[corp-focus] Big Pharma and the Global Response to HIV/AIDS

[Robert Weissman]

Big Pharma and the Global Response to HIV/AIDS
By Russell Mokhiber and Robert Weissman

One of the perquisites of power is that the powerful can always command a
fresh start. Past crimes and misdemeanors, and even current misdeeds, are
not held against them.

Consider the case of the pharmaceutical industry and the issue of access
to HIV/AIDS and other essential medicines.

The rich countries are now, belatedly, gearing up to commit some
substantial monies to address HIV/AIDS in Africa and elsewhere in the
developing world. The brand-name pharmaceutical companies are jockeying
for a central role in determining how those monies are spent. And, unless
sufficient public opposition emerges, they are likely to secure it.

There is now no serious dispute that the brand-name pharmaceutical
companies have worked overtime to deny poor countries access to lifesaving
medicines.

The industry insistence in maintaining its lawsuit challenging South
Africa's Medicines Act helped forge a broad, worldwide consensus -- from
the New York Times to the European Parliament -- against the industry's
role in interfering with poor countries' efforts to promote access to
essential medicines. International condemnation forced the industry to
back down in the suit, but the South Africa case was only one of many
instances where the industry has played a pernicious role. Big Pharma's
obsession has been to block the introduction of generic competition --
which has the potential to bring drug prices down by 95 percent or more --
and it has employed misleading propaganda campaigns, threats of
litigation, promises of trade sanctions, and new trade agreements to
advance its aims.

Against this backdrop comes a set of proposals for a global AIDS fund, or
a global tropical disease fund. In late June, the United Nations will hold
a special session on HIV/AIDS. Then the elite rich countries, grouped
together in the G8, will meet in Genoa, Italy, in July. There is
widespread expectation that the rich countries will agree to a framework
for a new fund, and make preliminary dollar commitments. UN Secretary
General Kofi Annan has requested contributions of $7 billion to $10
billion per year. The United States is expected to announce a $200 million
commitment shortly.

How the fund will be governed and operated remains very unclear.

One possible starting point is a new, U.S.-initiated fund, housed at the
World Bank. The World Bank AIDS Trust Fund was created by Congressional
action last year, and the United States has allocated $20 million for the
fund. This fund was intended to galvanize international donations, but
they have not materialized, and some thought the fund would never get off
the ground. However, Kofi Annan's proposal for a global fund sounded very
similar to the World Bank AIDS Trust Fund, leading some to think the World
Bank entity would be revamped and become the big global fund.

That makes governance of the fund very important. The U.S. Treasury
Department is in charge of establishing the charter for the World Bank
AIDS Trust Fund. The Treasury Department's proposal envisions a governing
board made up of donors, with some participation by recipient countries.
"Donors" would include not just governments, but private parties --
meaning not just private foundations, but private corporations =C9 includin=
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the drug companies. Under the Treasury Department proposal, for $5 million
contributions, the drug companies would be able to buy themselves seats on
the Trust Fund's governing board.

This is a morally outrageous proposal. There are many parties to blame for
the horrible toll taken by the AIDS pandemic in poor countries (with as
many as one in three adults now HIV-positive in some African countries,
and virtually all of the HIV-positive people certain to die from AIDS
unless treatment costs are radically reduced), but the drug companies are
hugely culpable. That they would be permitted a key role in directing the
world's belated response to the crisis dishonors the memories of the
millions who have died preventable deaths from HIV/AIDS.

Underlying the moral argument are very practical considerations. Big
Pharma participation on the governing body of new global fund would create
an irresolvable, structural conflict of interest.

For example, a crucial decision for the new fund will be whether it buys
drugs at best world prices, from multiple sources, including generics. The
brand-name companies are intent on excluding generics, and the brand-name
companies certainly should not have a role in the fund's decision-making
on this issue.

Suggestions that the brand-name companies could simply recuse themselves
from such issues offer no solution. The brand-name companies should not be
positioned to influence fellow board members. And lots of decisions the
board will make -- from matters relating to the mechanisms to deliver
drugs, drug registration rules, preferred drug regimens, and much more --
will involve issues where drug company conflicts will be pervasive, but
may not be recognized.

If Big Pharma wants to redeem itself and be "part of the solution" to the
AIDS pandemic, there is plenty it can do, starting with issuing licenses
for its HIV/AIDS drugs to the World Health Organization, which could then
contract with generic makers to provide cheap drugs for distribution in
poor countries. But putting the industry in charge, or partially in
charge, of the primary global response to HIV/AIDS -- especially while the
brand-name companies continue to place enormous obstacles in the way of
the generic competition that could make AIDS drugs far more affordable and
save millions of lives -- would be unconscionable.


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, and co-director of Essential Action, a corporate
accountability group. They are co-authors of Corporate Predators: The
Hunt for MegaProfits and the Attack on Democracy (Monroe, Maine: Common
Courage Press, 1999).

(c) Russell Mokhiber and Robert Weissman