HIV Drugs Still Costly for Africans

HIV Drugs Still Costly for Africans

NY Times March 15, 2001




Filed at 5:37 p.m. ET


ABIDJAN, Ivory Coast (AP) -- The sudden wave of cost cuts in HIV drugs for Africa was welcomed Thursday in struggling clinics like Marc Aguirre's, where poor patients receive care on four beds in a converted garage.


But only as a start.


Even at drug companies' newly promised prices -- at- or below-cost for some key drugs -- effective treatment against AIDS will remain far out of reach for Africans hardest hit by it, Aguirre and other AIDS activists and workers across Africa said.


``Working in the trenches day to day, and seeing people suffer and die just because they don't have access to drugs, it's hard,'' said Aguirre, who regularly sees HIV-infected people turned away because they cannot afford what in Abidjan is the already vastly subsidized treatment price of about $13 a month.


``This is good news -- but I think really there needs to be a collective response,'' said Aguirre, an American, stressing that AIDS drugs have to be used in a cocktail. Some drugs are now cheaper, some remain unaffordable.


``Hopefully, this will stimulate momentum for other pharmaceuticals to kind of get initiatives like this going, so we have as many options for patients as possible.''


The recent cost-cut announcements follow years of pressure by AIDS activists.


Bristol-Myers Squibb Co. said Wednesday it would sell two AIDS medications below cost to countries in Africa. The announcement came on the heels of similar deals by leading pharmaceutical companies, including Merck and Co.'s statement last week that it would sell two key AIDS drugs -- Crixivan and Stocrin -- to poor countries for about a tenth the U.S. price.


``This victory has come about as a result of the global effort by HIV/AIDS activists,'' said Treatment Action Campaign, a South African AIDS activist group.


``The pressure has become too much for (Bristol-Myers) and they are relenting,'' the group said.


Already, agreements between leading pharmaceutical companies and governments in Africa have brought down costs. In Rwanda, the cost of lifesaving HIV treatment has fallen in three months from about $530 a month to $182, said Dr. Desire Ndushabandi of the Health Ministry.


Cheaper -- but still impossible for many in a country with a per capita yearly income of less than $800, far from the lowest in Africa.


Further, AIDS workers said, the limited number of drugs being offered at reduced costs would leave Africa's health workers with a reduced packet of ammunition against AIDS.


That risks development of more drug-resistant versions of the virus -- ultimately, perhaps worsening Africa's AIDS problem. The more drugs the better against the AIDS virus.


But AIDS activists pointed to another announcement by Bristol-Myers as the true breakthrough: the company's statement that it would waive its patent rights for one of its AIDS drugs in South Africa.


The move opens the market to generic -- and cheaper -- versions from other companies.


Tony Kasper, coordinator for Doctors Without Borders of a campaign for access to essential drugs, called that a ``welcome step to allowing greater generic competition.''


The patent-waiving ``will improve access to medicine in sub-Saharan Africa,'' Kasper said.


``That's great news. That's ultimately the way to go,'' said Aguirre, who works in a country where one out of every 16 people are estimated to be HIV positive.


``The problem has been the standoff -- and the standoff, because of the positions that haven been taken, hasn't allowed looking at other options,'' Aguirre said.



Copyright 2001 The New York Times Company