The American Drug Lords

[Robert Weissman <rob@essential.org>]

Thanks to new drug therapies, many people with HIV/AIDS in the United
States are now able to live relatively healthy lives. "Triple drug" 
therapies, or "drug cocktails" allow HIV-positive people to reduce their
HIV blood load in some cases to undetectable levels. 
	
In the Third World, however, where HIV/AIDS is at epidemic levels and
spreading rapidly, these therapies are unavailable to most HIV-positive
people.
	
The drug therapies are unavailable for a simple reason: they are
unaffordable. And they are unaffordable, to a significant extent, not
because the cost of manufacture is so high, but because patent- or
license-holding drug companies choose to set outlandishly high prices,
irrespective of the consequences in human suffering. 
	
Patent rights and other exclusive controls are not etched on holy stone
tablets, however. For countries that are members of the World Trade
Organization (WTO), minimum standards are imposed by treaty.  But even
though the WTO intellectual property agreement is heavily tilted toward
industry (indeed, it was drafted in considerable part by U.S. 
pharmaceutical and software companies), it still affords countries some
latitude to bring down drug prices. One of the most important WTO-legal
means is compulsory licensing. 
	
Compulsory licensing laws enable governments to instruct patent holders to
license the right to produce a patented good to competitor manufacturers
for a reasonable royalty -- this introduces competition and reduces
prices. Compulsory licensing is explicitly permitted in the WTO
intellectual property agreement. The United States government regularly
uses compulsory licensing in the area of antitrust enforcement and in many
other contexts. 
	
But the Clinton administration does not want other countries to follow the
U.S. example. 
	
Dancing to a tune called by the Pharmaceutical Researchers and
Manufacturers Association (PhRMA) and the rest of the industry, the United
States has threatened to impose sanctions, or has actually imposed trade
sanctions, on South Africa, Thailand, India, Argentina, Brazil and others
in response to their intellectual property policies for drugs. 
	
These threats or sanctions come despite country compliance with their
obligations under the WTO, as Lois Boland of the U.S. Patent and Trademark
Office acknowledged in a presentation at a conference on compulsory
licensing held in Geneva last month.
	
In Thailand, U.S. pressure recently led the Thai government to restrict
dramatically the scope of compulsory licensing. 
	
As a result, thousands and thousands of the approximately one million
Thais with HIV/AIDS are likely to suffer needlessly. According to
representatives of Medicins San Frontieres (MSF, Doctors Without Borders),
the price of triple drug therapy in Thailand is $15 to $23 a day. The
daily minimum wage is less than $5 a day. 
	
Compulsory licensing of HIV/AIDS drugs could make therapy much more
affordable. Consider the case of Fluconazole, a drug used to treat
cryptococcal meningitis, a fungal infection of the brain which affects
nearly one in five of Thailand's HIV-positive population. According to
MSF, in July 1998, when Pfizer held exclusive rights to sell Fluconazole
in Thailand, the treatment cost was $14 a day. With Pfizer's period of
exclusive control now over, two Thai drug companies are also making the
drug, and the price of treatment has dropped to $2 a day. 
	
Were Thailand able to maintain and use its compulsory licensing law, it
would be able to similarly drive down the price of the anti-retrovirals
used in the HIV/AIDS drug cocktails, as well as the price of drugs used to
treat opportunistic infections associated with AIDS or other diseases. 
	
Compulsory licensing is no elixir for the problem for high-priced drugs.
Even "reasonably" priced drugs will be out of reach for much of the
HIV-infected population of Africa, for example. Nonetheless, it is a
policy tool that could vastly enhance developing country access to
HIV/AIDS and other essential medicines. 
	
But it is a tool the United States government is intent on denying
developing countries. "Patents are not a cause of [drug] access problems," 
rationalized Boland in her remarkably callous and duplicitous comments. 
	
Now, however, there may be hope that the Clinton administration will be
reined in, and developing countries will gain freedom to pursue public
health policies even where they conflict with U.S. corporate interests. 
	
Representative Jesse Jackson, Jr.'s "HOPE for Africa" bill contains a
provision that would prevent the use of U.S. government money to pressure
African countries to adopt intellectual property rules more strict than
those required by the WTO. And legislation that would apply this ban to
all developing countries is expected to be introduced soon. 
	
Meanwhile, ACT UP and other members of the U.S. HIV/AIDS activist
community are quickly becoming engaged with the issue -- ensuring that,
finally, the Clinton administration will be hearing more than just the
drug industry's point of view on the matter. 

Russell Mokhiber is editor of the Washington, D.C.-based Corporate Crime
Reporter. Robert Weissman is editor of the Washington, D.C.-based
Multinational Monitor. 

They are co-authors of Corporate Predators, published by Common Courage
Press. For more information on Corporate Predators, see
<www.corporatepredators.org>. 

(c) Russell Mokhiber and Robert Weissman

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