Africa: Blocking AIDS Treatment, 02/06/01

Africa: Blocking AIDS Treatment, 02/06/01

Africa: Blocking AIDS Treatment Date distributed (ymd): 010106 Document reposted by APIC

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Region: Continent-Wide Issue Areas: +economy/development+ +health+ +US policy focus+ Summary Contents: This posting contains several documents and links to additional resources, along with a brief introductory note. They all concern the escalated efforts by drug companies and the Bush administration to block the rising demand to make AIDS treatment accessible to people with HIV/AIDS in Africa and other regions where almost no patients are receiving anti-retroviral drugs or drugs to counter AIDS-related diseases. According to the latest estimates, over 25 million people are living with HIV/AIDS in sub-Saharan Africa.

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APIC Note: Blocking AIDS Treatment

Almost none of the more than 25 million Africans living with HIV/AIDS have access to currently available drug treatment for AIDS, which now prolongs life for most people with AIDS in developed countries. Until last year, the dominant perspective was simply to ignore this fact, silently writing off the deaths, while pharmaceutical companies raked in profits from sales in the developed worlds and the U.S. led an aggressive fight for ever-expanded protection for the companies' patent rights.

Now the momentum to challenge this dismissal is growing rapidly, building on the emphasis on the right to treatment as well as prevention at the international conference on AIDS in Durban and the African Development Forum in Addis Ababa last year. The media reflect significant shifts in viewpoint, as illustrated by the frontpage January 28 New York Times Magazine article ('How to Solve the World's AIDS Crisis') by Tina Rosenberg citing Brazil's example as proof that 'Patent laws are malleable. Patients are educable. Drug companies are vincible. The world's AIDS crisis is solvable.' See

Stephen Lewis, former deputy executive director of UNICEF, wrote in the Globe and Mail (January 26, 2001) that 'there are generic drugs from India to treat the majority of HIV-positive Africans for $350 per person per year. If we had the political will, there is no question that we have the money. Then why isn't it being done? And because it's not being done, why doesn't it amount to murder? Mass murder.'

Yet the Bush administration and drug companies are responding by escalating the attacks against efforts to make treatment accessible in South Africa, Brazil and other countries, even while denying that their actions will have that effect. The attacks are proceeding on several fronts, including the courts in South Africa, the review of the May 2000 Clinton executive order, and an attack through the World Trade Organization (WTO) on Brazil's successful use of generic drugs to counter AIDS.

Below several relevant documents:

(1) Sign-on letter initiated by the Health Gap Coalition calling for pharmaceutical companies to withdraw their suit against South Africa scheduled to go to court next month. Executive Director Salih Booker has endorsed the letter on behalf of APIC, the Africa Fund and the American Committee on Africa.

(2) Background note from the The Henry J. Kaiser Family Foundation and a note from the Progressive Caucus in the House of Representatives, concerning the Bush administration decision to review the May 2000 Clinton executive order which mandated greater 'flexibility' on compulsory licensing and parallel imports.

(3) Action alert from ACT UP Paris calling for international agencies to speak out against the U.S. request to the WTO, and for the Bush Administration to withdraw the attack on Brazilian legislation.

For additional details please refer to the web sites noted in the documents, as well as a wider range of sources on APIC's web site at

Two substantive background articles on compulsory licensing and parallel importing are:

Compulsory Licensing and Parallel Importing (July 1999)

Brazil: What Went Right? (December 2000)

Regular updates and discussion on treatment access can also be found at:


Stop Big Pharma's lawsuit against South Africa

Health GAP Coalition,

Treatment Action Group

For more information:

Please review this important sign-on letter and send individual and organizational endorsements to

[The initial deadline for signatories for this letter was Feb 2, but additional signatories may still be accepted. Check the Health Gap website for updates on signatories. South Africa's Treatment Action Campaign (TAC) has called for a global week of action beginning with the March 5 court date for the case in South Africa.]

Consult the TAC website (, as well as the websites above, for news about upcoming events in the US and abroad to protest multinational drug company price-gouging and US government collusion in time for the March 5 court date in South Africa.


January 29 2001

Dear [Plaintiff],

[The list of plaintiffs can be found at:]

We the undersigned are members of the community of HIV/AIDS treatment activists. You are receiving this letter because you are suing the government of South Africa in an effort to maintain high prices for patented pharmaceuticals, which will prevent millions of people from obtaining life extending treatment (Pharmaceutical Manufacturers Association of South Africa versus the President of South Africa, case no. 4183/98). As you know, oral arguments on this case will begin March 5, 2001 before the High Court in Pretoria. This three-year lawsuit, a protracted effort to derail implementation of South African Medicines and Related Substances Control Act ("the Medicines Act"), is having a deadly impact on South African people and citizens of poor countries around the world. Therefore we demand you immediately remove yourself as a plaintiff from this lawsuit.

The Medicines Act is an effort by the South Africa government to reform apartheid-era legislation and to increase affordable medication access for its people through familiar provisions including parallel importing, compulsory licensing, and generic drug substitution. The grave crisis in lack of access to medication in South Africa cannot be overemphasized: in the case of HIV disease, more than 4.3 million South Africans are infected with HIV but less than 0.2 percent of infected people have access to drug treatment to stabilize disease progression and extend life. Your lawsuit has tied the hands of the South African government, making it unable to implement potentially life-saving reforms while South African citizens die preventable deaths every day.

The Medicines Act, you claim, would unfairly infringe on the intellectual property rights of drug makers and would cost substantial profits. In fact, the entire continent of Africa generates less than 1.3 percent of global profits from drug sales. Clearly your concern lies not with the lives of the tens of millions of poor people who have no access to drugs, but with protecting your unfettered access to the few in the North who are willing to pay top dollar, no questions asked.

While a slim minority of people with HIV in wealthy countries reap the life extending benefits of overpriced HIV medications, 90 percent of the world's 36 million people with HIV have absolutely no hope of anything beyond a death sentence, including virtually all of the 4.3 million people with HIV living in South Africa. But companies - including yours - claim they are doing enough to increase HIV drug access for the tens of millions of people who have no access to HIV treatment.

For example, the much-hyped UN/drug company HIV medication price reduction initiative, touted by industry as a far reaching, innovative program, has been roundly criticized as moving too slowly, subjecting individual countries to prolonged imbalanced negotiations, and having an unacceptably narrow impact. You and the other 41 plaintiffs in this case are preventing South Africa from implementing its domestic plan to end inequity in medication access. Battling the extraordinary devastation wreaked by the AIDS crisis requires many strategies and modes of attack - not only industry-controlled charity programs.

We do not claim that affordable drugs are a panacea in the fight to end the global AIDS crisis. But truly affordable medication is the foundation of any meaningful effort that will actually save lives.

The shameful three-year battle by your company and the other plaintiffs is a wholehearted effort to ensure that medication is denied to those who need it most. This lawsuit stands squarely in the path of South Africans, as well as millions from other countries who are closly watching this precendent-setting case and who are desperately seeking access to life extending, affordable medication. You have a choice: unless you take action and remove yourself from the lawsuit, you will be known forever as the company who sued to prevent the South African government from daring to increase the availability of life-extending medication for its citizens. Your lawsuit directly threatens the lives of millions. We therefore call on you to withdraw from the PMA of South Africa lawsuit without further delay.


[For list of signatories, see]

cc: The Honorable Thabo Mbeki, President, Republic of South Africa; Dr. Manto Tshabalala-Msimang, Minister of Health, Republic of South Africa; Zackie Achmat, Chairperson, Treatment Action Campaign; The Honorable Kofi Annan, Secretary General, United Nations; James Wolfensohn, President, The World Bank; Dr. Gro Harlem Brundtland, Secretary General, World Health Organization; Dr. Peter Piot, Executive Director, UNAIDS; The Honorable Colin Powell, Secretary of State, USA; Robert Zoellick, United State Trade Representative-Designate; Congressional Black Caucus


The Henry J. Kaiser Family Foundation

One Page Background on Africa Aids Drugs and Clinton Executive Order

1/23/2001 Bush Reviewing Executive Order Allowing International Importation of Generic HIV/AIDS Drugs President Bush may reverse former President Clinton's executive order that allows sub-Saharan African governments to import generic versions of HIV/AIDS medications from other countries where the drugs are manufactured while still under U.S. patent, Bloomberg News/Pittsburgh Post-Gazette reports. According to drug companies such as GlaxoSmithKline, the "world's largest producer of AIDS drugs," as well as Merck & Co., Bristol-Myers Squibb Co. and Roche Pharmaceuticals, the executive order, signed by Clinton in May, "changed the way their drugs are priced" (Rosenkrantz, Bloomberg News/Pittsburgh Post-Gazette, 1/22). According to the order, the United States "shall not seek, through negotiation or otherwise, the revocation or revision of any intellectual property law or policy" of sub-Saharan African countries provided that they promote "access to HIV/AIDS pharmaceuticals or medical technologies for affected populations in that country." In essence, the order holds African countries to the "less stringent standard of a World Trade Organization agreement on intellectual property protection," instead of U.S. trade laws concerning patents (Kaiser Daily HIV/AIDS Report, 5/11/00).

>From 5/11/2000 AFRICA TRADE BILL: Clinton Issues Executive Order Relaxing Intellectual Property Rights Almost one week after lawmakers stripped Sens. Dianne Feinstein (D-Calif.) and Russell Feingold's (D- Wis.) compulsory licensing and parallel importing provision from the African-Caribbean Basin Initiative trade bill, President Clinton yesterday signed an executive order affording sub-Saharan governments the "flexibility to bring life-saving drugs and medical technologies to affected populations" (Clinton letter text, 5/10). According to the order, the United States "shall not seek, through negotiation or otherwise, the revocation or revision of any intellectual property law or policy" of sub-Saharan African countries provided that they that promote "access to HIV/AIDS pharmaceuticals or medical technologies for affected populations in that country" (Executive Order text, 5/10). U.S. Trade Representative Charlene Barshefsky said, "Given the devastating impact of AIDS, the United States will not require or negotiate restrictive rules in the intellectual property rights area" (Abrams, AP/Philadelphia Inquirer, 5/11). Thus, the United States will not invoke U.S. trade laws concerning patents, but instead will hold sub-Saharan countries "to the less stringent standard of a World Trade Organization agreement on intellectual property protection." The United States negotiated a similar deal with South Africa last year (Burgess, Washington Post, 5/11). The order also states that the United States will "encourage sub-Saharan African nations to take steps to address the underlying causes of the HIV/AIDS crisis and that the United States should work with individual countries to assist them in developing effective public-education campaigns" (AP/Philadelphia Inquirer, 5/11).

AIDS activists praised the president's action, while the pharmaceutical industry and some lawmakers criticized it. Jeff Jacobs, director of governmental affairs for AIDS Action, said, "With the stroke of his pen, Bill Clinton has signaled that the country is seriously engaged in the global war on AIDS. America can and should do more, but this is a bold, important first step" (AIDS Action release, 5/10). Paul Davis of ACT-UP Philadelphia also lauded the president, but "faulted [the order] for only covering sub-Saharan Africa and AIDS drugs." He said, "There are more killers than HIV/AIDS and lots of folks who have AIDS in other countries." But Alan Holmer, president of the Pharmaceutical Research and Manufacturers of America, said that the move sets "an undesirable and inappropriate precedent, by adopting a discriminatory approach to intellectual property laws, and focusing exclusively on pharmaceuticals." Holmer added that pharmaceutical companies "continue to play an essential role in pioneering applied research and development, our best hope of winning the war against AIDS. Strong intellectual property protection is the only way to encourage this research" (Washington Post, 5/11). Senate Majority Leader Trent Lott (R-Miss.) also indicated his disapproval of the plan, saying, "There seems to be a pattern now of [Clinton] doing executive orders that exceed what he should be doing. That should be done legislatively. He doesn't make the laws. And so I would hope that he would be careful about doing that" (Lewis, New York Times, 5/11). Kaiser Daily HIV/AIDS Report


PROGRESSIVE CAUCUS Dennis Kucinich, Chairman

January 23, 2001

TOPIC: Bush Examining Revocation of Executive Order Providing Low-Priced AIDS Drugs to Africa

SUMMARY: News reports today confirm that on his third day in office, President Bush is already exploring using his office to do the bidding of one of his biggest corporate backers: the pharmaceutical industry. Specifically, reports confirm that Bush "may reverse former President Clinton's executive order that allows sub-Saharan African governments to import [lower-priced] generic versions of HIV/AIDS medications from other countries." In 1999, progressives supported an amendment that would have cemented this into law, but it was defeated by the drug industry and its allies in the GOP leadership.

David J. Sirota Communications Director Rep. Bernie Sanders (202.225.4115)

For a sample press release, see



Friday, February 2, 2001

Press Contact: Julien Devemy / Sylvain Coudret - (33) 01 49 29 44 75 Marie de Cenival - 04 95 08 29 94

The WTO Menaces the Survival of 100,000 People with AIDS

(Geneva) Yesterday at 10:00 am local time, the World Trade Organization received a request from the United States and established an arbitration panel to investigate the conformity of a Brazilian intellectual property law to WTO rules.

The Bush administration views this law, which allows 100,000 people with HIV/AIDS to survive because of access to generic antiviral drugs, as a threat to US pharmaceutical company patents.

The measure has permitted Brazil to duplicate and produce seven antiviral brand-name AIDS drugs since 1996 and distribute them free of charge to sick Brazilians at a cost ten times less than the price proposed by American drug companies. In conformance with "TRIPS" intellectual property provisions, the law stipulates exceptions to patent rights in rare cases. In a public health emergency, the measure allows production of medicines normally protected by a license, without the authorization of the patent holder. Protected by this exemplary legislation, Brazil can pursue its policy of caring for people suffering from HIV/AIDS free of charge. It could extends its production of AIDS drugs to protease inhibitors, the new HIV drugs that, when added to three-drug regimens, are extremely effective in reducing the amount of virus in the body and improving overall health.

The lives of more than 100,000 Brazilians, and millions to come who could benefit from Brazil's export capacity or technology transfer, are held in the balance by the discussions at the World Trade Organization.

Following an appeal by more than one hundred Brazilian activist NGOs, ACT UP-Paris put the WTO and its experts on notice that they must resist unprecedented pressure from multinational drug companies. The case of Brazil will set an important legal precedent.

ACT UP-Paris condemns the intense pressure of multinational drug companies on the US government, bought at the cost of millions of dollars: these multinational drug companies spent $230m in campaign contributions to help elect a US president who would protect their interests.

ACT UP-Paris condemns the murderous pressure that the Bush administration has brought to bear on the World Trade Organization, whose laws have been dictated by the same interests that are endangering the lives of tens of thousands people.

ACT UP-Paris calls on the leaders of the principal international organizations charged with world health policy - ONUSIDA (UNAIDS), OMS (WHO), UNICEF, PNUD (UNDP), - to declare that they are in favor of protecting Brazil's patent law, and the Bush administration to withdraw its complaint.

Marie de Cenival Act Up-Paris Commission Nord/Sud tel (33) 04 95 08 29 94 fax (33) 01 48 06 16 74


Message-Id: <> From: "APIC" <> Date: Tue, 6 Feb 2001 11:34:50 -0500 Subject: Africa: Blocking AIDS Treatment

Editor: Ali B. Ali-Dinar

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