Sachs to Announce Plan for ‘Massive New Effort’ Aimed at Fighting AIDS in Africa
Harvard economist Jeffrey Sachs is expected to announce today an "unprecedented" coordinated effort to combat AIDS in Africa, the Philadelphia Inquirer reports. The United Nations, U.S. government officials, the European Union, African governments, the World Health Organization, the World Bank, pharmaceutical companies and private foundations, such as the Bill and Melinda Gates Foundation and the Rockefeller Foundation, have been discussing the plan -- which calls for $6 billion a year from industrialized nations -- "privately for months," the Inquirer reports. Nearly half of the money raised would go toward the purchase of antiretroviral medications for more than 10% of the estimated 25.3 million HIV-positive Africans, while the rest would be used to "greatly accelerate" HIV prevention programs in Africa. Drugs would be "carefully" distributed using the continent's existing medical infrastructure and possibly a network of HIV prevention trial sites recently established by the National Institute of Allergy and Infectious Disease, the agency responsible for coordinating AIDS trials in the United States, in South Africa, Zambia, Zimbabwe, Malawi, Tanzania and Uganda. Drug therapies would also be "closely monitored," most likely using a system of "direct[ly] observed therapy," which involves volunteers visiting patients at home to observe them taking their medications. The "proposed assault" on AIDS would be the largest campaign ever waged against a single disease anywhere in the world and would also include plans for improving treatment of tuberculosis and malaria. Today's announcement by Sachs, who is director of the Harvard Center for International Development and a consultant to the project, will offer the first details of the program, including the estimated number of Africans who will receive medication, the cost of the plan and the size of donations needed to subsidize the proposed programs.
The announcement is also "aimed at influencing the Bush administration to take the lead" in supporting the effort. It "remains to be seen" whether the administration will fully support the effort, but the Inquirer reports that Secretary of State Colin Powell is said to be "receptive to the relief program." The needed U.S. contribution is projected to be about $2 billion a year, well above the current $260 million the government currently spends on AIDS in Africa. Most of that money goes toward HIV prevention efforts and care of people affected by the epidemic, such as AIDS orphans. "Almost none" goes toward the purchase or distribution of antiretroviral medications. Sen. Bill Frist (R.-Tenn) is working on a budget amendment to increase U.S. funding for African AIDS programs, but does not currently have a dollar amount. "The U.S. will come in strongly and rightly. The current line they are taking is absolutely right. They are giving warm encouragement and waiting to see what will happen," an unnamed WHO official said. Italy and Great Britain have already come out in favor of an international fund for AIDS medicines. U.N. officials hope to have "specific financial commitments" from the United States and other G7 nations by their July meeting in Italy.
Why Now? What's Changed?
The new proposal was made possible by the recent price reductions from the world's major pharmaceutical companies, according to the Inquirer. The price cuts have turned what was once thought to be "hopeless" into a "do-able, if ambitious, treatment effort," the Inquirer reports. Most patients will be given a three-drug combination therapy, projected to cost $500 per patient annually. U.N. agencies have reached a "consensus" that in exchange for the price reductions, the pharmaceutical industry's patent rights will be protected in their "core markets" in the West. The plan now hinges on funding. "The beginning and end of this is U.S. money. The drug companies are not going to solve the problem on their own. This has finally come down to the bottom line of whether the taxpayers will help do that," Sachs said last week. The consortium hopes to have a "concrete plan" prepared in time for the U.N. General Assembly's special session on the AIDS epidemic at the end of June (Collins/Warner, Philadelphia Inquirer, 4/4).