US URGED TO FUND AIDS WAR IN AFRICA

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US URGED TO FUND AIDS WAR IN AFRICA

Author: By Donnelly, Globe Staff Date: 03/16/2001 Page: A1 Section: National/Foreign WASHINGTON - Although encouraged by the recent free fall of prices for AIDS drugs in Africa, health specialists say it diverts attention from the main issue in trying to corral the pandemic: the need to win commitments for billions of dollars from rich nations to get the drugs to the neediest sufferers. Senior Bush administration officials and public health policy makers said in interviews the price cuts have acted as a catalyst in recent weeks for the US government to consider significantly expanding the amount of money it gives to combat AIDS in the developing world. The money would be needed to buy the suddenly more-affordable anti retro viral drugs as well as building health centers and training health workers throughout sub-Saharan Africa, where an estimated 25 million people infected with the HIV virus are now likely to die prematurely. The United States spends roughly $460 million to fight AIDS overseas, but several leading economists and health specialists have said that rich countries together should increase annual spending to Africa alone to about $5 billion a year to stem the outbreak. Asked if it was realistic that the United States would spend $1.5 billion to $2 billion a year to fight the disease in Africa, a senior US official said yesterday: " I think we have to. I think if we say it's a priority, we have to put the funding behind it that demonstrates an effort to address the problem. " The official, whose responsibilities include AIDS policy, added, " We need to be more creative in terms of how we tackle it, and not simply reduce it to a money issue, but we also should not run away from the money issue. " Those comments, coupled with recent statements made by Secretary of State Colin L. and Trade Representative B. Zoellick, appear to signal a commitment to the issue far beyond that given by the Clinton administration. , saying AIDS in Africa is a pressing issue, has appointed a representative to conduct a government-wide review of US response to the problem. Zoellick has backed policies developed in 1999 and 2000 that give more leeway to developing countries to produce or import cheap generic drugs to treatment HIV or AIDS patients. Global health activists said they hope the Bush administration and Congress will sharply increase funding this year for AIDS programs in Africa, but such an outcome is very difficult to predict, especially with key administration jobs still vacant. In Congress, support has risen in the last year for dramatically increasing funding, as well as supporting better health care infrastructure in sub-Saharan Africa. Among the leaders are Senators F. Kerry, a Massachusetts Democrat, and Bill Frist, a Tennessee Republican. " We are going to have a jump in investment, " said Frist, a surgeon and chairman of the African affairs subcommittee. " History is going to record what we do when we face the terrible waste of life and hope that is the global AIDS epidemic today. Our grandchildren will ask us what we did to fight it. " The US government's level of support is seen by many activists as the next major hurdle after the debate over the price of a combination of anti-AIDS drugs and patent rights for the pharmaceutical industry. If the US administration sharply increases funding, activists said, other wealthy nations would probably follow. The AIDS pandemic has exacted a greater death toll, primarily in sub-Saharan Africa, than any worldwide infectious disease since the bubonic plague tore through Europe in the 14th century. The first serious hope for treatment came just five weeks ago, when an Indian generic drug company, Cipla, announced it would cut the price of a " cocktail " of AIDS drugs to $350 a year to a medical non profit group. Last week, Merck & Co. said it would offer its two AIDS medicines at production costs. On Wednesday, Bristol-Myers Squibb said that it would sell two drugs below cost and that it would no longer fight generic-drug makers from selling copies of one of its HIV drugs in Africa. " Things are moving very rapidly now, " Ben Plumley, an official at the United Nations AIDS office in Geneva, said yesterday. " Dealing with the affordability of drugs helps us deal with the other issues - funding, infrastructure, counseling, testing. All of that is key in order to get the rate of transmission down. " Nils Daulaire, president of the Global Health Council, an alliance based in White River Junction, Vt., and Washington, said many public health experts are eager to move policy discussions beyond the price of drugs. " What all of us who are public health practitioners know, that even if the cost of the antiretroviral drugs is reduced from $10,000 a year to even $100 a year, 1 percent of the cost in the United States, that won't solve the problem, " Daulaire said. " We need to make the prices as low as possible in order to get on with the real challenges - developing the health care systems essential for providing these drugs and providing realistic financing mechanisms for purchasing them. " A second US official who works on African issues said in an interview that the most important step needed to fight the disease would be for African leaders to take forceful roles in educating people about the dangers of having sex without condoms and reusing needles, the two most common ways of transmission. The official also said that during this " pre vaccine period, " African and industrialized nations should put a major effort into starting new community health centers, medical laboratories, and training thousands of new health care workers. " The AIDS cocktails are not a panacea, " said the official. " The silver bullet won't come until we have a vaccine. But even if we have a vaccine, that doesn't address how we treat people now or how we get it to people. " Donnelly can be reached by e-mail at donnelly@...