Global AIDS - Africa

The Politics of AIDS Drugs in Africa - Highlights of Special Report
By Kwame Kuadey

Africa is said to be home to 70% of adults and 80% of children living with HIV in the world. The continent has buried three-quarters of the more than 20 million people who have died of AIDS worldwide. Estimates show that close to 2.3 million people died of HIV-related illness in Africa in 2001.

Although there is no cure for AIDS, drug cocktails and improved medical care in developed countries are significantly extending the lives of people living with HIV. In this article, I will examine issues affecting the availability of drugs and care for HIV/AIDS patients in Africa, and explain why the production of cheaper generic versions of HIV/AIDS drugs is the best available option in providing hope for the millions already infected with HIV/AIDS.

AIDS and HIV Drugs

No so long ago, testing positive for HIV meant an automatic death sentence. Now things have changed for the better. A combination of drugs introduced about five years ago have turned AIDS from a death sentence to a treatable disease. These drugs are able to prolong life a few ore years. Even for people dying of AIDS, new drugs are available that can restore health temporarily. When taken the right way, these drugs can drive the HIV virus below detectable levels. The bad news is that these drugs are very expensive and can only be afforded by a few patients, mostly in advanced countries. In Africa, fewer than 50,000 people living with HIV have access to HIV treatment (out of over 25 million people infected).

AIDS Drugs in Africa

Few Africans can afford the drugs needed to fight AIDS, which can cost between $500 and $1,000 a month. Additionally, many African governments do not have the funds to import these drugs. The average African nation spends less that $10 per person each year on health care. At the same time, these governments have to fight diseases like malaria, TB and cholera, among others.

Even simple antibiotics prescribed to patients who begin to show signs of so-called opportunistic AIDS infections, like tuberculosis and other bacterial infections, are not available for patients in many African countries. Another drug, Fluconazole, which is essential in the management of HIV-complications (like meningitis, which is a common infection in many AIDS cases in Africa) is too expensive and therefore unavailable in many Sub-Saharan African countries.
This means that a majority of the 25.3 million Africans infected with AIDS won't get the best available treatment and will die as a result. In Zambia, one of the few growth industries is coffin making. It is estimated that 200 people die of HIV-related illnesses in Zambia each day. The availability of affordable drugs for AIDS patients should be seen as an urgent situation than needs the attention of African governments, pharmaceutical companies and the international community. What good is a drug, if 95 percent of the people it was meant to help cannot afford it?

Why Are AIDS Drugs So Expensive?

The drug used to fight HIV/AIDS are manufactured by pharmaceutical companies usually based in Europe and North America. These companies spend billions of dollars on research and development of HIV/AIDS drugs. They are therefore determined to profit from their drugs at all cost. This makes them less sympathetic to the plight of AIDS patients in Africa. As rightly noted by Richard Holbrooke, former US ambassador to the United Nations, "Pharmaceutical companies would rather treat a bald American than a dying African."

South Africa, Kenya and Uganda have attempted to produce generic versions of these HIV/AIDS drugs to help fight the disease in their respective countries. There is nothing illegal about this practice. According to Article 31 of the World Trade Organization's TRIPS Agreement - an agreement on Trade Related Intellectual Property Rights - a country has the right, by declaring a 'National State of Emergency', to look for and investigate the possible product of cheaper alternative drugs. This agreement therefore allows South Africa and other African countries to produce cheaper drugs due to national emergencies. Besides, the drugs are for public, non-commercial use.

However, this attempt has been strongly resisted by the drug companies. They have been able to successfully lobby the US government to the point where former US Vice President Al Gore actually threatened South Africa with trade sanctions for trying to develop generic and cheaper drugs to fight AIDS. To save face, the drug companies have argued that cheaper drugs alone are not the answer. They point out that the drug cocktails need to be taken in a systematic way, and that patients need to be closely supervised, something the health care system in Africa cannot provide.

The Current Situation

The controversy surrounding generic AIDS drugs continues. In March 2001, 39 foreign drug companies went to court to challenge the Africa law that would allow the country to buy cheap, generic substitutes for patented AIDS drugs.

After pressure from NGO's and AIDS activist groups, the pharmaceutical companies unconditionally dropped the case. This provides hope, not only for South Africa, but also millions of AIDS patients around the world.

Already, South Africa's largest generic drug manufacturer, Aspen Pharmacare, has announced that it would seek permission from the world's largest pharmaceutical companies to make affordable copies of their patented AIDS drugs. Also, Cipla, an Indian manufacturer of generic medicines, has asked the African government for permission to sell inexpensive versions of 8 of 15 anti-H.I.V. Drugs.

Since the court victory, many of the world's pharmaceutical giants have been slashing prices of AIDS drug cocktails. However, despite these price cuts, they remain too expensive for many African countries. For example in Ghana, Kenya, and many other African countries, the minimum wage is less than $1 a day. The solution therefore lies in producing affordable generic versions of the AIDS/HIV drugs. 25.3 million people are at risk of dying.