Kaiser Daily HIV/AIDS Report - Thu, 21 Jun 2001
* Mogae Discusses Botswana's Efforts to Stem HIV/AIDS Epidemic
* Indian Drugmaker Says It Will Offer World's Lowest Price on Triple-
Therapy AIDS 'Cocktail'
* NYT Editorial Says South Africa Should Make Efforts To Distribute
Mogae Discusses Botswana's Efforts to Stem HIV/AIDS Epidemic
Speaking yesterday at the National Press Club, Botswana President
Festus Mogae admitted he is "scared" for his nation, the world's
worst HIV-infected country with an infection rate of 36.8% among
adults aged 15 to 49, the Boston Globe reports. "[W]e are frightened.
We don't know what will happen," he said. He added, however, that
Botswanans "intend to survive. That is why we need assistance." Bot-
swana, which had been an "economic and political success story" prior
to the onset of the HIV/AIDS epidemic, now finds its survival
"threatened," the Globe reports. AIDS has "sucked from us our pride
and our achievements," leaving behind a "national sadness," Mogae
said. But the nation, seen as a "key battleground" in the fight
against the disease, has recently taken steps to initiate what it
hopes will be the first nationwide HIV treatment program in sub-
Saharan Africa. The government hopes to begin dispensing antiretrovi-
ral drugs by the end of the year, assisted by a team of Harvard Uni-
versity experts that includes Harvard AIDS Institute Chair Myron
"Max" Essex. Funded by a $100 million grant from the Bill & Melinda
Gates Foundation, the program will also include initiatives to stop
vertical transmission, start HIV vaccine trials and expand a labora-
tory. Debswana Diamond, Botswana's largest employer, also has an-
nounced it will provide treatment for its HIV-positive employees.
However, Mogae worries that these efforts may not be "fast enough or
reach enough people." Of an estimated 300,000 infected people in the
country, only about 30,000 know their status. "We are determined, but
our national mood is sad, very sad," he said (Donnelly, Boston Globe,
Indian Drugmaker Says It Will Offer World's Lowest Price on Triple-
Therapy AIDS 'Cocktail'
Indian drugmaker Aurobindo Pharma announced yesterday that it will
offer a triple-therapy drug "cocktail" of stavudine, nevirapine and
lamivudine for $295 per patient per year, "possibly the lowest price
in the world," Agence France-Presse reports. The offer is open to
"anyone either in the private market or government agencies or chari-
ties," P.V. Ramprasad Reddy, Aurobindo's managing director, said,
adding that the company is selling the drug "at an almost break-even
price" as a "service to humanity and not a profit-making exercise."
The company is in the process of registering the drugs in South Af-
rica, Namibia, Zimbabwe and Brazil and has already received approval
from South African officials for drug-production facilities, Reddy
said. Although Aurobindo only began to manufacture AIDS drugs three
months ago, the company is prepared to offer the reduced prices be-
cause it makes all of the drugs' raw ingredients. "We are very strong
in the raw material technology and make our profits in producing bulk
drugs," Reddy said. Rival Indian drugmaker Cipla "shook" the pharma-
ceutical industry in February by offering the same triple-combination
for $350 per patient per year compared to the U.S. price of $10,000
to $12,000 per patient per year. The patents on the three drugs are
held by Bristol-Myers Squibb, Boehringer Ingelheim and GlaxoSmith-
Kline respectively. Indian patent law only protects the process by
which a drug is formulated and not the final product itself, allowing
companies to produce generic forms of drugs by slightly altering the
process. Reddy said he "expect[s]" a WHO team to study Aurobindo's
proposal and inspect its facilities soon (Agence France-Presse,
NYT Editorial Says South Africa Should Make Efforts To Distribute An-
It is "dismaying" that the South African government is "still not
planning" to distribute antiretrovirals, despite the withdrawal of
the pharmaceutical industry's lawsuit against its Medicines and Re-
lated Substances Control Act, a New York Times editorial states. The
editorial states that "South Africa's government has an ignoble his-
tory of skepticism about treating AIDS," citing South African Presi-
dent Thabo Mbeki's questioning of the causal link between HIV and
AIDS as an example. The editorial also notes that even discounted an-
tiretrovirals are still too costly for South Africa. "But reserva-
tions about treating AIDS cannot explain why South Africa is also
stalling on simple and cheap programs to cut mother-to-child trans-
mission," the editorial says, adding, "The cabinet has withheld ap-
proval, preferring to study the programs endlessly." Although the di-
rector of South Africa's AIDS programs recently allowed the provinces
to implement treatments aimed at curbing vertical transmission, the
editorial states that "[t]his is welcome, but is far less than the
enthusiastic embrace needed to encourage widespread use of mother-to-
child programs." The editorial concludes, "Antiretrovirals are being
used successfully in African nations less developed than South Africa
to extend the life and health of AIDS patients. Their use in South
Africa is not only a moral imperative, it is a practical necessity"
(New York Times, 6/21).
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