Africa: "You talk, we die", 09/30/03

AFRICA ACTION Africa Policy E-Journal September 30, 2003 (030930)

Africa: "You talk, we die" (Reposted from sources cited below)

As the 13th International Conference on AIDS and STIs in Africa (ICASA) concluded in Nairobi, Kenya last week, observers were unanimous in noting the stress on the urgent need for leaders - national and international - to deliver on promises. Despite overwhelming consensus on the need for treatment, UNAIDS reported that at the end of 2002 only an estimated 50,000 people in sub-Saharan Africa were receiving life-prolonging anti- retroviral treatment, about one percent of 4.1 million in immediate need of such treatment. The predictable result - millions of deaths - is still meeting with such responses as President Thabo Mbeki's recent remark that he personally didn't know anyone who had died of AIDS, and the Bush administration's drive to defeat an additional $1 billion of U.S. funding for the Global Fund to Fight AIDS, TB, and malaria.

Reports noted the new level of commitment by the World Health Organization, which pledged to ensure treatment for an additional three million people by 2005. Attaining this goal, however, will require massive increases in resources, as well as full use of low-cost generic drugs. On that front, the prospect emerged last week that Canada might become the first G-7 country to join Brazil and India in providing generic anti-retrovirals to countries unable to manufacture them. If this should happen, despite the lobbying of pharmaceutical companies against it, it could be a major breakthrough in turning promises of treatment into reality.

This posting contains two reports from Nairobi, including the closing speech by Nomfundo Dubula on behalf of the Pan African Treatment Access Movement. It also includes a press release and excerpts from a letter from Canadian organizations on the current move to amend Canada's patent act to allow increased export of Canadian generic medicines.

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"You talk, we die": Activists protests poor access to treatment in Africa

Nigeria-AIDS eForum

September 26, 2003

Kingsley Obom-Egbulem Nigeria-AIDS eForum correspondent Email:

Nairobi, Kenya

The 13th International Conference on AIDS and STIs in Africa (ICASA) would not have been complete without their presence and action.

And they had waited patiently to make their presence and feelings felt.

Just as delegates were about settling down to business on the third day of the conference, they rose and spoke, and ensured that everyone heard their voices.

Numbering just about a hundred, the activists under the aegis of the Pan-African AIDS Treatment Access Movement (PATAM) spoke, kicked, railed and acted up against many 'enemies' of access to treatment for HIV/AIDS in Africa: Big Pharma, the unfeeling, profit-focused multinational corporations, African leaders who have refused to provide treatment for their peoples.

"You talk, we die", yelled the activists, as they mounted a blockage of the VIP and heads of governments lounge at the Kenyatta International Conference Centre, venue of the ICASA.

"I am alive today because of access to treatment", cried Prudence Mabele of the Positive Women's Network South Africa, as she joined others to stage a lie-in on the conference grounds.

"AIDS treatment now", the activists chanted as they marched round the premises, making quick stops at the stands of Bristol Myers Squibb, Glaxo Smithkline (GSK), Merck Sharp Dome (MSD), - all major western pharmaceutical companies - as well as that of the United States Agency for International Development (USAID). Each stand was blockaded and covered up in posters bearing messages: 'Guilty', 'Keep your promises', 'You talk, we die'.

"No thanks to these people, Africans are dying because we can't get drugs", said one of the activists. The death, last month, of Togolese AIDS activist Iris Kavege must have infuriated the activists who felt her life would have been prolonged if she had access to life-saving but unaffordable treatment.

About 60,000 Africans are said to have access to drugs. This figure is about 1 percent of the actual number of people who need treatment. Several promises have been made to improve the situation but the activists feel it needs to be backed by necessary action so as to prolong the life of PLWHAs.

Mercy Otim of the Kenya Coalition for Access to Essential Medicines called this "the height of government neglect."

"In Kenya, about 250,000 people living with HIV need immediate treatment or they will die," she said.

Ironically, the 13th ICASA was partly sponsored by some of the pharmaceutical companies the activists are protesting against. Could they still be accused on insensitivity considering this gesture? Mohammed Farouk Auwalu of the Treatment Action Movement (TAM) Nigeria described that as a Greek gift.

"It is a fraction from the money they made from those of us who are infected that they are using to sponsor these conferences so that they can launder their image. We don't want conferences...we want drugs, affordable or even free drugs".

At a press conference called after the protest, the activists also criticized some African governments for holding the view that what people living with HIV is nutrition, not treatment.

"We are eating. We have food in Africa, but we cannot eat food alone. We must take drugs to compliment good nutrition," said Patricia Asero of the Kenya Treatment Access Movement.


Closing ceremony, ICASA 2003 (September 26, 2003)

Speach by Nomfundo Dubula on behalf of the people living with HIV

My name is Nomfundo Dubula. I am a person living with HIV. I am from the Treatment Action Campaign in South Africa and I also represent the Pan African Treatment Access Movement.

I want to say that as communities and people living with HIV we ARE ANGRY. Our people are dying unnecessarily.

African leaders, the ball is on your hands. You have to decide whether you want to lead a continent without people. So, stop playing hide and seek whilst people are dying.

The World Health Organisation has declared antiretroviral therapy a STATE OF GLOBAL EMERGENCY and our leaders are still in state of denial.

The Doha and the UNGASS declarations have opened the way to decide about the future of Africa, so, WHEN IS YOUR ACTION ?? The Doha declaration on health is hope, and it MUST be implemented.

Two years ago, the Abuja declaration promised 15% of the budget on health BUT up to now that has not happened. How many people must die?? Please, move from talks to real action.

Give women powers to decide and lead and they will overcome this epidemic.

African leaders, lead us. Don't divide people living with HIV, as we all want to assist in this fight.

We need CCM's in each country with positive attitudes towards treatment, specially ARV's, so that we have effective and unequivocal treatment plans.

We need you to speak out about nutrition and not confuse us with the debate about nutrition versus ARVs. NUTRITION GOES HAND IN HAND WITH ARVs!

I also want to address the WHO. WHO has promised to give technical assistance in the procurement of drugs. Now we need your assistance in our countries to ensure that cheaper generic drugs reach every country, with or without manufacturing capacity.

You also have a key role in ensuring resources for poor countries. The 3 by 5 plan should also ensure that all treatment programmes include treatment literacy efforts. On our side, we commit ourselves in educating our people and ensure adherence.

We need real leadership in the implementation of effective strategies to reach the 3 by 5 goal. We will assist you in this effort if you show commitment and independence in prioritizing people's health over any other interest.

I want to refer to the drug companies, whose bags are full with profits. Stop squeezing poor Africans which only represent 1.3% of your global market.

Don't delay access by giving exclusive licenses that are only transferring the monopoly to local companies blocking competition.

Your diagnostics are still too expensive and inaccessible.

Provide low prices and allow our governments to bring us life-saving drugs and the necessary monitoring systems.

I want to say to the donors that they should donate more money to the Global Fund. We welcome the US initiative led by president Bush. But we want money that is free of hidden agendas. Put more money in the Global Fund and stop blocking our government's rights to import generic drugs.

IMF and World Bank should cancel the debt, as Africa is fighting for its life. Don't even pinch the last drop of its blood.

And where was the Global Fund in this conference? How can you communicate with our brothers and sisters, and what is going on with their countries proposals? We need you to have a booth in the GNAP+ conference so that you can be visible, and we can ask questions.

The Pan African Treatment Access Movement - PATAM - is fighting for the lives of Africans. So, we will continue to mobilize our people as we did in the court case of the Pharmaceutical companies against the South African Governent.

We will continue to mobilize our people as we South Africans did in the PMTCT court against our government.

We will continue to mobilize our communities to ensure access to treatment and care.

We will continue giving treatment literacy workshops to ensure adherence, promoting VCT, prevent new infections and promote openness.

We will be watchdogs in ensuring real implementation.




Export of generic medicines to developing countries

Amendment to Patent Act must benefit as many as possible, urge Canadian organizations

Press Release Canadian HIV/AIDS Legal Network

September 26, 2003

For more information: Richard Elliott Director, Policy & Research / Directeur, politiques et recherche Canadian HIV/AIDS Legal Network / Reseau juridique canadien VIH/sida 890 Yonge Street, Suite 700, Toronto, Canada M4W 3P4 Tel : +1 (416) 595-1666 Fax +1 (416) 595-0094 E-mail: Web:

For information or interviews, contact: Jean Dussault 514 708-0128

Toronto, September 26 - The Canadian HIV/AIDS Legal Network welcomed today the federal government's announcement that it will amend the Patent Act to allow exports of lower-cost generic medicines to developing countries, and called on all parties in the House of Commons to support this measure. But the Network also cautioned that the government must not restrict the amendment in ways that would limit its real benefit to patients needing medicines.

"We congratulate the government for heeding the call to action," said Richard Elliott, the Network's Director of Policy & Research. "This is an opportunity for Canada to act on its stated commitment to international human rights, and respond in a concrete and immediate fashion to the health challenges facing developing countries. We urge all political parties to ensure speedy passage of this amendment. Thousands are dying by the day."

The Legal Network called on the government to follow through with legislation that will translate into concrete benefits for as many people as possible, and to resist any calls to water down the amendment, highlighting three concerns:

* "We are concerned by any suggestion that this amendment will only allow generic exports to countries facing health 'emergencies'," said Elliott. "There is no justification for restricting Canada's response in this fashion. How many people would have to be sick or die before something is considered an 'emergency'? Waiting for things to become a crisis before getting medicines to people would be bad medicine and bad public policy." He also noted that, despite inaccurate interpretations often reported in the media, WTO rules and agreements do not say that countries can only limit patent rights in emergency situations.

* Elliott also warned against any attempt to limit the amendment to just providing generic drugs for specific diseases. "Are we going to say that someone in a developing country should be able to get less expensive drugs if they have HIV or tuberculosis, but they should just die if they have cancer or diabetes or asthma?"

* Finally, the Legal Network called on the government to not limit, by Canadian law, the countries to which generic medicines could be exported. Elliott explained, "It is up to other sovereign countries to decide how to respond to the health needs of their people. If a drug is not patented in a country, or a compulsory license has been issued there to allow the import of generic drugs in accordance with that country's laws, there is no reason why Canadian law should stand in the way of generics being exported to that country."

Before the government's announcement, the Legal Network and other organizations wrote this week to the Minister of Industry putting forward a proposed amendment and requesting a meeting to discuss the details. "We look forward to hearing from the Minister soon about our request," said Elliott. "It is important that it not just be government and industry involved in this. Civil society groups with expertise in this area and who are responding on the ground need to be part of the discussions."


Patent Act amendments and the export of Canadian-made generic medicides

Letter from Canadian HIV/AIDS Legal Network, M,decins Sans FrontiSres (Canada), Interagency Coalition on AIDS and Development (Canada) and Director Oxfam Canada

[excerpts only; full text at]

September 23, 2003

Hon. Allan Rock Minister of Industry Office of the Minister 235 Queen Street East Ottawa, ON K1A 0H5

Dear Minister:

Re: Patent Act amendments and the export of Canadian-made generic medicines

We write to you, as representatives of Canadian civil society organizations, to request that the Government of Canada take a simple, yet significant, step to demonstrate leadership and to enhance our country's response to the HIV/AIDS pandemic and other global health challenges: we ask that you amend Canada's Patent Act to facilitate the export of Canadian-made generic medicines to developing countries in need. We also respectfully request the opportunity to meet with you to discuss our proposal in more detail.

Recent developments at the World Trade Organization

As you know, for several years a worldwide debate has been occurring over the impact on access to affordable medicines in developing countries of stringent provisions on intellectual property protection in international treaties such as the Agreement on Trade-Related Aspects of Intellectual Property Rights (TRIPS Agreement) of the World Trade Organization. In November 2001, at the 4th WTO Ministerial Conference in Doha in November 2001, WTO members unanimously adopted a "Declaration on the TRIPS Agreement and Public Health". In that Declaration, they expressly stated that:

"We agree that the TRIPS Agreement does not and should not prevent Members from taking measures to protect public health. Accordingly, while reiterating our commitment to the TRIPS Agreement, we affirm that the Agreement can and should be interpreted and implemented in a manner supportive of WTO Members' right to protect public health and, in particular, to promote access to medicines for all..."

In Paragraph 6 of the same Declaration, WTO Members recognized that countries "with insufficient or no manufacturing capacities in the pharmaceutical sector could face difficulties in making effective use of compulsory licensing under the TRIPS Agreement." ... WTO Members instructed the Council for TRIPS to find an expeditious solution to this problem by the end of 2002.

Since the Declaration was adopted in Doha, it has taken over 21 months for WTO members to agree on a "solution" as called for by the Ministerial Conference. On 30 August 2003, WTO Members adopted an agreement ostensibly aimed at solving this problem, so as to make it possible for countries lacking domestic manufacturing capacity to import generic medicines produced elsewhere under compulsory license.

We welcome the fact that, despite the efforts of some countries, this agreement is not limited in its application to only specific diseases, nor is it restricted to emergency situations only. However, as you will be aware, numerous humanitarian and other nongovernmental organizations have been critical of this deal for imposing various restrictions on the use of compulsory licensing not faced by countries with developed manufacturing capacity in the pharmaceutical sector. In our view, the "solution" is burdened with procedural obstacles and is open to abuse by those who wish to limit or prevent countries from availing themselves of it in order to access imports of less expensive generic medicines. ...

To this end, countries such as Canada have a contribution to make, as the home to potential suppliers of lower-cost medicines. We have a well-developed generic pharmaceutical sector, with the capacity to produce medicines urgently needed in many developing countries. We note that the Canadian General Pharmaceutical Association has consistently stated that its member companies wish to produce generic formulations of medicines for export to developing countries. ...

Yet, because of the state of Canadian law, the resources of this sector cannot currently be marshalled to respond to this global need. ...

We call upon the Government of Canada to show leadership immediately amending the Patent Act to facilitate the production in Canada of generic medicines for export to developing countries.

Proposed amendment to the Patent Act

... It would, therefore, be open to Canada to simply amend the Patent Act to insert a provision creating the following "limited exception" to the exclusive rights of a patentee under Canadian law:

Manufacturing of a pharmaceutical product by a person other than the patentee shall be allowed if the pharmaceutical product is intended for export to a country in which, in respect of that product, either a compulsory license has been issued or a patent is not in force.

An accompanying amendment should make it clear, in line with the wording of the decision adopted by the WTO General Council on 30 August 2003, that the term "pharmaceutical product" means "any patented product, or product manufactured through a patented process, of the pharmaceutical sector" and includes "active ingredients necessary for its manufacture and diagnostic kits needed for its use."

Such an amendment would be the most straightforward manner in which to facilitate the production of Canadian generics for export to respond to the need for more affordable medicines in many developing countries. ...

We wish to point out that not only does Canada have a moral duty to take such a simple step to prevent unnecessary death and suffering, but amending our Patent Act to remove restrictions on generic exports is also consistent with Canada's duties under international human rights law. ...

Amending our Patent Act as we have proposed is in line with our legal obligations to take legislative and other measures as part of Canada's international assistance and cooperation in protecting, promoting and fulfilling the human right to health.

The situation facing many developing countries is dire already, and worsening by the day. We trust you share our sense of urgency and our wish to ensure that Canada does whatever it can to respond quickly and effectively to the global crises of HIV/AIDS, tuberculosis and malaria, and the many other health needs of poor people and countries. ... It is time to take this small, but significant, step in helping sick people get access to affordable medicines. ,,,

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Date distributed (ymd): 030930 Region: Continent-Wide Issue Areas: +health+ +economy/development+ +security/peace+


Message-Id: <> From: "Africa Action" <> Date: Tue, 30 Sep 2003 10:15:42 -0500 Subject: Africa: "You talk, we die"