World AIDS Day Dec 1
"HIV/AIDS is a global problem of catastrophic proportions. The challenge is enormous, but we are not powerless to face it." — United Nations Secretary-General Kofi Annan. At the start of this new millennium there were 34.3 million people around the world living with HIV/AIDS: 33 million adults, 15.7 million women and 1.3 million children under the age of 15. In the year 2000 alone there were three million deaths due to HIV/AIDS, including 500,000 children under the age of 15. An estimated 22 million people have died since the beginning of the epidemic. Women are becoming increasingly affected by HIV — now accounting for 46 per cent of the adults living with HIV. More than 95 per cent of all HIV-infected people live in the developing world, which has likewise experienced 95 per cent of all deaths from AIDS. AIDS has left 13.2 million children orphaned. One year ago, at the XIII International AIDS conference in Durban, South Africa, a Global Manifesto was issued, expressing the anger and frustration felt by HIV sufferers, AIDS organisations, and governments of the Third World over the lack of action, indifference, and greedy manipulation of the AIDS crisis by industrialised nations and international pharmaceutical companies. It stated frankly: "AIDS has become a catastrophe that threatens the very future of this planet. Terribly high levels of HIV infection and death due to AIDS are now a reality (rather than merely a projection) in poor communities worldwide... causing widespread devastation in Africa and Asia especially. "THIS WAS AVOIDABLE. "It is the consequence of negligence, particularly on the part of 'first world' governments whose resources could have been mobilized to come to the practical assistance of poor nations many years ago. "Political authorities have preferred to neglect public health, taking for granted the exorbitant cost of treatment, refusing to implement measures necessary for the strengthening of health systems, and prohibiting countries from setting up local medication production or from importing treatments essential for the survival of their populations. "The wager of financial institutions, led by the World Bank and the European Union and corporate interests, assumed that they would manage to control the situation with the lowest effort, but it is a failure for which they bear responsibility." Despite the bleak worldwide outlook, 2001 transpired to be a year of significant victories for people around the world living with HIV/AIDS. In the year since the Durban conference: * the United Nations issued a Declaration of Commitment on HIV/AIDS — supported unanimously by 189 countries; * The WTO meeting in Doha recognised the fundamental right of governments to protect public health, specifically in the fight against AIDS. South African Government victory In April this year the Pharmaceutical Manufacturers Association (PMA) and all the pharmaceutical companies unconditionally withdrew their lawsuit against the South African Government and AIDS activists. They conceded to the legal arguments prepared by the South African Government and bowed to public criticism and worldwide outrage. The victory against the PMA also represented an important victory of activists, poor people and people with HIV/AIDS over corporate abuse of power. The pharmaceutical companies were using the courts in an attempt to force the South African Government to repeal its Medicines Act 1997, on the basis that it contravened South Africa's commitment to the Agreement on Trade- related Aspects of Intellectual Property (TRIPS). The Act established a legal framework to allow the Government to take three important measures in securing affordable treatment for people living with HIV/AIDS. Firstly, it allowed generic substitution of off-patent medicines. This forces pharmacists to prescribe a cheaper generic version of a medicine, if one exists, when presented with a prescription from a patient. The measure is to protect the public from unscrupulous doctors and pharmacists, and the savings could be significant: a 20-pack of brand-name Bactrim sells for 95 Rand in South Africa, its generic substitute Purbac sells for R16. Parallel importation, referring to the purchasing of patented medicines from foreign countries, is also permitted. For example, Bayer's sells its patented antibiotic ciprofloxacin in South Africa at R2.93 for one 250mg capsule for. However, in India the retail price for the same Bayer drug is R0.65 per capsule. Parallel importation would allow the Government to purchase the drug at retail prices from India, rather than from Bayer directly. Another element of the Medicines Act is the introduction of a pricing committee that will set up transparent pricing mechanisms, including forcing pharmaceutical companies to justify the prices they charge. It will also reduce over-charging by pharmacists in the private sector. The South African Communist Party played an active role in the campaign, mobilising thousands in demonstrations against the pharmaceutical companies. Celebrating the Government's victory, the Party issued a statement saying, "The SACP regards the withdrawal of many of these companies as a reminder that the bosses and their system of capitalism is not invincible." General Secretary of the South African Communist Party (SACP), Blade Nzimande said, "Given our level of economic development and the massive public health crisis we face, it is unconscionable that South Africa should pay prices similar to the United States of America for its medicines". "For the SACP, the only way in which we, as a country, can tackle the massive public health crisis, and the deepening racial, class and gender inequalities in our society is through an economic transformation path led by our democratic government which puts the people at its centre."* * * To be concluded: Part 2: UN declaration on HIV/AIDS, WTO statement on public health and national emergencies, Dec 1 — the world remembers.