Helping AIDS in Africa
What is happening regarding AIDS and access to medicines in Africa? Are the pharmaceutical companies really putting money and profit before people's lives? Who is responsible for trying to turn the tide in what is becoming one of the greatest human tragedies of our time - the AIDS epidemic in sub-Saharan Africa?
Student interest in these issues was plain to see at the well-attended forum organised by the Link Africa Student Society on 2 May, entitled "AIDS and medical patents in Africa". The panel consisted of a number of experts with different specialities and interests in this contentious issue. The forum was chaired by Dr. Vincent Magombe, director of the media institute Africa Inform International.
First to speak was Dr. Andrew McMichael, Director of the Weatherall Institute of Molecular Medicine and of the MRC Human Immunology Unit. Dr. McMichael is leading a group of Kenyan and British researches in trying to develop a vaccine for HIV/AIDS. Some progress has been made and the vaccine is now undergoing phase one clinical trials in Oxford and Nairobi. According to Dr. McMichael, one of the main advantages of a vaccine as compared to the anti-retroviral drugs available today is that it could be made available even to destitute people. Furthermore, the anti-retrorvirals, however useful, still do not provide a cure for AIDS.
Ms. Vicky Ehrich, representing the viewpoint of the pharmaceutical industry, more specifically GlaxoSmithKline, also stressed that anti-retrovirals do not provide a solution to Africa's AIDS problems, which need to be seen within the wider context of the problematic healthcare sector in Africa. In her view, the recent criticism against the pharmaceutical companies, especially as relates to the South African court case, has not been justified. Instead, she argued that many African governments are not prepared to face the enormity of the task of fighting HIV/AIDS (in some countries such as Botswana and Swaziland over 30% of the population are infected) and have turned down offers of drugs on the grounds of expense, despite companies offering to provide the drugs at cost or even below.
Mr. Mick Matthews of AIDS Consortium did not support this view, claiming that medicines would be more readily available if the 'cartel of pharmaceutical giants' cared less about making huge profits. However, Mr. Matthews also stressed that provision of anti-retroviral drugs without simultaneous improvements in health infrastructure would not solve the problems. Speaking from his own experience, he highlighted that anti-retrovirals require very strict regimes to function properly and in developing countries it would be almost impossible to get this to work. AIDS also needs to be looked at from a broader development perspective and massive efforts are needed to get to grips with the basic issues of poverty that underlie the current epidemic.
Dr. Mogha Kamal-Smith from Oxfam took a tougher stance against the pharmaceutical industry, showing concrete figures on how much cheaper generic versions of certain drugs are as compared to the original ones. The figures spoke for themselves and it was clear that a large proportion of the audience disagreed with the views that Ms. Ehrich had put forward earlier. However, Dr. Kamal-Smith also stressed that Oxfam is not against pharmaceutical companies as such, since they are crucial in the development of new drugs, but believes that the industry needs to take its responsibility in providing drugs for third-world countries, especially in Africa.
During the debate, there were times when the NGO side of the table pushed their stance against the pharmaceuticals quite forcefully. It is clear that most research is being done on diseases that are immediately related to the rich, industrialised countries. For example, more money is being put into developing drugs against obesity than AIDS or malaria medicines!
Interestingly, Dr. McMichael's research provides a case in point - it is funded by the International AIDS Vaccine Initiative and the MRC, with little or no help from large companies. Perhaps this might be because it focuses on the African A-strain of the HIV virus, and in Africa there's obviously not that much money to be gained.
No general conclusion was reached but it was more or less universally agreed that in order to come to grips with the dreaded disease, particularly in Africa, massive joint efforts are needed.
Whereas provision of cheap medicines might be part of the solution, it will not provide the final answer. Pharmaceutical companies should take a larger degree of responsibility, but governments also need to act much more decisively, whilst funds and expertise from NGO's, international organisations (e.g. WHO, World Bank, IMF) and the industry are probably needed to really make a difference. Furthermore, for the time being it is clear that education and prevention remain the only really efficient ways of reducing the spread of HIV/AIDS, something the African governments should, arguably, become more focused on.
24th May 2001