[Ip-health] MSF letter to the editor in response to Abner Mason's San Francisco Chronicle editorial

[Rachel COHEN]

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The following letter to the editor, which appeared in Saturday's San
Francisco Chronicle, is from Dr. Roger Teck, head of mission for MSF in
Malawi.  It is in response to an inaccurate and misleading editorial by
Abner Mason that appeared in the Chronicle on Wednesday of last week.

Regards,
Rachel
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http://www.sfgate.com/cgi-bin/article.cgi?file=3D/chronicle/archive/2004/12=
/04/EDGB4A65K31.DTL

 Generic AIDS drugs work

 Editor -- It is difficult to understand what could motivate Abner Mason to
 spread such irresponsible and inaccurate claims about generic AIDS
 medicines (Open Forum, Dec. 1.) Here in Malawi, we treat more than 4,500
 people with HIV/AIDS, using mostly generic antiretrovirals. Worldwide,
 Doctors Without Borders treats 23,000 people in 27 countries.


 Our clinical results, published in peer-reviewed medical journals and
 presented at international conferences, parallel those in the United
 States. Like physicians in the United States, I prescribe generic
 medicines every day, and would never consider using "suspect" or "untested
 AIDS treatments." Several generic AIDS medicines were recently removed
 from the World Health Organization's prequalification list, but only to
 resolve important questions about their bioequivalence, not because of
 deadly side effects. In fact, two of the medicines in question were
 re-approved on the very day Mason's misleading piece appeared.


 No amount of misinformation or out-of-context quotes can hide the fact
 that AIDS treatment has only been possible in some of the world's most
 impoverished regions because generic competition led to dramatic price
 drops - - from $15,000 per person per year to just $150. Without the
 medicines Mason derides, thousands of our patients would probably be dead,
 their names silently added to the shameful list of 20 million needlessly
 lost to the scourge of AIDS.


 ROGER TECK


 Doctors Without Borders


 Thyolo, Malawi




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Rachel M. Cohen
U.S. Director, Campaign for Access to Essential Medicines
Doctors Without Borders/M=E9decins Sans Fronti=E8res (MSF)
333 Seventh Avenue, 2nd Floor * New York, NY * 10001-5004 * USA
Tel: +1-212-655-3762
Mobile: +1-917-331-9077
Fax: +1-212-679-7016
E-mail: rachel.cohen@newyork.msf.org

http://www.doctorswithoutborders.org/
http://www.accessmed-msf.org/



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      Slouching toward drug resistance


      - Abner Mason Wednesday, December 1, 2004


      The United Nations was dealt another blow last month: The hasty
      approval of cheap, untested AIDS drugs by one of its agencies has
      likely caused new strains of HIV to emerge in the developing world,
      according to the American Foundation for AIDS Research. American
      taxpayers give nearly $1 billion per year to the United Nations and
      its agencies, comprising roughly 25 percent of its budget. Congress
      is now sure to take a hard look at how tax dollars have been
      mismanaged in the U.N. fight against AIDS.


      Such a somber audit may be long overdue. After tests showed flaws in
      its AIDS drugs, Indian generic drug maker Ranbaxy issued a global
      recall -- unfortunately, it came three years after these dubious
      drugs were originally "approved" for use by the U.N. health agency,
      the World Health Organization. For three years, the suspect medicines
      have been used by tens of thousands of Africans. Relief groups like
      Doctors Without Borders and the Salvation Army have spearheaded
      efforts to get these generics into the developing world. They may now
      face liability claims for distributing these insufficiently tested
      knockoffs.


      The Indian generic drugs have been buoyed by big-name political
      endorsements -- Rep. Henry Waxman, D-Los Angeles, Sens. Ted Kennedy,
      D-Mass., and John McCain, R-Ariz., in addition to the Clinton
      Foundation, have all given their "approval" even in the absence of
      adequate and rigorous testing from regulatory agencies. Seeking to
      drive a wedge between the Bush administration -- an advocate of using
      its $15 billion AIDS relief war chest to purchase only tested AIDS
      drugs -- politicians and activists have exhausted considerable
      political capital to sell the public and media on the promise of
      Indian generics.


      Cleaning up this mess is a tall task. Last summer, AMFAR raised
      eyebrows with its report warning that the bevy of unproven Indian
      generics in the developing world could lead to "drug resistance,
      eradicating years of progress. " Despite concerns raised by this
      report, Daniel Berman of Doctors Without Borders recently told the
      Washington Post: "We are not worried about the safety of our
      patients. We are confident in the drugs we are using."


      The WHO is still recommending that patients already taking Ranbaxy
      drugs continue with their regimens. The all-too-hasty rush toward
      untested Indian generics may end up costing lives. And the
      recklessness of the politicians and activists who have touted them
      has been dangerous. "Standards and guidelines are important ... I
      just don't want people to wait for a road map. Be bold and willing to
      take risks," said Doctors Without Borders official, Rachel Cohen,
      reacting to the AMFAR report at the Bangkok AIDS conference this
      summer.


      We may have taken one risk too many.


      Abner Mason is founder and executive director of AIDS Responsibility
      Project (www.aidsresponsibility.org).


      Page B - 11


      URL:
      http://sfgate.com/cgi-bin/article.cgi?file=3D/chronicle/archive/2004/=
12/01/EDGBQA47T31.DTL

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