Treatment/TAC/Antiretrovirals:
Business Day, 02 October 2002, HIV/Aids Activists' New Complaint Not Helpful, Richard Tren

AIDS activists in SA recently lodged a complaint of excessive drug pricing against GlaxoSmithKline and Boehringer-Ingelheim with the SA Competition Commission. This is a dangerous move that does not tackle the real problem and will potentially do long term harm.

Zimbabwe provides an excellent case study of how not to increase essential drug access. For some years, Boehringer-Ingelheim has been trying to provide free antiretrovirals to the Zimbabwean government, yet uptake has been negligible. The government has been offered branded GlaxoSmithKline drugs at huge discounts but they are just not being delivered.

Three months ago the Zimbabwean government declared a six month state of emergency so that it could import generic versions of patented AIDS drugs that had already been offered for free. Halfway into the emergency period, not one generic drug has been imported and not one more person has received medicines.

Also it is likely imported generics would be more costly than the brandname drugs in Zimbabwe and would not come with the vital logistical support and advice GlaxoSmithKline or Boehringer-Ingelheim would provide.

At the time of the emergency declaration, Zimbabwean AIDS activist Jefter Mxotshwa correctly pointed out the barriers to AIDS treatment were a lack of health infrastructure and the fact that professional medical personnel were leaving the country.

Reports emerged recently that Zimbabweans in need of drug treatment have been travelling to neighbouring Botswana. With a higher HIV/AIDS infection rate, it chose not to issue compulsory licences or importing generic copies of AIDS drugs. Instead, the government entered into a co-operative partnership with drugs firm Merck and the Gates Foundation, with each giving $50m and the former free drugs too. This approach has ensured many more people are treated.

The complaints to the Competition Commission come at a time when the SA Medical Association, supported by Nelson Mandela, announced plans for an $8m private antiretroviral treatment programme.

Should the commission rule against the drug firms, they risk a fine of 10% of annual turnover. This would be paid to the treasury. Given government's track record, it's unlikely the money would pay for health infrastructure or antiretroviral drugs.

The AIDS activists want to see more people getting AIDS treatment. Yet punishing firms not at fault and giving more money to a government that stubbornly refuses to treat AIDS patients is a perverse way for activists to achieve their noble aims.

GlaxoSmithKline, Boehringer-Ingelheim and other research drug firms spend hundreds of millions of dollars in drug development. Then, because of bad publicity or sound humanitarian motivation, they offer to give them away for free or at vast discounts.

The companies remain accused of blocking access and now risk a massive fine. With justification, their shareholders will no doubt urge a withdrawal from SA.

The commission ought to reject AIDS activists' complaints. In basing their campaigns on an outdated socialist agenda to bash profit and big business, the activists do no justice to those needing drugs now or in future.

Tren is a Director of the SA health NGO, Africa Fighting Malaria, and coauthor of Ideal Matter: Globalisation and the Intellectual Property Debate