Few Drugs for Malawi’s AIDS Patients, Washington Post Reports
Malawi, a small, impoverished, densely-populated country in
sub-Saharan Africa, has seen 70,000 deaths from HIV/AIDS in the
last year alone, but cannot afford drugs that are considered the
"gold standard" for HIV treatment in developed countries, the Washington Post reports in a
front-page story. There are currently more than one million HIV-
positive people in Malawi, yet only 30 are on triple-drug therapy,
according to Post interviews and records of drug
inventories. Mwaiwathu Private Hospital, where only the richest
Malawi residents can afford care, is the only hospital in the
country that offers access to a protease inhibitor,
Crixivan. Mwaiwathu charges patients $500 a month for
Crixivan, but the annual per-capita income is less than $200.
Although the Malawian government stands out among other
sub-Saharan countries because it has "acknowledged the scope of
AIDS, even producing an official 'strategic framework' for
dealing with the disease over the next several years," the
government's plan focuses on prevention, not treatment for those
already infected. "In reality, we cannot entertain it. It is
just too expensive to contemplate. So all we are saying,
unfortunately, is that they have to die," Wesley Sangala, the
heath official who oversaw the development of the government's
plan, said. The government has made some headway, securing a
deal with
Glaxo Wellcome to purchase HIV drugs at a 25% price
reduction, but the effort took two years and four months, and
came just as Glaxo decided to reduce the price of HIV medicines
to poor nations by as much as 85%. Unfortunately, the 25%
reduction deal for Malawi was closed, and it was "too late" for
the country to receive the 85% reduction. Peter Moore, Glaxo's
medical director for sub-Saharan Africa, said of Malawi's
circumstances, "I'm not really sure it's our responsibility to be
involved in the ethical issues. ... If our proposals aren't
adequate, we need governments to tell us what we could be doing.
You know, you can't negotiate in a vacuum." Malawi's public
antiretroviral program finally began at the end of May, and
includes only dual therapy without protease inhibitors, instead
of the three-drug "gold standard." In a country with a health
budget of less than $1 per person per year, "and where AIDS
competes for attention with malaria, tuberculosis and other out-
of-control diseases," the compromise in treatment is necessary to
make HIV drugs affordable for even the luckiest residents
(Finkel, Washington Post, 11/1).
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