Tackling AIDS: the gravest threat to Africa

Date:24/07/03

The next stage in the war against AIDS and other major killers will take place at the World Trade Organization ministerial conference in Mexico. David Cronin examines the chances and risks of a compromise

DATA about the AIDS pandemic often comes with a new analogy, putting the destruction it wreaks into a horrifying perspective.

In a recent piece for the International Herald Tribune, Abbas Gullett, the Red Cross director of disaster management, wrote: "Last year alone, 2.4 million Africans, most of them in the prime of their lives, died from HIV/AIDS. This toll is equivalent to more than 15 fully loaded passenger jets crashing every day of the year."

Romano Prodi used similarly apocalyptic terms in his 16 July address to the International AIDS Society conference in Paris.

The European Commission chief described the disease as the gravest threat to Africa's survival.

Yet is the EU doing enough to tackle this modern-day Holocaust? Nelson Mandela believes it is not. On the other hand, the former South African president has praised American President George W. Bush for signing his €13.3 billion anti-AIDS plan into law last May. "Given the size of its collective population and economy, Europe should at least be matching, if not exceeding, the United States' contribution", Mandela said in Paris last week.

Prodi has signalled his personal disappointment that calls by UK premier Tony Blair and French President Jacques Chirac for the EU to grant at least &036;1 billion (€884 million) per year to the Global Fund to fight AIDS, tuberculosis and malaria have not won support from all the Union's 15 governments. Yet in Paris he replied to Mandela by urging the South African not to harbour doubts about the European Union, as it is the world's largest donor of development aid.

The next battle in the war against AIDS and other major killers could take place at the World Trade Organization (WTO) ministerial conference in Cancún, Mexico (10-14 September).

Diplomatic efforts are ongoing to finalize a deal on the thorny access-to-medicines dossier by or during Cancún. The deadline agreed at the organization's 2001 gathering in Doha for settling the matter by the end of last year was missed.

The latest AIDS treatment unveiled this month by Swiss pharmaceutical giant Roche once again illustrates how prices of branded drugs are beyond the reach of people on subsistence incomes.

Known as Fuzeon or T-20, it would set an AIDS patient back some €8,500 per annum.

The nub of the issue in Cancún preparations is a clause in the WTO's trade-related intellectual property rights (TRIPS) accord which restricts the use of compulsory licences for drugs, predominantly for the supply of the domestic market in which they are produced. By late 2005, the full rigours of TRIPS are due to apply to India, Thailand and Brazil. At present these middle-income economies are all exporters of cheap generic drugs to poorer countries, particularly in Africa. But, after 2005, the amount they export under compulsory licence to address public health emergencies would be vastly reduced.

According to Pascal Lamy, all bar one of the 146 countries due to be represented at Cancún are ready to sign a deal which would allow the poorest countries without a manufacturing capacity of their own to continue importing generic medicines.

"All we need is the US on board to close out the deal," the European trade commissioner commented in a Wall Street Journal article (17 July).

Commission insiders say they feel the ball is now in Washington's court and, even though the Bush administration committed itself before the Group of Eight (G8) leading industrialised countries last month to joining a consensus, it remains uncertain whether a deal is on the short-term horizon.

A crucial hurdle that needs to be overcome, officials add, is the way pharmaceutical firms who have a major bearing on the US stance have become divided into two camps. The more moderate camp would be willing to accept a deal provided they receive a comfort letter, stating it will not lead to the unravelling of the TRIPS agreement. The hardliners, though, are seeking more water-tight guarantees on their patent rights to be inserted as amendments to TRIPS.

Pfizer spokeswoman Colette Goldrick confirmed her company is the most vociferous voice in the latter camp: "This idea of a Machiavellian company twisting arms in Washington...well, if only the world was that simple. But we do feel strongly on the intellectual property rights issue. Intellectual property rights are the lifeblood of our industry."

Lamy's remarks could be interpreted as a claim that the EU is on the side of the needy and the US on the side of the greedy. A US diplomat said, though, the two share common goals of providing low-cost drugs to poor countries, while simultaneously maintaining a viable patent system.

Anti-poverty advocates also believe the situation is more nuanced than Lamy appears to suggest. Many have contended that it would be preferable for Cancún to finish without any pact than one that is not in the best interests of the developing world.

Mohga Smith, a health policy officer with charity Oxfam, voiced worries that a bad deal will be accepted by the ministers.

These may decide that a deal has to be thrashed out, lest disagreements over access to medicines derail talks on other contentious dossiers in the Doha trade round, especially agriculture.

Simon Wright, HIV campaign manager with ActionAid, says the European Commission historically does not have a good record. For example, Lamy's predecessor Leon Brittan came under fire for opposing a 1997 South African law, overruling patents on branded medicines sold in the country.

"A balanced compromise might be a compromise too far for developing countries," adds Wright, who believes those states should be able to override patents on treatments for a broad range of illnesses.

"The EU has looked for a compromise but we don't think it is in the interests of developing countries to accept a compromise that restricts them."

The AIDS epidemic in Africa is set to feature on the agenda of the Fifth World Trade Organisation Ministerial Conference in Cancun, Mexico on 10-14 September 2003.