Kofi's AIDS Fund as a diversion manoeuvre

[Guest guest]

Planet Africa: Act Up-Paris' Press document - 07/20/01

`AIDS: G8 has to pay for Generic Drugs `

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A logical consequence of the mounting debate on the access to drugs in

poor countries, AIDS is on the agenda of the G8. Indeed, governments

and backers must abandon the wait-and-see policy that they had

maintained for 20 years.

However, as during the United Nations Special Session at the end of

June, announcements and discussions around the creation of the global

Fund launched by Kofi n last April, are likely to elude the real

debate posed by access to health and drugs and maintenance of

intellectual property in poor countries.

On the one hand, money announcements from rich countries take place

while these countries have drastically reduced their official

development assistance (ODA), a part of which is intended for the

fight against AIDS, for the last 10 years.

On the other hand, according to Gaëlle Krikorian of Act Up-Paris,

announcements from governments look like a diversion manoeuvre. It

obscures the issue of production and access to generic drugs in poor

countries,as well as the debate on the WTO TRIPS agreements and their

dramatic medical consequences for years to come. And Gaëlle Krikorian

wonders whether the international financial backers hope to buy the

silence of the people with HIV and ensure the upholding of

intellectual property by announcing a paltry hundred million for a

nebulous global Fund.

Today, one of the priorities of the fight against AIDS is the

launching of an international invitation of open tender for generic

drugs and copies manufacturers, allowing purchase of drugs at the

lowest price through economies of scale and competition between

manufacturers. The financing of such an operation does not require the

creation of a " global and omnipotent Fund, but a simple program within

an existing organization.

(1) Beyond this measure and since the WTO agreements seem to be unable

to permit the defense of health interests, the fight against AIDS

imposes the abolition of intellectual property everywhere where it

kills.

Kofi's Fund as a diversion manoeuvre

Thus, last April, Kofi n launched the idea of a global Fund

intended to collect some 7 to 10 billion dollars a year for the fight

against AIDS.

Patients in poor countries, NGOs and activists can then believe that

this Fund will mark a turning point in the fight against the epidemic:

to finally allow a change in scale of financing and medical care for

the million patients who still do not have access to drugs.

Now, though, just as the G8 summit arrives in Genoa, enthusiasm has

waned. The Fund has been transformed: it will also be used for

tuberculosis and malaria; the announced amounts are ridiculously low;

there has been a dilution of objectives and a return to an

all-prevention strategy.

Ridiculous amounts

The United States, the leading economic power in the world, set the

tone last May by announcing a contribution of 200 million dollars,

that is 2% of the amount set by Kofi n.(2) Statements by Lionel

Jospin, the French Prime Minister, echo this tone by proposing 130

million dollars over three years. The Japanese advance 100 million

dollars. The strategy is clear. The Fund is thus deprived of its

principal quality: financing of a new magnitude on a worldwide scale.

The thundering initiative of Kofi n is first useful to the

international financial backers, and in particular the countries of

the North, which can easily give the illusion that they are mobilizing

- the money is far from being released, financing will certainly come

from existing allocations.

Dilution of objectives

Funds targeted to three diseases at the same time cannot meet the

needs and the emergency that the AIDS epidemic imposes. Its too broad

sphere of action will only lead to diluting the objectives and

submerging the priority stakes such as access to treatment in a vast

hodgepodge. Moreover, if governments are free to target their

financing, the majority of them will probably direct it towards

malaria or tuberculosis to the detriment of AIDS, towards prevention

to the detriment of treatment, towards brand-name drugs to the

detriment of generics. The recent statements of the American(3) and

British governments, of officials of the European Union(4) or

representatives of international agencies(5) have already indicated

this.

Time to die

The initial deadline by the end of 2001 is illusory. Everything leads

us to believe that the setting up of this Fund will require several

years - the glorious experience of the International Therapeutic

Solidarity Fund launched by Chirac in December 1997 is still in our

memory. How many million patients will die while political leaders and

international financial backers wonder about the objectives,

management or governance of this Fund? Will each actor wait for all of

its partners to act? The patients however do not have any time to

lose.

Creation of an nth international coordination entity

One of the pretexts for the creation of this Fund is the coordination

of the action of financial backers. The WHO and UNAIDS themselves have

as a mandate the harmonization and coordination of international

health and AIDS policies; neither of these agencies however manages to

honour this mandate and to impose on Member States joint action

adapted to the needs of the populations. Under no circumstances will

the creation of an nth international entity, whose mission remains

deliberately vague, make it possible to achieve this goal.

The setting up of a global Fund should not be the sine qua non for a

massive increase in financing. Rich countries do not need a global

Fund to increase by tenfold their efforts in the fight against AIDS.

On the other hand, they are likely to seize this opportunity to

continue a massive disengagement in development aid, covered up by the

launching of international initiatives that are media-worthy rather

than operational.

What the G8 hides

Policies unworthy of aid to development

For 10 years, rich countries have drastically reduced their official

development assistance (ODA), a part of which is intended for the

fight against AIDS. Rare are the countries that devote to it 0.7% of

their GNP, their minimum commitment. In France, the amount of APD has

decreased steadily since 1995 and represents today 0.31% of the GNP.

As for the United States, it occupies the last rank among OECD

(Organization for Economic ation and Development) donors, with

0.1% of its GNP.

In this context, G8 countries announcements are hardly credible.

A real awareness of the seriousness of the AIDS epidemic would impose:

- an immediate ten-fold increase in bilateral aid to the programs of

global medical care for people living with HIV/AIDS in developing

countries,

- implementation as soon as possible of the EU action plan for the

fight against AIDS, tuberculosis and malaria (this plan is still not

budgeted),

- massive financial and technical support for drug policies targeting

generics.

The refusal to question intellectual property in poor countries

The monopoly of some manufacturers on the AIDS market is contrary to

broad and durable access to drugs for all the patients who need them.

Today, certain countries of the South have the capacity to manufacture

copies of antiretrovirals at prices much lower than those of the major

producers. Only competition between different manufacturers will

permit a drastic and durable decrease in the prices of pharmaceutical

products -

this dynamic of competition has already obliged Western manufacturers

to align their prices with those of manufacturers of generics for a

certain number of molecules.

The Kenyan Coalition recalled this in its press release of May 27

during the visit of the American Secretary of State Colin : one

of the major reasons that explains the death of such a large number of

people is the price of antiretrovirals and other essential drugs,

which remain inaccessible. Although manufacturers of generics sell

triple therapies in certain African countries (Cameroon, Nigeria) for

USD 350 per patient per year, in Kenya, the lowest price that

hospitals have been able to negotiate is between USD 1,330 and 1,620

per patient per year (6).

Today, patients in developing countries should be able to benefit as

soon as possible from the entire range of therapies against HIV/AIDS

at cost. The urgency of treating the millions afflicted with AIDS in

developing countries necessitates a rapid multiplication of sources of

production in countries of the South and the development of

South/South exchanges.

However, the political pressure that still surrounds the issues of

intellectual property blocks the initiatives of poor countries that

want to produce or import copies of drugs - witness, for example, the

case against Brazil recently brought before the WTO by the United

States.(7)

Thus, the breaches provided for by international agreements on

intellectual property - compulsory licenses or parallel imports - as

many parapets against the monopoly of major manufacturers, remain

unexploitable given the current balance of power. Intimidation is the

rule, and examples of aborted attempts abound.

Intellectual property rights should allow commercial exploitation of

pharmaceutical products to generate reinvestment in research and

ensure the broadest access to innovations in the health field. In

reality, patents guarantee only one thing: profits for a few

multinationals benefiting from a 20-year monopoly for the exploitation

of drugs, while restricting access to patients who can afford them,

the others depending on the sporadic charity of these multinationals.

It is from this reality that the announcements made by rich countries

today diverts us.

Recent events at the World Assembly on Health in Geneva (May 15 - May

22) illustrate this: while Kofi n had just re-announced the

creation of the Fund to a room of enthusiastic Ministers of Health,

behind the scenes, Americans and Europeans were agreeing to force

Brazil or South Africa to give up the concrete resolutions that they

proposed for access to generics or strengthening health care systems

in developing countries.

Act Up-Paris requires:

- The financial involvement of G8 countries at the level proportionate

to the needs of poor countries;

- An immediate release of these funds;

- The launching by UNICEF of an international invitation to tender

open to manufacturers of generics for the wholesale purchase of drugs

intended for poor countries;

- The abolition of intellectual property everywhere it kills.

(1)UNICEF has experience with the wholesale purchase and distribution

of pharmaceutical products on a worldwide scale and would be capable

of organizing this invitation to tender.

(2)On the other hand, the debt of the United States to the WHO is a

hundred million dollars this year.

(3) " Africans do not know the meaning of time in the Western sense. One

must take these drugs at certain hours of the day, or they do not have

any effect. Many people in Africa have never seen a clock or a watch

in their life. If you give them a certain hour in the afternoon, they

do not understand what you are talking about. They understand morning,

nooN and evening and also the darkness of night. " Natsios,

director of USAID (United States Agency for International

Development), June 2001.

(4)Poul Nielson, European commissioner for development, thus stated,

on May 16, 2001, that one of the conditions for the contribution of

the European Union to the Fund was that prevention of AIDS remains the

priority.

(5)During the conference of the United Nations on June 4 in Geneva,

the WHO insisted on the fact that the funds should be used primarily

for the prevention of AIDS and treatment of malaria and tuberculosis.

(6)The Kenyan Coalition for access to essential drugs includes: Action

Aid, The association of People with AIDS in Kenya (TAPWAK);

International Health Action (HAI Africa); Network for People living

with HIV/AIDS (NEPHAK); Women Fighting AIDS in Kenya (WOFAK); Society

for Woman and AIDS in Kenya (SWAK); Nyumbani; International Federation

of Women Lawyers Kenya (FIDA); CARE International; Doctors Without

Borders (MSF); DACASA; Pharmacists Without Borders (PSF); Medical

Kenya Association (KMA); Consumer Information Network; Campaigners for

AIDS Free Society.

(7)The United States brought an action against Brazil before the WTO

on February 1, 2001, under the pretext that Brazilian legislation on

drugs violates international agreements. This law provides for the

granting of licenses for local production of drugs when the companies

owning the patents do not themselves produce these drugs or that the

prices charged are abusive. This type of legislation, which is not

contrary to international agreements on intellectual property, exists

in the United States, Japan, as well as in most European countries.

In Brazil, 7 antiretroviral molecules out of the existing 13 are

currently produced by State laboratories. The free distribution of the

drugs by the government has allowed a 50% reduction in deaths from

AIDS.

Sylvain Coudret

Planet Africa

Commission Nord/Sud

Act Up-Paris

BP287

75525 Paris cedex 11

Tel: 01 49 29 44 75

Mobile: 06 88 77 42 46

Fax : 01 48 06 16 74

email: planetafrica@...

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Cross posting from intaids@...

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