AIDS and the Drug Companies
 

We had a thread a couple of weeks' ago on the AIDS Summit, at which some delegates called for the voiding of patents so that drugs could be made more widely available to victims in developing nations.

I offer this as a follow up to put the role of big pharmaceutical companies in perspective. They provide more charity to combat AIDS than do many EU/OECD governments.

Articles of Faith

Why are children in Africa dying of AIDS? It's the "genocidal action of the drug cartels" claims Jesuit Priest Angelo D'Agostino. In fact, D'Agostino's mean-spirited accusation is a good example of the ignorant anti-freedom mentality which has caused so much suffering in Africa.

D'Agostino is founder and medical director of "Nyumbani," the Children of God Relief Institute of Nairobi, Kenya. Nobody questions his sincerity, but his judgement is terrible. According to D'Agostino, the reason that AIDS is a killer in Africa is "the genocidal action of the drug cartels who refuse to make the drugs affordable in Africa even after they reported a $517 billion profit in 2002. This is a moral issue that shows the lack of social conscience by these capitalistic enterprises, which could easily save the lives of the 25 million sub-Saharan Africans who are HIV+ and otherwise doomed. How will we as Christians explain this silence on our part some 50 years from now?"

In truth, the entire 2002 global pharmaceutical market for all drugs, generic and proprietary, was about US $451 billion (Source: Medical and Healthcare Marketplace Guide; IMS; Bain Analysis).

It is obviously impossible that the drug companies could have profits larger than their gross sales. Either the pharmaceutical companies are the Harry Potter of the market, using a magic wand to multiply profits out of thin air, or Fr. D'Agostino's data are flawed. The "517 billion" factoid is circulated by the Socialist Part of Sweden but it has no basis in reality.

Rather than letting himself be used as a pawn by people who want to use the AIDS crisis as an occasion to disseminate falsehoods about capitalism, Father D'Agostino should have checked the facts before condemning the drug industry's allegedly "criminal" selfishness.

In truth, pharmaceutical companies are offering HIV drugs to Africa by donation, or at very steep discounts.

For example, in Kenya nevirapine (which is intended to prevent mother-child transmission) is offered free of charge by Boehringer Ingelheim. Pfizer is donating Diflucan to treat HIV related disorders. Merck is offering its two HIV medicines at "no profit" prices. One of the Merck drugs, Stocrin, being sold for 30% below the best copycat competitor. The price is so low that in Kenya, the anti-globalization group Doctors Without Borders and Father D'Agostino's own orphanage have decided to purchase from Merck.

Six leading pharmaceutical companies are working together in the Accelerating Access Initiative, which is a partnership of five United Nations organizations and industry. As December 2003, the Initiative had supplied treatment to over 150,000 people in Africa.

In combined donations, the pharmaceutical companies are giving more money to AIDS charity in Africa than many European/OECD governments are giving in annual aid for AIDS to Africa!

It is hideously irresponsible for Father D'Agostino to point the finger of "genocide" at companies that save so many lives every day, and give away their products so generously -- never mind that they invented the medicines in the first place.

If the companies are so generous, then why so many people in Africa and other poor nations still unable to afford drugs? One reason is Third World governments' rapacity. For example, South Africa imposes a 14% Value Added Tax on all medicines, including AIDS drugs; Ethiopia imposes a 30% import duty on medicine (although this has been recently dropped for HIV medicines); Ghana, Senegal, and Tanzania impose 10% customs on imported medicines. Kleptocracy being the standard form of government in Africa, only a small share of the money with governments raise by taxing medicine ever goes to help suffering people.

As Africa Fighting Malaria director Richard Tren puts it, "Africans are ill, unable to receive medical treatment and short of food because most African governments have kept people poor, frustrated trade and interfered with markets. By increasing economic freedom and enabling the private sector to thrive, Africa will be able to create the wealth that can build health infrastructure."

In other words, the main reason that many Africans cannot afford medicine is not because they do not work hard, or because their nation lacks natural resource. Rather, the main cause of African poverty is thieving African governments.

Father D'Agostino and the rest of the anti-globalization crowd are so fixated on their hatred of capitalism that they refuse to acknowledge the very obvious charity of the pharmaceutical companies. Instead of defaming the companies which invent and donate life-saving drugs, Father D'Agostino ought to be calling for reform of the abusive taxes in the Third World. Why should the notoriously corrupt third world kleptocracies impose hefty import taxes on the drugs which citizens need to survive? If there's a problem with greed, the malfeasants are corrupt finance ministers, not the pharmaceutical companies.

The Catholic Church, perhaps the institution in the world most concerned with the fate of the poor, should fight import taxes on drugs, for these taxes are a primary enemy of the world's most desperate people.

The first person to answer with "Capitalism drives innovation in the drug market" must simply answer this, for me please.

Is there more profit in treating an illness or in curing it?

Why are children in Africa dying of AIDS? It's the "genocidal action of the drug cartels" claims Jesuit Priest Angelo D'Agostino.

What is the connection between the availability of AIDS drugs and the spread of the AIDS virus? Is this accusation claiming that most of the AIDS cases are caused by transfer from mother to child and is therefore preventable? What I'm getting at (I must admit I am a novice in this subject) What is the correlation between the availablity of drugs that treat AIDS and the spread of the AIDS virus? Do AIDS drugs prevent the disease from being transfered (besides the obvious case of from mother to child)? Or is it a matter of influencing the changing of the lifestyles of the people instead of the provision of drugs that is needed to impede the spread of AIDS. I'm not saying that drugs do not play an important role I am just wondering how important that role is.

I live in Africa.

Why are people dying of AIDS? Because they are irresponsible. Its not the drug companies' fault. And they SHOULD be allowed to make any kind of profit on their products, since its THEIRS. They developed it, so its their property, and they can do with it what they wish.

People here in Africa REFUSE to use condoms, even though they are educated on their use and why they should use them. And the men here refuse to have single partner relationships. The people of Africa are too damn primitive, you cannot save them from AIDS. No amount of AIDS drugs will help.

Need does NOT give you the RIGHT to anything.

Interesting. So much is said about Africa and AIDS that it's intriguing to see the viewpoint of someone who is IN Africa (albeit, only a single person)

So if I'm to understand the article correctly, the 10% tax on medicine levied by 3 nations and the 30% tax leveled by one nation is the cause of the AIDS medicine shortage in Africa? That seems like a bit of a stretch to me. Some of these medicines cost more per dose than a sub Saharran African earns in a year....subtract 10% from too much and you're still left with too much.

AIDS in africa is seen as mystical, and the traditional healers (withc doctors) tell people to have sex with infants (can you believe that - babies get raped to death here on a regular basis) to cure them of AIDS.

Generalising about a continent of people and focusing on some of the worst aspects of humanity there does nothing to address the looming health crisis. Regardless of why they are poor or whether or not they are "primitive," there is a terrible problem there that demands attention. Do you think that the rest of the world will remain unaffected if we let the worst case scenarios unfold?

I've seen a couple of news reports (long, documentary-style ones) about AIDS in africa, the total lack of safe sex, and the drug costs.

It seems from everything i've read, heard, or seen, and I suppose I could be wrong on this, that many of them simply do not understand or care about what's going on around them. They are perpetuating the horrors they live in, and they, themselves, are doing very little to stop it. We send tons of money in relief in the form of drugs, food, programs to educate people, etc.

Where is the wake-up call for them?

Thank you for this post. It is telling that Uganda has had the greatest success in preventing AIDS - they have chosen to advocate abstinence and monogamy instead of "safe sex".

AIDS is a disease spread by irresponsible behavior.

Africa, in particular those Sub-Saharan areas most hard hit by AIDS, is place that I think most any American would find nearly impossible to comprehend.

Africa is going backwards. Their economy is shrinking (not just stalling), their governments are a mess, their resources are out of their control, their people are becoming less educated, the population is growing, but getting younger as life expectancy drops.

The answer to AIDS in Africa isn't just drugs, but drugs are part of the equation.

Africa is a continent without the benefits of Western society, but with all of the ills. Only a very comprehensive long-term approach will solve any of her problems for real.

Actually, Uganda adopted the "ABC" campaign -

Abstain, but if you can't,
Be faithful, and/or use
Condoms.

This is a much more comprehensive sex education/disease prevention message than most politicians in the U.S. are touting, focusing only on the abstinence message. The realities are much more complex, and it is likely that a change in a number of behaviors - including delayed sexual activity (not abstinence per se), increased fidelty, AND increased condom usage are behind Uganda's success. It's reductionistic and dishonest to focus only on abstinence and monogamy.

<a href="http://www.agi-usa.org/pubs/ib2004no2.html">http://www.agi-usa.org/pubs/ib2004no2.html</a>

Tell that to Ryan White.

Uganda subordinated the use of condoms to abstinence and monogamy.

Ryan White was the victim of someone else's irresponsible behavior. The tainted blood did not spontaneously develop out of the ether.

No one knew about AIDS when Ryan White was infected....is that anyone's fault? AIDS is not always the direct result of someone's lapse in judgement. Maybe our time could be better spent in exploring solutions to this problem rather than spreading blame and demonizing an entire continent. Of course, devaluing someone makes ignoring them so much easier.

Ryan White was diagnosed with AIDS at the age of 13 in 1984.

AIDS was identified by the CDC in 1981 - the linkage to blood was announced in 1982. Prior to this, AIDS was often referred to as the Gay Disease due to the majority of victims being homosexuals at that time.

http://www.aegis.com/topics/timeline/default.asp

Ryan White was diagnosed with AIDS in 1984, but when he contracted it from lifelong hempohilia treatments is not known.

Ryan White's contraction of the HIV virus some 20-odd years ago is far different from those people becoming infected today.

We know what causes it, we know how to prevent its spread. Twenty years ago it was a mystery but today it is spread due to nothing more than pure ignorance (with few exceptions).

True, but it is an example of how the contraction of AIDS is not always a product of irresponsibility.

I agree that ignorance is a major contributing factor to the spread of AIDS. Can you really call someone irresponsible if they are ignorant of the possible consequences of an action?

I'm not trying to say that no one who contracts AIDS is culpable at some level or another. I do think that pointing fingers at the victims of a disease is counter productive and evokes memories of the scorn for the gay community that existed in the early 80's.

Irresponsibility does not warrant a death sentence, and financial capabilities should not be a factor.

If an African fucked up, then that's that. But if an African who fucked up can also afford at-cost produced pills and American drug companies hold out on him because he can't afford at-cost + profit they choose, then I've got no problems if they miss out on entire national markets due to companies infringing on their patents and selling affordable treatments.

And if that recourse should stifle innovation, I ask again: What's more profitable, treating an illness or curing it?

Treating an illness is more profitable. As Chris Rock said, the dealers get you on the come back.