[Pharm-policy] The Activist Response to Boehringer Ingelheim's drug donation

[James Love]

---------- Forwarded message ----------
Date: Sun, 9 Jul 2000 06:54:23 -0400 (EDT)
From: Sharonann Lynch <salynch00@earthlink.net>
Reply-To: healthgap@CritPath.Org
To: Multiple recipients of list <healthgap@CritPath.Org>
Subject: The Activist Response to Boehringer Ingelheim's drug donation

Press Statement
ACT UP PHILADELHIA o ACT UP PARIS o ACT UP NEW YORK
For Immediate Release
Contact:  Gaelle Krikorian +082 858 0416
  Asia Russell +083 438 2894

Activist response to Boehringer Ingelheim's drug donation announcement

8 July 2000: AIDS activists offered a critical response to the first 
of an expected flurry of announcements from pharmaceutical companies 
of amorphous or spurious drug donation schemes. Yesterday, Boehringer 
Ingelheim released a statement announcing a five-year nevirapine 
donation program (brand name: Viramune) to developing countries for 
prevention of perinatal transmission of HIV-1.

The release states that Boehringer Ingelheim believes "that our 
initiative...will help make an impact on the HIV/AIDS epidemic," but 
provides no structure or timeline for implementation and no details 
for involvement with participating governments -- common 
characteristics of drug company announcements of donations, which 
ultimately offer very little medication for very few people.

Further, Boehringer Ingelheim acknowledges that "providing Viramune 
is only one component of making prevention of HIV-1 mother to child 
transmission possible in the developing world," but refuses to offer 
affordable nevirapine as treatment for HIV infected adults.

  "Boehringer Ingelheim intends to give pregnant women two doses of 
nevirapine and nothing more-when there are treatments available that 
could extend their lives," said Joe West of ACT UP. "The only 
acceptable program must provide a clear plan for treatment to women 
and other infected family members, as well as assurance of medical 
follow up and treatment for mothers and babies."

An announcement of a donation, with no plan at all for providing for 
the care of the mother or child is completely unethical. Multiple 
issues are not substantially addressed, including informed consent, 
voluntary counseling and HIV testing, and breastfeeding.

ACT UP offers no support for this program unless and until acceptable 
responses are provided to these concerns:

o	Any ethical MCT prevention program must be part of a 
comprehensive program for treatment of HIV positive women, children, 
and other family members. Boehringer Ingelheim's announcement makes 
no mention of the need to connect HIV prevention in newborns to 
access to HIV treatment for adults, resulting in countless needless 
deaths of both parents and orphans.

o	As one of five participating companies in the UNAIDS/Big 
Pharma 'partnership initiative,' Boehringer Ingelheim has revealed 
the lack of coordinated effort from the 5 participating companies. 
Rather than providing a substantial plan for improving nevirapine 
access for treatment--not only prevention--the Boehringer Ingelheim 
announcement proves that the UNAIDS initiative is nothing but smoke 
and mirrors that holds no significant promise for any real provision 
of combination therapy.

o	A donation scheme must not be allowed to obscure efforts to 
increase access through means such as compulsory licensing and 
parallel importing. Any country doing generic production or 
importation of nevirapine must not be excluded from this offer, if it 
is indeed genuine.

  "To save lives, including those of children born to HIV positive 
mothers, we need widespread access to combination therapy, requiring 
broad coordination between companies," said Laura McTigue of Health 
GAP Coalition. "They're not even talking to each other, they had 
their day in the sun with their announcements, and they've all gone 
home. Drug donation announcements are no substitute for verifiable 
and sustainable public health measures to increase access."

  "These announcements raise the hopes of millions of people with HIV 
worldwide. When drugs do not materialize,  or programs are so small 
as to have virtually no impact, people with AIDS are left with 
despair instead of treatment," said Julie Davids of ACT UP. "In 
addition, community leaders in Kenya and Uganda have reported that 
the UNAIDS announcement in May created tension between doctors and 
patients: people with HIV and their families heard of rumored 
discounting but were still unable to access medicine and concluded 
that local doctors were getting free or cheap drugs but holding out 
at a higher price to make a profit.

  "Announcements follow announcements and each actor tries to keep its 
image clean but the reality of people living with HIV/AIDS remains 
the same," said Gaelle Krikorian of ACT UP Paris. "It is imperative 
for countries to find their own solutions, by using generic 
medications produced by national drug companies, by building up 
regional markets, and by purchasing from suppliers that offer 
reasonable prices."

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