The Guardian November 28, 2001


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.

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