Kaiser Daily HIV/AIDS Report - Tue, 1 May 2001
* South African, Indian Health Ministers Sign Agreement on Access to
Cheaper AIDS Drugs
* Annan Calls on Foundations to Support Global Fund Against AIDS,
World Bank Endorses Plan
South African, Indian Health Ministers Sign Agreement on Access to
Cheaper AIDS Drugs
South African Health Minister Manto Tshabalala-Msimang yesterday
signed a declaration of intent with Indian Health Minister C. P. Tha-
kur for cooperation on obtaining cheap drugs for the Southern African
Development Community, the South African Press Association/BBC Moni-
toring reports. Tshabalala-Msimang said, "We will be discussing fur-
ther the possibility of transferring technology and building the ca-
pacity of our country and region with regard to pharmaceutical ser-
vices." South Africa's Health Department would also work with India
on community-based HIV/AIDS and tuberculosis programs, nutrition pro-
grams, research and combatting waterborne diseases. In addition, In-
dia and South Africa would share health and medical information
(SAPA/BBC Monitoring, 4/30). Now that the multinational drug compa-
nies have dropped their lawsuit against South Africa's Medicines Con-
trol Act, the country is "looking forward to partnerships for afford-
able medicines," Tshabalala-Msimang said. According to the Press
Trust of India/BBC Monitoring, Thakur said that the agreement would
increase the South African market for Indian drug makers, noting that
several Indian companies have already begun their manufacturing base
there and that South Africa may become a "gateway of entry" to the
entire continent. He added that the countries would adhere to World
Trade Organization agreements (PTI/BBC Monitoring, 5/1).
Annan Calls on Foundations to Support Global Fund Against AIDS,
World Bank Endorses Plan
Speaking yesterday before the annual meeting of the Council of Foun-
dations, an "umbrella group" of 1,800 charitable foundations and cor-
porations, U.N. Secretary-General Kofi Annan called on the philan-
thropic institutions to "put their financial might behind a new
global fund designed to orchestrate a new coordinated attack on the
AIDS pandemic," Reuters/Contra Costa Times reports. If the founda-
tions "make the fight against AIDS a top priority," Annan said he
would "wager that governments and the general public will not be far
behind." Annan proposed the fund Friday at the largest-ever African
AIDS conference in Abuja, Nigeria, stating that on top of the $1 bil-
lion already spent annually on HIV/AIDS in developing nations, an ad-
ditional $7 billion to $10 billion a year is needed to launch an ef-
fective "global assault" on HIV/AIDS, malaria and tuberculosis. Yes-
terday, he asked the foundations to increase their monetary contribu-
tions and to "act as levers and advocates" to "stimulat[e] others to
emulate your generosity." The foundations "have the flexibility to
provide funds quickly, and use them to plug gaps, where other insti-
tutions may be held back by political considerations, or by the terms
of their mandates," he told the conference (Morgan, Reuters/Contra
Costa Times, 4/30). Annan stressed that the "heavy lifting" must come
from wealthy industrial nations, which currently spend "100 times"
the amount he is seeking for HIV/AIDS on their military budgets. Al-
though details of the fund have not been solidified, Annan said he
hopes to have commitments from donors and an action plan ready when
the United Nations convenes a special session on HIV/AIDS at the end
of June (Collins, Philadelphia Inquirer, 5/1).
A Five Point Plan
In his speech, Annan outlined five "key action areas" for the cam-
paign against HIV/AIDS, including:
1. Containing the epidemic: The campaign must prevent further spread
of HIV "especially by giving young people the knowledge and power to
protect themselves," Annan said. "Large-scale" awareness and preven-
tion campaigns are needed, as well as additional counseling and test-
ing and condom distribution programs.
2. Reducing vertical transmission: Annan called mother-to-child HIV
transmission the "cruellest, most unjust infections of all" and advo-
cated HIV testing for all pregnant women, as well as the administra-
tion of "short-term" antiretroviral drugs to HIV-positive pregnant
women and their newborns to reduce vertical transmission rates.
3. Accessible treatment: Based on his recent meeting with pharmaceu-
tical industry leaders, Annan said that the industry is prepared to
supply anti-AIDS medications to the developing world at "greatly re-
duced prices." These discounts will help increase drug access, but
drugs are only part of the "comprehensive HIV care package" that is
needed. Counseling and testing, home- and community-based care and
"simple" treatment of opportunistic infections is also needed.
4. Advances in science: The creation of an effective HIV/AIDS vaccine
and a cure for the disease must be given "higher priority" in scien-
tific budgets, Annan said.
5. Orphans: Those made "most vulnerable" by HIV/AIDS must be "pro-
tect[ed]," Annan said, adding that the world's 13 million AIDS or-
phans, most of whom reside in Africa, must be given greater attention
(U.N. release, 4/30).
World Bank Gives Its Endorsement
At the close of the IMF/World Bank meeting in Washington, D.C., the
World Bank's governing committee yesterday officially gave its en-
dorsement to the idea of a global AIDS trust fund and said it will
administer the fund with the United Nations, the Washington Post re-
ports. The endorsement follows similar actions Sunday by the IMF and
the G7 nations. World Bank President James Wolfensohn said he had the
"distinct impression that industrialized countries are prepared to
ante up the funds" for the trust and predicted that "proof" of that
commitment will appear in the "next month or two." The bank estimated
that a "well-funded effort" could reduce HIV transmission by a quar-
ter, despite Africa's lack of adequate health infrastructure. The
bank also said that such an effort could prevent nearly 7.5 million
deaths annually from infectious diseases such as malaria and TB.
Treating those already infected with HIV would require the "full
goal" of $7 to $10 billion Annan announced, Chris Lovelace, the
bank's health director, said (Pearlstein/DeYoung, Washington Post,
Doing the Grunt Work
The United Nations, the World Bank and the World Health Organization
have not yet addressed how a new global fund would be divided between
treatment and preventive measures. They also have not determined
which agency will take the lead in the initiative. Although the
United States and other Group of Seven nations have expressed support
for the fund, exact contribution figures have not been determined,
nor has the length of the commitment been discussed. In addition, de-
tails about whether the fund will address HIV/AIDS in developing
countries outside of Africa and what, if any, other diseases will be
targeted have not been worked out. Annan "side-stepped" these issues
in an interview with the Philadelphia Inquirer yesterday, the paper
reports. He also declined to comment on the role generic drugs would
play in any treatment plans. Many activists credit generic drug com-
petition with helping to lower the cost of brand-name AIDS medica-
tions and are "concerned" that if generic drugs are not a "strong
part" of any global AIDS program, the major pharmaceutical companies
will lack any further incentive to reduce their prices. Annan said he
is planning to meet with the heads of several generic drug manufac-
turers soon (Philadelphia Inquirer, 5/1).
Annan's request for global AIDS funds was greeted with an "enthusias-
tic response" from Council of Foundation members, Reuters/Contra
Costa Times reports. "It was an eye-opening speech," Paul Di Dinato,
head of a consortium of AIDS-related foundations, said. He predicted
that HIV/AIDS-related charitable giving could "easily rise" to $200
million within three years. U.S. foundations donated an estimated
$27.6 billion last year, of which less than $100 million went toward
AIDS-related projects (Reuters/Contra Costa Times, 4/30). Susan Ber-
res Ford, president of the Ford Foundation, said that the council
"heard" Annan's message. She predicted such a global effort would
"promote collaborations between foundations and governments" and act
as a "safeguard against duplication" (Carr, Atlanta Journal-
The 'Lion's Share'
Annan added that he hoped the foundations' positive reactions would
be well received by the Bush administration, and encouraged the White
House to increase its funding of the global AIDS effort. "It would be
presumptuous of me to say how much the U.S. should pay. I hope, con-
sidering the size of the government, that it would be substantial,"
he said (Cappello, Associated Press, 5/1). Administration officials
said yesterday that they support the "idea of a multilateral attack"
on HIV/AIDS, but it remained unclear how much the government is will-
ing to put toward the effort (Philadelphia Inquirer, 5/1). British
Finance Minister Gordon Brown, who heads the International Monetary
Fund's policymaking team, said that the United States could be
"pressed" into lending greater support "by the enthusiasm of others."
According to Brown, Great Britain and Italy have been "working behind
the scenes" to promote a trust fund since February. "I want us to
treat this issue with the same urgency that we treat the debt issue.
We cannot stand by and allow lives to be lost when there are poten-
tially drugs and vaccines that can stop this needless loss of life,"
Brown added (Willard, Reuters/Contra Costa Times, 4/30). Brown will
address the United Nations today to offer the G7's support of the
fund. The "precise amount" of money to be provided by the nations --
including the United States, the United Kingdom, Canada, Germany,
France and Italy -- will be decided later this year, but total con-
tributions could be as high as seven billion British pounds. "The
scale of this would have to be very big indeed. Governments will
pledge what they can afford and we expect the biggest countries are
in a position to do the most," Brown said, adding that the United
States, as the world's wealthiest nation, will be expected to con-
tribute the "lion's share" (Thornton, London Independent, 5/1).
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