glOBAL CHALLENGES
#2 ACCESS TO TREATMENT: NEWSWEEK PROFILES PROGRAMS IN
THAILAND, GUATEMALA, AND SOUTH AFRICA
Newsweek profiles indigent populations' access to HIV/AIDS
drugs in Guatemala, Thailand and South Africa, countries that
have taken three very different approaches to reconciling the
dilemma posed by a shortage of resources and a surplus of
patients. In Guatemala City, doctors are forced to rely on an
ad-hoc patchwork of antiretroviral hand-me-downs and clinical
drug trials. Neither of these provide a steady stream of
medications, leaving patients abruptly without needed drugs.
Newsweek reports that doctors at the Luis Angel Garcia AIDS
clinic, who have seen patients sell cars and homes to buy drugs
only to end up penniless and without medication, "recommend that
patients go on the drugs only if they can guarantee a steady
supply." The clinic, which tests about 2,000 people annually,
17% of whom are HIV-positive, receives suitcases and backpacks of
donated drugs from American doctors, also works as a liaison with
companies like Merck. A Merck Crixivan study helped 59 patients
dramatically -- but the yearlong trial ended in September, and
supplies will run out by fall. Doctors have taken to raffling
off the remaining stock (Zarembo, Newsweek, 6/5 issue).
STANDING ALONE
In South Africa, the government is locked in a contentious
dispute with U.S. trade representatives and drug companies over
parallel imports and compulsory licensing. At issue is section
15C of the South African Medicines and Related Substances Control
Amendment Act, which "gives the minister of health the power to
prescribe conditions for the supply of more affordable medicines
in certain circumstances so as to protect the health of the
public." Newsweek reports that the act "doesn't spell out
exactly what the government can and can't do to get AIDS drugs" -
- but U.S. officials argue it threatens international patent law.
Drug companies go a step further. Tom Bombelles of the
Pharmaceutical Research and Manufacturers of America said the
South African government "is creating a false opposition between
intellectual-property rights and access to medicines. ... It's
much more complicated than getting pills to people. Where there
is one doctor for 10,000 people, no roads and no hospitals, (drug
cost) is a red herring. What's more, if AIDS cocktails aren't
taken correctly, new and more resistant strains of the virus may
spring up." South African and U.S. activists counter that the
"dispute is really about a different interpretation of the" World
Trade Organization's Trade-Related Intellectual Property Rights
agreement (Mabry, Newsweek, 6/5 issue).
GOING ALONG TO GET ALONG
Thailand, on the other hand, plays by the U.S.'s rules.
Under pressure from U.S. officials last year, "the Thai
government brought its intellectual property laws in line with
those of the developed world. Bangkok can no longer issue
compulsory licenses for patented medicines or allow parallel
imports to bring in cheap drugs." More importantly, the
country's Pharmaceutical Patent Review Board can no longer force
drug companies to release their pricing information. Why did
Thailand bend? The international monetary crisis made it highly
dependent on U.S. and International Monetary Fund aid. Newsweek
reports, however, that while "[r]eform of everything from banking
to accounting to trade law is the Western prescription for the
country's economic ills," a "prescription for its HIV problem ...
has yet to be written" (Moreau, Newsweek, 6/5 issue).