of nine for several days.

Now HIV/AIDS is a commonplace illness in my homeland. South Africa has one of the world's highest AIDS infection rates: More than 4.7 million people in a country of 43 million were infected by the end of last year, including one in four pregnant women.

The expensive drugs needed to combat the incurable disease are beyond the reach of most South Africans. Pharmaceutical companies, responding to mounting pressure to make AIDS drugs more affordable, recently slashed prices. But these prices remain high, particularly for poor nations saddled with heavy debts, struggling economies and a host of intractable social and economic problems. Wealthy nations must play a role in offsetting the cost.

World attention has focused on a landmark legal case in South Africa that could dramatically affect the price and accessibility of AIDS drugs. Thirty-nine pharmaceutical companies are challenging the legality of a South African law that would allow the country to import cheap generic brands of patented AIDS drugs.

Since the lawsuit was filed three years ago, 400,000 South Africans have died from AIDS-related illnesses. By the end of the decade, 6 million South Africans will die from AIDS, and one in three children will be orphaned, if people don't gain access to affordable drugs that have significantly lowered the death rate in the industrialized world.

Far less expensive

Legal experts believe the 1997 law South Africa has invoked is consistent with international trade agreements the country has signed. Under the law, two Indian companies that now manufacture generic versions of many AIDS drugs would be able to sell them to South Africa at prices below those offered by pharmaceutical companies. For instance, an AIDS cocktail therapy would cost South Africans about $600 a year, a fraction of the $11,000-$15,000 Americans pay.

Drug companies maintain that poor education, lack of infrastructure and inadequate health services are greater barriers than price for Africans infected with HIV/AIDS. But this is not entirely true. Last year, in the Khayelitsha township near Cape Town, 50,000 HIV-positive residents could have benefited from treatment, yet not one could afford AIDS therapy, according to Doctors Without Borders.

Save money and lives

AIDS drug therapy not only saves lives, but also is cost-effective. Two recent studies in The New England Journal of Medicine found it saves an average of $2,000 per year per patient in the United States by keeping people out of hospitals. These benefits, researchers believe, could also accrue to nations such as South Africa -- if they can afford the AIDS drugs. The grim reality is that most African countries have minuscule health budgets.

Some drug companies are doing more to help Africans fight the AIDS pandemic. Pfizer, which is not among the firms suing the South African government, is giving away an anti-fungal medication used to fight cryptococcal meningitis, a lethal brain disease found in many AIDS patients. The drug had cost South Africans $15 a dose.

The World Health Organization estimates that 5 million infected Africans could benefit from access to AIDS drugs -- yet only a few thousand can afford them. AZT, for instance, has proved effective in reducing the risk of mother-to-infant transmissions of the disease. If it were free, AZT could save tens of thousands of the African babies infected with HIV/AIDS every year.

Africa's fate hinges on vanquishing the AIDS pandemic. By the end of last year, 25.3 million Africans were infected. The beleaguered continent, which has only 13% of the world's population, is now home to 90% of the world's HIV infected children and 70% of infected adults. Because of AIDS, life expectancy in sub-Saharan Africa is expected to plummet below age 30 by the end of the decade -- the lowest level in 100 years.

Drug companies, African governments and rich nations must urgently cooperate to contain the pandemic before millions more die.

Mark Mathabane, a lecturer and author, is writing a book about South Africa's Truth and Reconciliation Commission.