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[e-drug] African Aids drug plan faces collapse

E-DRUG: African Aids drug plan faces collapse
[a very worrying development: international funding for WHO 3x5 or Global
Fund is not forthcoming. This is the biggest public health crisis ever! 5000
die every day in Africa already, and some 28 million are to follow. Copied
as fair use. WB]

African Aids drug plan faces collapse

Alison Langley in Geneva
Sunday March 14, 2004
The Observer

A United Nations plan to provide three million HIV-infected patients in
Africa with anti-retroviral drugs by 2005 is in danger of collapsing owing
to lack of funds, UN and World Health Organisation officials said.

Some countries, particularly the United States, are balking at supporting
the project, Aids workers say, partly because the plan intends to use a
form of medicine called fixed-dose combination antiretroviral drugs whose
use is opposed by large pharmaceutical companies.

Only $2.3 billion has been secured for the $5.5bn WHO project, dubbed
'Three by Five' because it hopes to provide drugs to three million people
by 2005. Only the UK, Sweden and Spain have provided money to date,
officials said.

'If Three by Five fails, as it surely will without the dollars, then there
are no excuses left, no rationalisations to hide behind. There will only be
the mass graves of the betrayed,' said Stephen Lewis, the UN
Secretary-General's special envoy for HIV/Aids in Africa.

The WHO urgently needs $200m in the next few months to upgrade health
systems' infrastructures in 14 African states, Lewis said.

Aids activists say money isn't forthcoming because of WHO support of the
use of combination medicines. Called fixed-dose medicines, these drugs
combine two or more active ingredients in one pill, thereby reducing the
number of tablets an AIDS patient must swallow each day.

Fixed-dose drugs are also cheaper. Taking two fixed-dose combination pills
a day for a year costs $140 per patient, compared to about $600 per year
for six pills per day.

A fixed-dose combination pill 'has completely revolutionised people's
lives', said Ellen 'T Hoen, director of Mèdecins Sans Frontiéres' Access to
Essential Medicines programme.

The US, by far the largest donor with a $15bn plan launched last year, has
been reluctant to endorse the fixed-dose combination pills, saying they are
not yet convinced the medicines are safe.

In order to make the combination drugs, generic manufacturers use active
ingredients that were discovered by different pharmaceutical companies and
are under patent in wealthy countries.

'We need to have principles - standards by which the purchase decisions can
be made,' said Randall Tobias, the US Global Aids coordinator, in recent
testimony before the US Congress. Ambassador Tobias is the retired chairman
of Eli Lilly, one of the world's biggest pharmaceutical concerns.

WHO and Aids workers say the principles and guidelines are already in place
because the medicines must meet extensive guidelines by the World Health
Organisation before being approved for use.

The US is sponsoring a two-day conference starting on 29 March in Botswana
to discuss the principles of regulation of these generic medicines.

The fixed-dose pills approved for use by the World Health Organisation are
produced by three generic drug makers in India, which does not yet
recognise patent laws. Exceptions to the patent system allow local
manufacturers in poor countries to produce life-saving generic medicines
and export them only under certain limited circumstances to other poor

This means Indian manufacturers will agree to sell their wares in the 14
poorest African nations. Mèdiciens Sans Frontiére's 'T Hoen believes the US
stance is not motivated by safety. 'The US's position is to buy drugs only
approved by the (Federal Drug Administration),' she said. 'The fixed dose
can't be approved by the FDA because of patent problems, not because of
their safety or efficacy.'

International HIV/AIDS Alliance
Healthlink Worldwide
UK Consortium on AIDS & International Development
Stop AIDS Campaign

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