Kaiser Daily HIV/AIDS Report Rounds Up Editorials, Op-Eds on South African Lawsuit, Drug Access

The public continues to weigh in on the issue of AIDS drug access for developing nations, as well as the recently abandoned lawsuit brought by 39 pharmaceutical companies against South Africa. Excerpts from some pieces appear below:

• New York Times: The pharmaceutical industry's decision to drop its lawsuit is the "latest in a series of deserved setbacks for the drug industry on the issue of AIDS in the third world" and a "long overdue bow to both public health needs and common sense," a New York Times editorial says. But the move now puts the "burden" for distributing AIDS medications "squarely on [South Africa's] strangely inert government," which has been "inexplicably passive -- even hostile -- to treating the disease." Although officials fear that paying for AIDS drugs will "balloon the nation's health budget," failing to treat patients early "carries an even higher future cost in hospitalizations and deaths" of productive workers. While wealthy nations should help South Africa pay for AIDS drugs, the editorial concludes, "[T]he country itself must make a greater commitment to treating its millions of citizens infected with the AIDS virus" (New York Times, 4/20).
• Bergen Record: With the withdrawal of the drug makers' lawsuit, South Africa could now be able to make or import generic AIDS drugs, but the government has "acknowledged it would be some time before it could come up with a widespread plan to provide the medications to those who need them," a Bergen Record editorial states. The editorial concludes, "The United Nations should work with the government of South Africa and other sub-Saharan nations ravaged by AIDS to begin the long process of finding ways to distribute and monitor treatment" with drugs (Bergen Record, 4/20).
• The Age: "It is scandalous that it has taken so long for Africans to receive the benefits of AIDS research," according to an editorial in Australia's The Age. The blame, however, is not entirely on the drug companies; the editorial notes that South African President Thabo Mbeki has questioned the effectiveness of antiretroviral drugs and that the government has not ordered the production of generic drugs despite having the "legal power" to do so. Drug makers' profits will not be hurt seriously by their decision to drop the suit, the editorial adds, since Africa represents just 1.3% of the world's pharmaceutial market. Nevertheless, the "withdrawal is symbolically important because it acknowledges, by default, that human life carries a higher value than a patent" (The Age, 4/20).
• New York Daily News: In television ads for prescription drugs, the pharmaceutical industry touts itself as a "paragon of virtue and compassion," with slogans such as Pfizer's "Life is our life's work," columnist Arianna Huffington writes. But the fact that "it took world opinion turning on them -- and three long years of people dying -- to get them to drop their suit" in South Africa "proves the industry's collective slogan should be "Profit is our life's work," she adds. Huffington calls the FDA's decision to permit drug companies to advertise products directly to consumers a "serious mistake" that should be reversed. Though the industry's lobbying contributions will make that difficult, Huffington concludes, "[T]he industry's surrender in South Africa shows that public pressure and grass-roots protests really work. So let's build on this victory and rid our airwaves of this plague of prescription drug ads" (Huffington, New York Daily News, 4/20).
• London Independent: The decision by the 39 pharmaceutical companies to drop their lawsuit against the South African government is "welcome news -- if belated," an Independent editorial states. The editorial predicts that "[a]ny victory in court by the pharmaceutical companies would have been pyrrhic," since the "overwhelming negative publicity would have had clear commercial knock-on effects." But the recent settlement "puts the spotlight back on the South African government to show that it can use the benefit of cheaper drugs to conduct an effective campaign against the spread of a plague that its prime minister has sometimes seemed reluctant to acknowledge" (Independent, 4/19).
• London Guardian: The resumption of the case offered the drug firms "an opportunity to begin repairing the damage they have wreaked in South Africa," a Guardian editorial states. The editorial says, "Even the industry now recognizes what a PR disaster [the case] has been," noting that GlaxoSmithKline last month "privately confessed" to a Guardian health correspondent that it "was sorry it had brought the lawsuit" (Guardian, 4/18).
• Malaysia New Straits Times: Patent monopolies provide "a very inferior means of financing research" and are "enormously wasteful," Mark Weisbrot, co-director of the Center for Economic and Policy Research, an organization that promotes "democratic debate" on social issues, writes in a New Straits Times opinion piece. Weisbrot states that pharmaceutical companies are motivated by "pure, unadulterated greed" in their dealings with developing nations and are poised to use a "formidable arsenal of weapons to force compliance from poor countries." These tactics include "economic pressures, lawsuits and the World Trade Organization," he writes, noting that the WTO is currently involved in a dispute between the United States and Brazil over Brazil's importation and production of generic antiretrovirals (Weisbrot, New Straits Times, 4/16).
• Washington Post: Responding to Post columnist William Raspberry's March 26 op-ed on South Africa and the HIV/AIDS crisis, South African Ambassador Sheila Sisulu writes in a letter to the editor that the piece "may have led some people to doubt the depth of South Africa's commitment to addressing the HIV/AIDS epidemic because of its decision not to declare a 'national state of emergency.'" Declaring an emergency, she writes, is "not the way to address the HIV/AIDS epidemic." Sisulu notes that the South African constitution only allows an emergency to be declared "when the life of a nation is threatened by war, invasion, general insurrection, disorder, natural disaster or other public emergency," and then only when "the declaration is necessary to restore peace and order." In addition, declaring a state of emergency "curtails the provisions" of the country's bill of rights, and the declaration can only last for 21 days, unless extended by South Africa's parliament, and carries other "complex consequences" (Sisulu, Washington Post, 4/16).
• Bulletin of the World Health Organization: "There is an urgent need for WHO and UNAIDS to provide ... central leadership in formulating similar clear plans of action for HIV/AIDS control" in developing nations, Madhur Dev Bhattarai, a postgraduate teacher at Bir Hospital in Nepal, writes in a letter to the bulletin. Bhattarai lists several examples of possible strategies to combat the disease, including outreach programs, short, educational TV and movie spots, HIV/AIDS education in schools, "vigorous" condom promotion and "increasing coverage of antiretroviral preventive therapy in pregnancy." Initiatives such as these, Bhattarai concludes, "would no doubt generate proper response from governments in the developing countries" (Bhattarai, Bulletin of the World Health Organization, April 2001).
• Boston Globe: The plan to fight HIV/AIDS in Africa put forward by Jeffrey Sachs and a number of other Harvard University professors "glosses over major issues" concerning the infrastructure of African health programs, Harvard University fellows Clive Gray and Malcolm McPherson write in a Boston Globe op-ed. The plan's recommendation of using existing infrastructures already developed for the treatment of other diseases raises the question of how long it will take to adapt these structures to meet the demands of fighting HIV/AIDS, the authors write. Gray and McPherson note that the World Bank and "other donors have spent billions expanding health infrastructure in Africa," but that these efforts proved to be "abject failures." In addition, many drugs shipped to Africa to treat other diseases are "pilfered before they leave the port," and those that do arrive at pharmacies are often sold to patients at full price so that the public health staff can "avoid starvation," they state. Gray and McPherson write that the Harvard plan calls for the implementation of "large-scale pilot projects" as well as the "rapid expansion" of existing pilot programs, a proposal that is "overly ambitious" and could "cas[t] a shadow on the whole exercise" (Gray/McPherson, Boston Globe, 4/16).
• San Jose Mercury News: A number of countries have "piously vowed" to help fight HIV/AIDS in Africa, but their offers have sounded "pathetically hollow," a Mercury News editorial states. The editorial endorses the Harvard plan, stating that its cost is "manageable ... when looked at internationally." Calling the plan an "innovative strategy" that offers "a comprehensive, stable and long term answer to the AIDS pandemic," the editorial calls on world leaders to give the proposal "strong consideration" when it is formally released this June (San Jose Mercury News, 4/15).