U.S. Blocks Medicine
for AIDS in Africa

Revolutionary Worker #1019, August 22, 1999

AIDS is taking its steepest toll in the Third World. Of the 33.4 million people estimated infected with the disease worldwide, 22.5 million are in sub-Saharan Africa, 6.7 million are in South and Southeast Asia, and 1.4 million are in Latin America. These people will die without access to essential medicines. Right now 1,400 people are dying each week in Zambia. 2,400 people die each week in Zimbabwe. But despite this toll in human lives the U.S. government and pharmaceutical companies are fighting efforts to make life-saving drugs available to people in poor countries.

1.4 million people died from AIDS in southern and eastern Africa in 1998 alone. Botswana's life expectancy has dropped from 61 years to 47 years. In Zimbabwe, morgue hours have been extended to cope with the soaring death rate. The epidemic has created a whole generation of orphans. By the end of this year it is estimated that two million children will be orphaned because of AIDS/HIV. And the virus' human toll is expected to rise exponentially in coming years.

New drug therapies have made it possible for many people living with HIV or suffering from AIDS in the U.S. to pursue relatively healthy lives. But the new triple drug therapies that are saving lives in the U.S. cost more than $10,000 a year per patient. And they are virtually unheard of in poor countries where the AIDS epidemic is hitting the hardest. For example, Zambia couldn't afford multidrug AIDS therapy for its population even if it spent its entire national income on AIDS/HIV drugs!

South Africa is one of several countries in Africa where over 20 percent of the population is estimated to be infected with HIV. Without treatment one-fifth of all adults in South Africa will die from AIDS/HIV in the next 10 years. 100,000 children were orphaned by AIDS in South Africa in 1998 alone. AIDS patients occupy 70 percent of the beds in some hospitals. In 1990, life expectancy in South Africa was 59 years. Now it is estimated that, unless there are dramatic changes, in the next 10 years it will fall to less than 40 years. New drug therapies are too expensive for poor people in South Africa where the average income is $2,600 per year.

In 1997, to cope with the crises facing their country, the South African government passed the South African Drug Act, a measure designed to make some of the new drugs that slow the progression of the disease more affordable.

The South African law would allow the government to begin issuing licenses to local firms to manufacture low-cost generic versions of patented anti-AIDS drugs--a process called compulsory licensing. James Love, director of the Consumer Project on Technology, estimates that compulsory licensing would reduce the price of most AIDS-related drugs by 30 to 95 percent. For example AZT, a drug made by Glaxo-Wellcome that has been proven effective in inhibiting transmission of HIV from pregnant women to their fetuses, costs $240 a month in South Africa. Indian drug firms manufacture a generic version of the drug that costs $48 a month.

The law also allows "parallel importing"--importing drugs from other than the authorized distributor. Identical versions of drugs are sold by the manufacturer for different prices in different countries. For example, the drug company SmithKline Beecham sells its version of the antibiotic Amoxil for $8 in Pakistan, $14 in Canada, $16 in Italy, $22 in New Zealand, $29 in the Philippines, $36 in the U.S., $34 in Malaysia and $40 in Indonesia. By purchasing drugs from a parallel importer it is often possible to save a substantial amount over the price set by the pharmaceutical company.

Both parallel importing and compulsory licensing are permitted under the World Trade Organization under the Trade Related Aspects of Intellectual Property Accord, known as TRIPS. In fact, the U.S. permits compulsory licensing under the Clean Air Act, for nuclear power, for public health purposes, for government use, and as a remedy for anti-competitive practices. Parallel importing of pharmaceuticals is common in several European countries.

U.S. Government's War Against Access

"We're negative toward compulsory licensing. We think companies that have the rights to new inventions should have the right to market them the way that they want."

Joe Papovich, Assistant
U.S. Trade Representative
for Intellectual Property Issues

"We need these drugs in order to survive this catastrophe. We cannot be condemned to death because we are poor."

37-year-old HIV-positive woman from the African country of Malawi

In the face of the devastation caused by AIDS in Africa, the U.S. has done everything it can to keep drug prices high. In February the U.S. State Department sent Congress a report detailing the government's two-year campaign against the South African Medicines Act. The report stated that repeal of the South Africa Medicines Act is "a top priority for the United States government's economic relations with the Republic of South Africa." According to the report, "all relevant agencies of the U.S. Government--the Department of State together with the Department of Commerce, its U.S. Patent and Trademark Office (USPTO), the Office of the United States Trade Representative (USTR) and the National Security Council (NSC) and the Office of the Vice President (OVP)--have been engaged in an assiduous, concerted campaign to persuade the Government of South Africa (SAG) to withdraw or modify the provisions of Article 15(c) that we believe are inconsistent with South Africa's obligations and commitments under the WTO Agreement on Trade Related Aspects of Intellectual Property Rights (TRIPS)."

On April 30, the USTR put South Africa on a trade watch list and scheduled South Africa for an "out of cycle review." Because of the dominant role the U.S. plays in the world economy, being on a U.S. government watch list and subject to pressures by the U.S. can have huge effects on the economy of a third world country. For example, in retaliation for the South African policy, the U.S. government denied South Africa tariff breaks on exports to the U.S.--worth more than $3 billion in 1998.

As part of its campaign to stop widespread compulsory licensing, the drug industry has raised concerns that poorly monitored use of the latest AIDS drugs could create resistant strains. However, an article in the Chicago Tribune reports that physicians who work in those third world countries, which desperately need AIDS drugs, call those complaints a false issue. The Tribune reports that "Mark Biot, a Belgium-based physician who oversees Doctors Without Borders' worldwide AIDS efforts, said clinics in most larger cities of the developing world would be fully equipped to handle AIDS patients if they had access to affordable tests and drugs."

Doctor Biot recently returned from Thailand where people begin lining up outside Bamrasnaradura Hospital in Bangkok at 3 a.m. for the weekly AIDS clinic run by his group. Many people at the clinic have recently stopped using combination drug therapy to treat HIV infection when the prices for the drugs exploded because of the Asian financial crises.

The campaign against the South African Drug Act is only a small part of a worldwide effort by the U.S. "In the old days, the government made the world safe for Standard Oil," said James Love, Director of the Consumer Project on Technology. "Now it's making the world safe for the drug companies."

The USTR has threatened at least seven countries with trade sanctions if they allow generic substitutes for the cancer drug Taxol into their countries. The USTR also threatened sanctions against Thailand because the government passed a bill requiring that generic substitutes be listed on brand name drugs. Argentina has been punished because it opposed the U.S. position on patent protections and the "intellectual property rights" of drug manufacturers in international forums.

Blood and Gore

On June 16, a group of AIDS activists brought attention to the outrageous actions of the U.S. by demonstrating at several stops on Vice President Gore's campaign tour and disrupting his announcement that he will be running for president. ACT-UP and AIDS Drugs for Africa organized the demonstrations. The demonstrators got within a few feet of Gore holding banners and chanting "Gore's Greed Kills." The activists dubbed the Gore 2000 campaign "Apartheid 2000." Gore as co-chair of the U.S.-South Africa Binational Commission has led the U.S. campaign against the South Africa drug law. The actions of the demonstrators were widely reported, including in the Washington Post.

In response to the protests Gore wrote a letter to James Clyburn, Chair of the Congressional Black Caucus, stating that he would not oppose South Africa's efforts to make these drugs affordable and available "so long as they are done in a way consistent with international agreements." However it is far from clear whether this represents a real change in U.S. policy or is merely a smokescreen. So far the U.S. has refused to take any concrete action or to clarify its position. In a meeting with AIDS activists on July 26, U.S. representatives said that they still consider the South African Drug Act to be "potentially" against international trade rules.

If the U.S. government does not back off from its campaign to deny access to the anti-AIDS drugs, the Treatment Action Campaign of ACT-UP has said it will call for increased public pressure against the U.S. government internationally including calling for World AIDS Day (December 1, 1999) to be used as an international day of action against the U.S. government, including protests in at least 20 countries and declaring World AIDS Day a `day of shame' for the U.S. government.


While U.S. drug companies reap record profits, millions are dying needlessly throughout the Third World. And the actions of the U.S. government--blocking needed medicine in the face of the devastating AIDS epidemic--are an outrage.

As RCP Chairman Bob Avakian said:

"If one is conscious of the fact that the world is dominated by imperialism and if one has any inkling of the consequences of this for the great majority of the world's people, then one should feel compelled to help shatter the whole imperialist system and its entire framework, and to remake social relations on an international scale."

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