Pharma + Profits = Continued AIDS Epidemic
Authors: Inder M. Verma
Journal: Molecular Therapy (2001)

No one can escape the word “global”–global economy, global environment, global investments, global health, and, unfortunately, global epidemic. Just as the World Bank, or the International Monetary Fund, provides aid to developing and even developed countries to ward off economic disasters like currency devaluation, should there not be a global fund to ward off global diseases like AIDS? Current estimates range from 30 to 40 million HIV-infected people worldwide, with nearly 70% (25 million) on the African continent, and these estimates are growing at a frightening pace. We all agree that behavioral changes combined with effective vaccines are the only answer in the long run. But what about in the interim—can we at least attempt to slow the spread of the disease? “Cocktails” of reverse transcriptase and protease inhibitors have had a dramatic effect on the reduction of AIDS-related mortality in the Western world. True, HIV-infected individuals have to consume many pills on a daily rigorous schedule, but they are alive, productive, and at a reduced risk of transmitting the virus. But these drugs are expensive, costing upward of $10,000 annually per patient, a price unimaginable to poor countries in Africa and Southeastern Asia where the annual per capita income is often less than $500. Under pressure from various national and international organizations, the international pharmaceutical companies, led by giants like GlaxoSmithKline and Merck and Co., have agreed to lower the cost of supplying the drugs to Africa. Although the companies refuse to release precise figures, Doctors Without Borders/Médecins Sans Frontières estimate the current price of a typical AIDS cocktail at about $1000 and steadily coming down. That is still exorbitant for the average HIV-infected person who dwells in sub-Saharan Africa or infected sex workers in Mumbai (formerly Bombay) or Bangkok. Dr. Yusuf K. Hamied of CIPLA Ltd., an Indian company, has publicly declared that they can supply triple-therapy drug cocktails for $350 annually. The multinationals are crying foul because CIPLA Ltd. is violating the patents. Indeed, GlaxoSmithKline forced CIPLA Ltd. to stop selling a generic version of Combivir in Ghana. Though CIPLA Ltd. backed down, these events sharpen the focus on patent protection vs the needs of poor nations. On March 5th, thousands of demonstrators congregated in Pretoria, South Africa, in protest against the international pharmaceutical industry, which is trying to overturn a South African law to ease access to AIDS drugs. In such protests, placards bearing signs like “AIDS Profiteers,” “Deadlier Than the Virus,” “Multinational Thugs,” “Pharma Mafia,” etc., are prominently displayed. Patients are destitute and dying, but the pharmaceutical industry wants to maintain the principle of patent protection, warning of chaos. After all, they have spent enormous sums in research leading to successful drugs. Furthermore, the companies maintain that the drugs are quite toxic and, if used improperly, have the potential to cause more damage than good. What is the solution? Sick and dying people need the drugs. If we are to be part of this “global world,” we must help. To supply every AIDS patient with drugs will cost 10 billion dollars per year (Bill Gates alone can provide drugs for every AIDS patient for 10 years). Jeffrey Sachs, director of The Center for International Development at Harvard, pointed out “that the U.S. could easily contribute $3 billion annually; about $10 for each of us—the cost of a movie ticket with popcorn.” Thus, it is really not the money, it is the lack of will coupled to our “disconnect” from AIDS patients in the developing world. They are not part of “our world”—they live far away and do not affect our daily life except for sad and hopeless faces on TV. A vast stretch of an entire continent is losing people in the prime of their lives for a lack of $300–500 to buy drugs. Why can't rich nations led by the United States form an “AIDS consortium” to provide drugs to every HIV patient in the world, at least until an efficacious vaccine is found? I am sure that years from now our children will point a finger at us for not doing our part. We still have time.