Death? Let's Make a Profit!

On March 5, pharmaceutical companies took the South African government to court to prevent them from buying cheap AIDS drugs.

The Pharmaceutical Manufacturers Association (PMA), a trade group that represents 39 drug companies around the world, is suing South Africa because of a law passed in 1997 that would allow the Health Ministry a limited right to import patented medicines at a cheaper price than drug companies are willing sell them for in South Africa. The law is meant to be used in case of a health emergency. AIDS is the main health crisis in sub-Saharan Africa, with an estimated 25 million people infected with the virus, including 10% of South Africa's population. AIDS drugs are being sold in sub-Saharan Africa at reduced prices, but the cost is still too high for most of those infected, and the government can't buy the medicine for its population without going bankrupt.

The PMA is arguing that the law will violate drug companies' patent rights and intellectual property rights, as set out under international law, by allowing the South African government to purchase generic, unlicensed drugs. Yet, when the PMA took its case to the World Trade Organization, it was rebuffed. The WTO, the UN, and the European Union all support the South African law. The US government originally supported the PMA, but after ACT-UP followed Al Gore on the campaign trail and shamed him, the US government backed down and gave its qualified support for the law.

The PMA is finding an unsympathetic ear in the Pretoria High Court. The judge in the case, Bernard Ngoepe, questioned whether his court even has jurisdiction over the case, since the law has never been signed by President Thabo Mbeki and has never been used by the South African government. Thabo Mbeki and his health minister have both expressed backward notions that AIDS drugs are poisons and that AIDS is not caused by the HIV virus.

However, AIDS activists have made progress with Mbeki, who now sees the need to sign the law and import cheap medicines to treat a growing epidemic.

Judge Ngoepe has also allowed the country's leading AIDS activist group, the Treatment Action Campaign (TAC), to testify as a friend of the court and present evidence on drug company pricing and the toll that AIDS is taking in Africa. On March 6, Ngoepe postponed the hearing until April 18 to give TAC time to compile and make its presentation and the PMA time to respond. Said a spokesman for the charity Oxfam: "This is the first time that the industry will have to justify their pricing policies and justify their patent process."

Oxfam is one member group of a coalition that includes Doctors without Borders and ACT-UP who are working to bring cheaper medicine to people dying of AIDS in Africa. In the US, AIDS drugs, which must be taken in a "cocktail" of three or four drugs at a time, cost about $10,000 per month. Currently an AIDS cocktail sells for about $950 per month in South Africa, but the same drugs sell for $500 in Uganda. Few Africans can afford the drugs even at those prices, because the average income in sub-Saharan Africa is only $1 per day. This leaves the burden of treatment on African governments, which labor under heavy debt loads and IMF-prescribed austerity measures that have cut money to medical infrastructure, instead of expanding it to meet the AIDS crisis.

Few Americans understand the agonies of Africans living with HIV. Picture, if you will, what it's like to live on $1 per day, while your government is practically bankrupt. Your village has no roads, no cars, no electricity, no running water, and no hospital. A small clinic is staffed by volunteers--it's a tent that's being slowly eaten to shreds by ants. There are no antibiotics available to treat your TB, so you vomit blood everyday. (AIDS patients in Africa are exposed to more severe opportunistic illnesses than those who live in the West, including: river blindness, cryptococcol meningitis, drug-resistant TB, and malaria.) Your main worry is having enough money to buy food, since you can't work as much as you did in the past. You don't eat everyday, so you're getting thinner and thinner--not from your illness, but from starvation. You want your children to go to school, but school is not free, because the IMF forced the government to stop paying its teachers, so now you have to pay the school fees. But the local school has no desks and no school supplies, so your children have to sit on the floor and draw in the dirt. Because you spend most of your time coughing and shivering with a malarial fever and can't carry water from the local well or farm your small plot of land to provide food for your family, it's better if your children stay home and work than go to school. Soon they'll be orphans anyway and need to know how to do these things.

If you're a city dweller, things are not much better. Even professionals don't make enough money to afford AIDS medicines. Many can only afford one or two of the drugs that they should take, not all three or four, so they end up spending most of their income on something that will not keep them alive.

Even more alarming is the admission by drug companies that they can cut the price of their AIDS medicines by almost 90% and still make a profit. This is criminal, when there are poor people all over the world (in the US and Europe, too) who are going without these expensive medicines. We often shrug our shoulders at the rising costs of health insurance and healthcare costs; seldom do we stop to think about the waste (i.e., "profit") in the system.