BY NORM DIXON
"I want someone to explain to me why it isn't called murder", said Stephen Lewis, former deputy director of the United Nations Children's Fund, in an article in the January 26 Toronto Globe and Mail. Lewis was commenting on the fact that as of last year 25.3 million Africans were infected with the AIDS-producing virus and yet the Western drug companies that produce anti-AIDS drugs are spending large amounts of money on legal fees to stop these people from accessing these drugs.
Lewis went on to note that last year there were 3.8 million new HIV infections and 2.4 million people died of AIDS in sub-Saharan Africa. "More than 16 million Africans have died of AIDS since the pandemic began in the late 1970s", Lewis wrote. Yet "[n]either the pharmaceutical companies who have the drugs, nor the governments who have the money, nor the governments who could amend their laws to make cheap generic drugs available, are prepared to prolong or to rescue African lives.
"The drugs exist and the money is available to prolong and improve the lives of millions... Then why isn't it being done? And because it's not being done, why doesn't it amount to murder? Mass murder?"
The answer to Lewis' question is brutally simple: in a world dominated by corporate capitalism, the profits of a handful of monopolistic corporations take precedence over all else — even if results in the deaths of millions of people too poor to afford live-saving medicines.
On March 5, the callousness of the world's capitalist drug monopolies made headlines as their long-running legal campaign against a South African law designed to allow the import of cheaper AIDS medicines reached the Pretoria High Court.
In 1997, the South African parliament passed the Medicines and Related Substances Act, which contained provisions — in section 15c — to make AIDS medicines and other vital drugs more available and affordable.
The law gave the government the legal authority to buy medicines — manufactured under licence from the big corporations — from countries where they cost less than those produced by the patent holder's local distributors (known as parallel imports). The act also gave the health minister the authority — in cases of national medical emergencies — to override sections of South Africa's patent law and allow local production of versions (or "generic") of expensive brand-name drugs (known as compulsory licensing), as long as a "reasonable" royalty is paid to the patent-holder.
Such measures can drastically lower the cost of essential drugs for Third World countries. Drug companies charge different prices from country to country, so parallel importing of brand-name drugs can result in big savings. Generic versions of anti-AIDS drugs sell for up to 90% less than the big corporations' brand-name versions.
In 1998, the Pharmaceutical Manufacturers Association (PMA) — a group of South African subsidiaries of some of the world's largest, mainly US and European, drug corporations — challenged the constitutionality of section 15c in the Pretoria High Court. Since then, the South African government has not attempted to put the law into effect.
Holocaust
While declining HIV infection rates and death rates from AIDS in the West — largely due to the introduction of new combination drugs — have encouraged the myth that the disease has been controlled, if not defeated, HIV/AIDS now rivals the worst epidemics in human history.
Africa is in the midst of a holocaust. Of the estimated 38 million people in the world infected with HIV, 25 million live in sub-Saharan Africa. They face certain death. Around 80% of all AIDS deaths have occurred in sub-Saharan Africa. By the end of the decade, the number of people in the world infected with HIV may reach more than 50 million.
The AIDS epidemic already ranks above the bubonic plague epidemic in the Middle Ages that killed 20 million people and the influenza pandemic of 1918-19 that also killed about 20 million people.
South Africa is being hit hard. Around 4.2 million South Africans are HIV positive — about 20% of the adult population — and the country has one of the fastest growing rates of infection in the world.
This compares to the 1998 world adult HIV-infection rate of 1%, and 0.76% in the US. The gap flows from inadequate measures to stop the transmission of HIV, falling health budgets (due to Western-imposed structural adjustment programs) and the unaffordability of the combinations of "anti-retroviral drugs" that stall the development of deadly AIDS-related diseases.
A minuscule 0.001% of sub-Saharan Africa's people with HIV presently receive treatment with drugs that are freely available in the West. Fewer than 1% of South Africans are being treated with the life-prolonging drugs and, because they must pay for the drugs themselves, only the well-off white minority can afford treatment.
If all pregnant South African women with HIV were given AZT during pregnancy and the first few weeks of breastfeeding, up to two-thirds fewer babies would have HIV passed to them, and 80,000 babies' lives each year could be saved.
Super profits
The drug corporations' campaign against the South Africa's legislation is motivated by the fear that their super profits will be undermined if Third World governments turn to the production or importation of generic drugs — or the parallel importation of patented drugs — to combat their countries' massive health problems.
What worries the pharmaceutical corporation bosses most is that AIDS sufferers and public health authorities in the West — where the vast bulk of the drug companies' profits are made — may cotton on to the fact that life-saving drugs are massively overpriced and that there are cheaper alternatives. To prevent that knowledge spreading, the drug corporations are prepared to let millions die in the Third World.
Last October, Zackie Achmat, a leading activist with South Africa's Treatment Action Campaign (TAC), dramatically illustrated how simply and cheaply affordable drugs can be obtained. He travelled to Thailand and purchased 5000 tablets of the anti-fungal drug Biozole, a generic version of Fluconazole, a drug whose patent is owned by the giant Pfizer corporation. In South Africa, the Pfizer pills cost approximately A$27 each; in Thailand, the generic version sells for 45 cents each!
The Indian drug company Cipla recently agreed to supply the humanitarian organisation Medecins Sans Frontieres with generic versions of anti-AIDS medicines for use in Africa at US$350 per patient per year. The patented drugs made by GlaxoSmithKline cost up to US$15,000 per patient per year.
The benefits that can be gained from defying the drug czars can be seen in Brazil. In the early 1990s, Brazil began a program of local production of cheap generic anti-AIDS medicines. The savings allowed the drugs to be supplied free to all who needed them. The result has been a 50% drop in the number AIDS-related deaths and an 80% drop in the number of AIDS-related patients in hospital. The use of generic medicines saved Brazil US$422 million in hospitalisation and medical care costs from 1997 to 1999.
The huge profits of the drug monopolies are only possible because a patent on a new drug gives a corporation a 20-year monopoly on its production and marketing. Drug companies claim that the super profits that come with these monopolies are necessary to recoup the money they spend on research and development as an incentive to develop new drugs. This is untrue.
Western governments generously subsidise drug industry research and allow companies to market discoveries made in government and university laboratories. The lion's share of new drug development costs are in preclinical research, and much of that is performed by universities and government-funded facilities, not the drug companies.
In 1998, around 6.1 million people, mostly in Third World countries, died of preventable or curable diseases such as tuberculosis, malaria and lower respiratory infections. Yet, only 1% of all new medicines developed and marketed by the multinational drug companies between 1975 and 1997 were designed to treat these diseases.
Only a tiny proportion of the industry's annual US$24 billion research budget is devoted to combating diseases in the Third World that afflict more than half a billion people. In 1993, a paltry US$84 million was spent globally on malaria research.
Vastly more is spent on developing hugely profitable "lifestyle drugs" for First World markets — remedies for athlete's foot, obesity, baldness, wrinkles and impotence — and on drugs for pets.
In 1999, the top 12 US drug manufacturers spent about 12% of their revenue on research and development, whereas 34% was spent on advertising and administration. The CEOs of the top 10 firms averaged annual salaries that topped $10 million.
The capitalist drug cartels — backed by Washington — are fighting back. Their attack on South Africa's legislation is just the most prominent. Last year, a deal to sell Cipla's cheap medicines to Ghana was foiled when the British firm Glaxo Wellcome (since merged with another drugs giant, SmithKline Beecham, to become GlaxoSmithKline) threatened to sue Cipla for violating its patent rights.
New trade rules being imposed by the World Trade Organisation, in its Trade Related Property Rights (TRIPS) agreement, will force Third World countries to recognise the drug corporations' patent rights in 2006.
While WTO rules allow governments to override patents in cases of national emergency, the US government is insisting on an extremely narrow interpretation of when such measures can be invoked. At the urging of the US drug industry, Washington has filed a complaint at the WTO against Brazil's law that requires the drug giants to either manufacture drugs in Brazil within three years of being granted a patent or lose it to local companies prepared to go into production.
The US has threatened sanctions against more than 17 Third World countries unless they give up plans to manufacture, export or purchase generic copies of drugs patented by US corporations.
On March 5, thousands of South Africans marched to the Pretoria High Court and the US embassy to protest against the drug conglomerates. It was jointly organised by the TAC and the Congress of South African Trade Unions. Marches and protests were also held throughout South Africa and around the world.
On March 6, Judge Bernard Ngoepe adjourned the PMA's lawsuit against the South African government until April 18.
[Visit the Treatment Action Campaign's web site at <http://www.tac.org.za>.]