South Africa battles for cheap AIDS drugs

Makers' lawsuit pits profits against health

March 05, 2001|By John Murphy | John Murphy,SUN FOREIGN STAFF

JOHANNESBURG, South Africa - Armies of patent attorneys will begin arguments today in a South African trial that is shaping into a modern-day morality tale that pits a Third-World David vs. a gang of First-World Goliaths.

In one corner of the courthouse in Pretoria are the world's pharmaceutical giants - multinational bullies, according to critics, out to defend their huge profits at the expense of the world's health. In the other is the scrappy South African government, struggling to deal with a population in which one in 10 people has the virus that causes AIDS.

At the heart of the case is a South African law that would give the government the power to import or manufacture cheap bootleg copies of brand-name drugs to treat its AIDS patients.

But standing in the way are 40 pharmaceutical companies that are trying to block the law that they say will compromise their intellectual property rights and threaten their ability to recoup research and development costs.

"This case ... is really about what comes first - the commercial interests of the companies or the human rights of the people who try to stay alive," said Ellen 't Hoen, a spokeswoman for Doctors Without Borders, the international medical assistance organization that has been leading the fight for cheaper drugs.

Marches in support of the South African government are planned for today in South Africa and as far away as New York, Philadelphia, Washington, Boston and San Francisco.

Pharmaceutical manufacturers appear unfazed by the mounting public relations campaign against them. In news conferences this week, the industry drew a very different portrait of the trial's players. The pharmaceutical companies say they are honest brokers whose efforts to provide South Africa with discount drugs have been met with indifference by a government unwilling and ill-prepared to deal with the AIDS problem.

"We believe quite firmly and we state quite categorically that what has been absent and what holds back treatment to South Africans living with HIV is a lack of political commitment," said Mirryena Deeb, chief executive of the Pharmaceutical Manufacturers' Association of South Africa.

The emotionally charged trial, which will run through March 13 in Pretoria High Court, will be closely watched by much of the developing world in Latin America, Asia and the rest of Africa, home to 70 percent of the world's HIV/AIDS cases.

Costly patents

South Africa has 4.2 million infected people. But only a fraction can afford the anti-retroviral drugs, also known as the triple drug therapy, that can delay or prevent the onset of AIDS. Such drugs can cost as much as $10,000 to $15,000 per patient each year in developed countries such as the United States. But in South Africa, where the average annual income is just over $3,000 and 80 percent of the population depends on public health care, such prices are way beyond the means of most people.

Under international patent law, drug companies receive a 20-year monopoly to produce and sell the drugs that they took the risks to research and develop. As a result, the drugs are often accessible only to the wealthy. The poor suffer without them. Such is the case with the key drugs needed to treat AIDS.

But developing countries such as India, which do not recognize Western drug patents, manufacture copies of brand-name AIDS treatments and other medicines and sell them at significantly lower prices. Cipla of Bombay, for instance, announced last month that it would sell the triple drug therapy for as little as $350 for a year's supply.

The South African law in question - the Medicines and Related Substance Control Amendment Act of 1997 - would allow the country to take advantage of such offers, if the government wins its case. It would also give it the right to override patents to produce affordable copies of drugs.

Mindful of international intellectual property rights laws, the South African government drew up the law so it would be in compliance with World Trade Organization regulations, which allow patent violations in cases of a national emergency or in cases of obviously exorbitant charges. Under the same provision, Brazil has started manufacturing AIDS drugs and is treating 90,000 patients.

A law that would allow South Africa to buy cheap generics from India or manufacture them here would give the country more leverage in negotiating with drug companies, government officials say.

"We believed we had reached a point in our discussion with [the drug companies] that certainly we needed to have something that empowers us to act if they continue on the same path, ... which was no visible movement in the direction of making the price of drugs far more affordable," said Dr. Ayanda Ntsaluba, director-general of South Africa's Department of Health.

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