The New Straits Times, April 29, 2001
By Professor Dzulkifli Abdul Razak
AT the 57th Economic and Social Commission for Asia and the Pacific (Escap) meeting this week in Bangkok, UNAIDS deputy director-general sounded a warning: there are signs that AIDS could start spreading faster in Asia than in Africa. Drugs are badly needed to stem the tide.
But this is not going to be readily accessible if one were to rely entirely on the wisdom of the pharmaceutical industry. The basic credo of the industry is, Price, Profits and Patents - 3P strategy.
As such any attempt to temper with any of the 3Ps would be met with stiff resistance from members of the industry.
And now governments too have been implicated in the foray as seen in the recent unprecedented lawsuit where 39 pharmaceutical companies, mostly multinationals, took legal action in South Africa over the so-called 'patent violation'.
It challenges the country to table laws permitting the import and manufacture of cheap generic versions of the patented drugs. To the industry whether the four million South Africans suffering from HIV/AIDS continue to be deprived of the necessary but highly priced drugs is of no consequence.
Reportedly, a year's treatment with a triple-drug combination therapy considered effective against HIV would cost US$10,000-US$15,000 (RM38,00-RM57,000) per patient per year - beyond the means of a majority of HIV/AIDS victims. It is not only confined to South Africans, but many other developing countries too.
In 1997, former President Mandela suggested that South Africa should be allowed to legally buy or make generic versions of the expensive drugs. This will enable the treatment to be equitably applied to a larger majority.
Out of a global estimate of 34 million HIV/AIDS sufferers, 25 million of them are in the African continent. While, some multinationals agreed to give in to a price 'reduction', due to intense international criticism, but the move is still not good enough.
According to reports, the so-called 'Accelerated Access Initiative' is fraught with conditions that would hamper its effective implementation. The battle for equal access rages on.
Countries such as India managed to manufacture an even cheaper anti-AIDS cocktail. The drug is being made available for use even in Africa by Medicins Sans Frontieres (Doctors Without Borders), a French-based voluntary organisation, through its "Campaign for Access to Essential Medicines". Brazil too is at the centre of the controversy when the country's patent law has been changed to allow better distribution of AIDS drugs.
Reportedly, the UN Human Rights Commission backed the Brazilian resolution calling on all states to promote access to AIDS treatment. Another country, Thailand, has been attempting since 1998, to produce yet another type of anti-AIDS drug (called DDI).
No doubt, without such measures and alternative generic sources, HIV/AIDS victims will not only continue to suffer, but the spread too continues unabated.
For such reasons alone the global drug supply system for life-threatening epidemics such as AIDS must be re-examined. Emphasis must be placed on equity of access to affordable drugs. In this context, the 3P of the pharmaceutical industry must be met with another 3P strategy combining the forces of People, Political will and Public health.
To some extent this has been articulated well by many health activists and advocacy organisations. They seem to have won the day when the multinationals unsuspectingly dropped their legal action last week. This may have been a bitter pill for the multinational drug companies to swallow, but it is long overdue.
Many developing countries are still combating long-standing and re-emerging diseases such as tuberculosis and malaria with no or limited supply of the much needed drugs. In fact, WHO estimated two billion people are reported to have no access to drugs deemed essential for basic health care. The recent lawsuit fiasco underscores that "the debate over supplying the Third World with AIDS drugs shows that large corporations cannot simply determine the rules of the game of the globalised economy as they see fit" to quote an article in Thailand's leading newspaper (The Nation, April 23).
This is a precedent that must not be overlooked in attempting to restructure the global drug supply system into one that is more rational, transparent and equitable.
Similar notion have been deliberated time and again by the World Health Assembly. It endorsed the resolution on Revised Drug Strategy, the last being in May 1999 that supports such a demand.
In fact as late as March 2001, the European Parliament adopted a similar resolution on access to drugs specifically for people with HIV/AIDS in developing countries. The new phase of struggle to seek justice for a more affordable and safe drug has just begun.
This will be the focus of the next World Health Assembly next month. Until the counter strategy of 'People, Political will and Public health' prevails over that of the drug companies, billions will continue to suffer from yet another unjust global system.
