Some of the US$15 billion announced by US President George W. Bush to save the lives of people with AIDS in poor countries could be spent on cheap copycat generic medicines that the giant US-based drug companies brand as "pirates," his advisers said yesterday.
In an extraordinary departure from the close relationship the US administration has always enjoyed with the major pharmaceutical companies such as Pfizer and GlaxoSmithKline, US Secretary of Health and Human Services Tommy Thompson and Anthony Fauci, the AIDS scientist who advises the president, said that the money would be spent on the cheapest good-quality drugs.
"We certainly want to get the highest quality at the lowest price," said Fauci, head of the National Institute of Allergy and Infectious Diseases in the US.
"It may mean the [major] companies bringing their price low enough to be part of the program. It does not exclude generic drugs," he said.
He said that under the WTO's agreement on patents, poor countries are permitted to buy generics "where a country is in a state of emergency and they are incapable of making the drugs themselves." The US had made it clear in the past year, he went on, that it would not challenge any country which ignored a patent on a drug it needed to cope with "a genuine emergency," such as AIDS.
The US has been accused of siding with the big drug companies and blocking a formal agreement that would allow developing countries greater freedom to buy generics for other conditions that threaten the health of their people. The pharmaceutical companies say that their rivals in countries such as India and Thailand are pirating their inventions, which cost millions of dollars to develop.
Fauci pointed to Uganda, the blueprint for the emergency AIDS plan, which has reduced infection levels by openness about AIDS, strong education and prevention programs and heavily promoting the use of condoms. It has moved on to treating people with the antiretroviral drugs used in affluent countries to keep people alive and well. "In Uganda the program already going uses generic drugs," Fauci said. "That's possible. Other countries have negotiated deals with [major] drug companies to get prices down as low as generic prices."
In an exclusive interview with The Guardian last February, Jean Pierre Garnier, chief executive of GlaxoSmithKline, said that he would beat any generic company on price if he were given a big enough order. If the Bush plan will seek drugs at the lowest price, it is likely to persuade the big companies to drop theirs further.
Thompson said he had spent some time with Bush after he returned from Africa last week.
"He was very positive about what he saw in Africa," he said. "He is more committed than ever to fight this fight. He told me, `Make sure you let people know that we are committed to the long haul and we need money to fight that fight,'" Thompson said.
Thompson is also chairman of the UN's Global Fund for Aids, Tuberculosis and Malaria, which gives grants to treatment projects -- so far in 93 countries -- it judges to be high quality. Bush authorized US$1 billion of his US$15 billion to go to the fund from next year, but Congress is currently arguing that the first year's tranche of money should be no more than US$2 billion, with just US$400 million of that to the fund.
Thompson said the US is by far the biggest donor and he hopes EU countries will put in more money.
In December, he plans to take a group of businessmen to Africa in the hope that they will feel as he did when the president sent him to find out how serious the AIDS crisis was two years ago. "I've learned so much," he said. "I'm hoping the things that move me so dramatically will move business people too," he said.
Yesterday, the World Health Organization called for free tuberculosis drugs to cut the death toll of those who succumb because they have HIV and their immune systems cannot fight off the infection.
"The TB epidemic has grown even worse, primarily due to the spread of HIV. We need to increase our efforts to address the deadly synergy between the two diseases, each of which is fuelling the other's impact," said Mario Raviglione, of WHO's Stop TB department.
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