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Political solutions

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  • Weber
    In the words of that great quote John sent... There are no technical solutions to what are essentially political problems (hey, but shouldn t this be a
    Message 1 of 1 , Apr 6, 2004
      In the words of that great quote John sent...
      "There are no technical solutions to what are essentially political problems"
      (hey, but shouldn't this be a technical problem.)  Timely response by the Clinton Foundation, don't you think?
      Loved the recent dialogue!

      AIDS Programs Called Threatened By Poor Funding, Disagreements Monday, March 29, 2004   (bold lines in this article are my editorializings...Cathy)

      Inadequate funding and disagreements over patents are slowing delivery of antiretroviral drugs to HIV/AIDS sufferers in poor countries, the

      New York Times
      reported yesterday.

      The World Health Organization estimates that about 300,000 people in the world's poorest nations, of the 6 million who need them, have received the drugs.

      Donations to the
      Global Fund to Fight AIDS, Tuberculosis and Malaria are now at about $1.6 billion a year, 20 percent of its estimated needs, and U.N. envoy for AIDS in Africa, Stephen Lewis, has said the U.N. plan to provide 3 million people with antiretroviral drugs by next year may collapse because of lack of funding.

      Despite a pledge last year to spend $15 billion on AIDS in Africa and the Caribbean over five years, U.S. President George W. Bush recently requested only $200 million for the fund in his most recent budget request, although the U.S. Congress authorized $550 million. European and Asian donations have also fallen short of needs, the Times reports (Donald McNeil, New York Times, March 28).

      Associated Press reports that other recent developments, such as a World Trade Organization agreement to let poor nations import generic AIDS drugs they are unable to manufacture, have generated some optimism among AIDS activists. Lewis told AP that the new trade agreement and WHO programs had produced "the largest quotient of hope we've had in a long, long time" (Barbara Borst, AP, March 27).

      Despite trade agreements, however, AIDS activists and others allege that the delivery of lower-priced generic antiretrovirals has been held up by the U.S. refusal to sanction the use of drugs that could violate U.S. patent law, although the drugs have been approved by WHO (McNeil, New York Times).

      Under the WHO system, drug companies — those making patented drugs and those making generics — can submit their products to WHO for testing by three-member teams of regulatory experts. If the drugs meet purity, safety and efficacy standards they appear on a "prequalified" list, the
      Washington Post reports (David Brown, Washington Post, March 27).

      The drugs are available at significantly lower prices. Daniel Berman of
      Medecins sans Frontieres said that the aid group planned to treat 1,000 Zimbabwean patients with a combination of three antiretrovirals from approved Indian generic drug-makers at an estimated cost of up to $292 per patient per year, while the U.S. Centers for Disease Control could make available the same treatment from pharmaceutical companies for about $562 a year. The aid group's treatment program would require a day's dose of two pills, while the U.S. program would mean a daily dose of six pills (McNeil, New York Times).

      The Bush administration argues, however, that it has no way to verify the confidential WHO data and that it does not want to approve drugs that could contribute to the virus's resistance through inappropriate drug distribution.

      "We could lose a whole continent," said Mark Dybul, the deputy chief medical officer of the U.S. global AIDS coordinator's office in the State Department (Borst, AP). "'Good drugs' isn't good enough. Because of the risk of resistance we need the highest possible quality drugs to avert a disaster on the continent," he said.

      Critics of the policy warn that it could delay starting AIDS treatment for some developing world patients or might require them to begin treatment with more expensive patented drugs and then have to switch to generics later. That could complicate treatment programs and the operations of newly opened clinics in poor nations, the Post reports (Brown, Washington Post).

      Generic drug advocates have accused the Bush administration of folding to pharmaceutical company pressures. Two prominent U.S. senators, Democrat Edward Kennedy and Republican John McCain, wrote the White House Friday to urge it to accept WHO-approved generic drugs, while Democratic Congressman Henry Waxman accused the administration in a separate letter of holding Indian generics to higher standards than those for U.S. drugs.

      Lembit Rago, who leads the WHO assessments, said he used exactly the same criteria as the U.S. Food and Drug Administration, which approves drugs, and that his inspectors came from regulatory agencies in Canada, France, Germany, Sweden and Switzerland.

      According to Dybul, however, "We will buy whatever drug is safe and effective at the lowest possible price" (McNeil, New York Times).

      U.S. officials will meet today with WHO, the Joint U.N. Program on HIV/AIDS and the Southern Africa Development Council in Botswana for a two-day meeting to work out principles for drug approval (Borst, AP).

      Many experts do not believe that another drug verification system is necessary, however, given the WHO program already in existence.

      According to Rago, the distinction between the WHO prequalification system and licensing is, in practical terms, irrelevant.

      "It doesn't matter which color is the cat. It just has to catch the mice," he said (Brown, Washington Post).


      Inexpensive AIDS Drug Deal Extended To All Poor Nations

      Tuesday, April 6, 2004

      The foundation of former U.S. President Bill Clinton said today it has extended a deal providing low-cost AIDS drugs to all poor nations supported by UNICEF, the World Bank and the Global Fund to Fight AIDS, Tuberculosis and Malaria.

      "We are hopeful that developing countries and those who support them in the fight against AIDS will take full advantage of this agreement and act quickly to do all they can to help in this fight," Clinton said in a statement.

      The New York-based foundation had negotiated the prices for 16 countries in Africa and the Caribbean last year, bringing basic HIV treatment to as little as $140 per person per year (Naomi Koppel, Associated Press/Newsday, April 6).

      Up to 122 countries will now benefit from the low prices — one-third to one-half of the lowest price available elsewhere — as part of an agreement with five generic drug manufacturers in India and South Africa (BBC Online, April 6).   Five firms that manufacture HIV/AIDS diagnostic tests have also struck deals with the Clinton Foundation that will reduce prices by up to 80 percent. 

      In developing countries other than Brazil, less than 200,000 people receive antiretroviral drugs of the nearly 6 million who need them.  The World Health Organization has set a goal of providing 3 million people with the drugs by 2005 (Koppel, AP/Newsday).

      "Access to HIV treatment for all who need it is a moral imperative and now the target of growing financial commitments," said Richard Feachem, executive director of the Global Fund.  "Today's agreements build on sound science, agreed policy and market economics to maximize the reach of those commitments.  As a result, hundreds of thousands of additional people will receive the drugs they need to stay alive and remain healthy" (UNICEF release, April 6).



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