[Ip-health] CAFTA will hurt people with HIV

[Robert Weissman]

Boston Globe



CAFTA will hurt people with HIV


By Rahul Rajkumar  |  May 26, 2005

IF CONGRESS wants to get serious about promoting a culture of life,
its
members might start by saving 275,000 lives in Central America.

That's the number of people infected with HIV in the countries party
to
the Central American Free Trade Agreement, or CAFTA. The agreement,
which may be ratified by the end of the month, will force its
signatories to strengthen protections on patents owned by
multinational
pharmaceutical companies, thus preventing the manufacture and
importation of many cheap generic drugs.

In the countries bound by the agreement -- Costa Rica, the Dominican
Republic, Guatemala, Honduras, Nicaragua, and El Salvador -- generic
competition has allowed for widespread access to life-saving
medicines.
In Guatemala, some AIDS drugs are as much as 98 percent cheaper than
their name-brand alternatives. The antiretroviral cocktail that costs
$4,818 per year when marketed by GlaxoSmithKline as Combivir can be
purchased by Guatemalans for $216 in generic form.

Given the financial strain many Americans experience when purchasing
drugs like Combivir, it's not difficult to imagine how devastating
similarly elevated prices would be for the farmers and impoverished
city
dwellers who make up the bulk of AIDS cases in Central America.

In addition to increases in patent protection, CAFTA mandates that
these
governments protect regulatory data on medicines -- an unprecedented
step that could effectively extend patents by a decade without any
form
of reprieve, even in a public health emergency. Data protection for
medicines means that if a drug is not patented, or if a country can
somehow maneuver around the patent, generic manufacturers would still
be
prohibited from selling the medicine unless they repeat costly
clinical
trials. Since few generic manufacturers in Central America have the
resources to conduct clinical trials, data protection will function as
another obstacle to generic competition.

The theory behind patents is straightforward. By allowing
pharmaceutical
companies to recoup development costs along with a sizeable profit,
they
provide an incentive for future innovation. The problem is that
innovation, as an end in itself, can be a hollow accomplishment. Drugs
must also be within reach of the people who need them most. Without
cheap access to the fruits of innovation, many poor patients will die
unnecessarily.

The nations of the World Trade Organization recognized this dilemma,
when, as part of the 2001 Doha Declaration, they unanimously resolved
that public health emergencies like HIV/AIDS may require circumventing
patent rules. CAFTA flouts this global consensus and is widely
understood to be part of the Bush administration's larger systematic
effort to undermine the WTO process -- that is, to use bilateral trade
agreements to bully small developing countries into waiving their
rights
under the WTO's intellectual property rules. The WTO's rules allow
developing countries to implement patent laws that meet their
individual
needs.

The office of the US trade representative maintains that nothing in
the
agreement prevents governments from producing generic drugs and that
it
will result in increased access to life-saving drugs as stringent
patent
protection encourages innovation in drug development.

The first of these claims is, unfortunately, false. CAFTA's protection
for drug test data ensures that while countries may be able to produce
generic drugs, they won't be able to use them. The second statement is
partially true but so disingenuous that it verges on outright
deception.
Increased protection for patent rights will certainly give drug
companies larger profits, and this could theoretically lead to more
innovation. However, the pharmaceutical market in Central America is
so
small that any increase in earnings will be negligible relative to the
overall profits of the pharmaceutical giants. Patients in Central
America will most likely end up getting nothing in return for the
higher
prices.

Congress will decide whether CAFTA goes into effect when it votes to
ratify the agreement. Many lives ride on the outcome of this vote.
Most
of the 275,000 HIV-positive people in Central America will die
needlessly without access to cheap antiretroviral drugs. Congress can
save these lives by voting down CAFTA and telling the Bush
administration to renegotiate the agreement's intellectual-property
provisions. Could there be any better way to demonstrate our
dedication
to the culture of life?

Rahul Rajkumar is a member of Universities Allied for Essential
Medicines.