Kaiser Daily HIV/AIDS Report Rounds Up Public Reaction to South African Drug Lawsuit
The public continues to weigh in on AIDS drug access in developing countries and last week's settlement of the lawsuit against South Africa's government brought by 39 pharmaceutical companies. Excerpts from some pieces appear below:
- New York Times: The statistics about the prevalence of AIDS in Africa are "so staggering as to seem unbelievable," columnist Thomas Friedman writes in the Times. With 25 million Africans infected with HIV, attention has recently been focused on securing cheaper antiretroviral drugs, "which would allow Africans afflicted with HIV to live meaningful lives," he says. Although "anything that will alleviate the suffering of Africa's destitute HIV/AIDS victims should be supported," experts are "worried that all this focus on drug companies ... is diverting attention from the real issue -- stemming the spread of the disease," Friedman writes. Drugs are not "going to enable us to overcome this major, major social problem," Dr. Fred Sai, Ghana's top AIDS expert, said. "It can only be done by education, preventive health measures and creating better living standards," he said, adding that he is "afraid" that the U.N. General Assembly's special session on AIDS in June will "get hijacked by this clamor for drugs." Even at the lower prices, the cost of drug treatment is still out of reach for many Africans and distribution plans are lacking, Friedman writes. Adding the antiretroviral drugs will most likely "cause distortions to the already struggling African health systems, by forcing in a new technology when they can't even distribute treatments for tuberculosis," he continues. What is needed is more education and prevention efforts, because despite the prevalence of HIV/AIDS, "many Africans remain either uneducated about how HIV is spread or simply do not believe they'll be infected," he writes. Senegal and Ghana are two examples of how the epidemic can be successfully stemmed with "home-grown self-help responses" and "widespread education" (Friedman, New York Times, 4/27).
- South Florida Sun-Sentinel: The lawsuit brought by 39 pharmaceutical companies against South Africa's Medicines and Related Substances Control Act was "one battle not worth winning," a Sun-Sentinel editorial states. "Technically, the companies are correct. Patents enjoy legal protections and it should be this way," in order to ensure that research and development continue, the editorial continues. "But knowledge that relieves human suffering should also be considered the patrimony of mankind," the editorial states. Even discounted drugs "will not stem the AIDS crisis" in developing nations. "Education, prevention and health systems are needed to combat the disease," the editorial continues, adding that "[w]ealthy nations also have a role to play" in subsidizing AIDS medications for the developing world. The affected countries themselves "clearly need to do more" or else "cheap anti-AIDS medications won't do much good." The attempt to block the legislation that would have allowed importation and manufacture of cheaper AIDS medications was "one battle the drug companies were wise to let go," the editorial concludes (South Florida Sun-Sentinel, 4/27).
- Wall Street Journal: "The settlement is a tragedy," Robert Goldberg, senior fellow at the National Center for Policy Analysis, writes in an op-ed to the Journal. "[B]ecause it is part of a strategy to impose price controls and limit patent protection on new biopharmaceuticals developed in the U.S., the settlement will help ensure that this current generation of AIDS drugs is the only one we have for a long time to come," he states. Goldberg continues, "It's a delusion to think that making antiretroviral drugs cheap, or free, will make millions healthier. ... Free and highly effective tuberculosis and malaria drugs in Russia and Africa have done little to stop the spread of a disease that claims two million lives a year." Goldberg concludes, "The truth is that the ultimate solution to AIDS is prevention. ... Price controls and the wanton destruction of intellectual property will do little to improve public health. But they will reduce innovation. The lag in HIV research and treatment will condemn the African continent to deeper darkness and death. And for that, the AIDS activists, their uncritical followers in the media, and their monstrous certainty about the evil of the drug companies will largely be to blame" (Goldberg, Wall Street Journal, 4/23).
- Philadelphia Inquirer: "Even the newest and best drugs alone aren't enough for a crisis as serious and widespread as the tragedy of AIDS in Africa," Grade-Marie Arnett, president of the Galen Institute, a health policy research organization, writes in an Inquirer op-ed. "The problem is much deeper," she writes, "rooted in poverty and culture. Arnett continues, "Even when the drugs are donated, African countries and international relief agencies lack the resources and infrastructure to distribute, much less to monitor, drug treatment for even a fraction of the tens of millions of people infected with the AIDS virus." Arnett describes the dangers of loosening patent restrictions, stating, "When the U.S. government doesn't help U.S. companies to protect their intellectual property, fewer of the new miracle drugs that the world both wants and needs will be created. And if our government capitulates on drug patents, can other technologies be far behind?" Arnett concludes, "Instead of spending so much time pointing the finger of blame, companies and countries should work together to get a more precise diagnosis of the problem and then bring their best resources together toward solutions" (Arnett, Philadelphia Inquirer, 4/25).
- Washington Post: "The feisty advocates who lead nongovernmental groups like to paint themselves as little guys, and in some ways this is reasonable," a Post editorial states, adding, "Yet the South African AIDS-medicine case that closed [last week] demonstrates the power of campaigning groups like Doctors Without Borders and Oxfam. These supposed Davids loaded their slings against the pharmaceutical-industry Goliath and felled him." The editorial continues, "[B]ecause the firm's arguments were self-serving and thin, nongovernmental groups were able to shame them into capitulation." The editorial criticizes the Bush administration for showing "little interest in leading an international effort to fight the scourge." The editorial concludes, "It is this indifference, echoed to varying degrees in capitals throughout the world, that is the real scandal of the international system" (Washington Post, 4/22).
- Lancet: "The outcome in South Africa has taught the world several important lessons," a Lancet editorial states. It continues, "Drug companies cannot put shareholder interests before their moral responsibility to take part in improving the world's public health. ... If the principle of access to affordable drugs applies to HIV treatment, it should equally apply to other infectious diseases, such as malaria and tuberculosis." The editorial concludes, "[I]t is time now for western governments to use the prevailing momentum worldwide to create an effective strategy to provide affordable drugs for all less-developed countries (Lancet, 4/28). In a separate letter to the editor, V. Manfrin of the Infectious Diseases Department of Vincenza, Italy-based S Bortolo Hospital, writes, "Although widespread availability of antiretroviral drugs can positively affect the HIV epidemic by diminishing transmission, some difficulties can be expected in less-developed countries." For AIDS drugs to be effective, patients must take them "regularly with no interruption." Therefore, "[a]dherance and drug availability is ... crucial." However, cohort studies have shown that "treatment failure is common" even in more-developed countries, and thus, in Africa, "we expect major difficulties, especially in remote rural areas." Further, he notes, much of the region currently does not maintain the health care infrastructure to monitor patients and determine appropriate timing of treatment. Manfrin states, "Deployment of resources to antiretroviral drugs without consideration of existing health structures, staff, equipment and their distribution will be wasteful. ... The goal must be the empowerment of the existing health systems, with a range of activities to fight AIDS" (Manfrin, Lancet, 4/28).
- Hartford Courant: "The companies' arguments about their rights are legitimate. An industry that spends billions of dollars on research and development of new drugs should not be expected to shrug off patent infringements," a Courant editorial states, adding, "[B]laming the companies for South Africa's AIDS woes would be unfair. For its part, the government in Pretoria has done little to control the spread of the disease." The editorial states, "Even with the court victory, the government's health minister said it might not move quickly, if at all, to get drugs to AIDS patients. Such a lackadaisical attitude is maddening" (Hartford Courant, 4/23).
- Chattanooga Times & Free Press: "A Wall Street Journal report ... note[s] that drug-company share prices rose more than twice as fast [as] the rest of the S&P 500 in the late 1990s, primarily for two reasons," a Times & Free Press editorial states. "One is that a growing, aging population has been using increasingly large amounts of medicine, as drug therapies have become the front line of medical defense against an increasingly broader range of disease. The other is that the Hatch-Waxman Act, passed by Congress in 1984, eased entry of generic drugs onto the market. That spurred drug companies to protect prices and patents, and to speed up innovations," the editorial continues. However, the editorial notes that the Hatch-Waxman Act "also greased the way for unconscionable profiteering." The editorial continues, "[T]he differentials between U.S. and 'at cost' prices under the African agreement suggest that the companies were charging far too much to begin with. Indeed, drug makers merit little praise for what at first glance appears a humane act. They stalled several years after the African nations' pleaded poverty and requested discounts because, industry sources say, they did not want to reveal the size of their profit margin" (Chattanooga Times & Free Press, 4/24).
- Dallas Morning News: Commenting on the South African government's "inaction" on distributing AIDS drugs to HIV-positive citizens, a Morning News editorial states, "Inexplicably, South Africa is proceeding like a country that has time on its side when it certainly does not." The editorial continues, "The government's refusal to validate scientifically proven treatment options is crippling the nation with doubt, confusion and inactivity. Wors[e] yet, when given an opportunity to build on the drug industry's concessions, South Africa again hedges" (Dallas Morning News, 4/26).