Africa: Can Canada Help Save It from AIDS?

The London Free Press (London, Ontario)
November 3, 2003

There is no part of the world that suffers more from AIDS than Africa, especially the south-central region of the giant continent known as the sub-Sahara.

There, in countries such as Botswana and Zimbawe, more than a third of the population has HIV/AIDS. In total, close to 30 million Africans -- equal to the entire population of Canada -- are afflicted.

That's bad enough, but the real tragedy is that drugs used to containand treat the disease in North America and other developed regions are not available to most Africans.

Developing countries are so poor, they simply can't make the drugs themselves, says David Agnew, president of UNICEF Canada. Neither can they afford to buy them from manufacturers in developed countries.

Canada is trying to change this. In an unprecedented example of a rich country putting poor people over profits, Canada has decided to export low-cost AIDS drugs to the millions of sick Africans who need them. Ottawa announced the plan this fall after the World Trade Organization ruled that developing countries could import less-expensive generic versions of brand-name drugs without fear of lawsuits from drug companies who own patents on the medications.

The initiative, however, still faces hurdles. One of the first tasks is to amend the Canadian Patent Act, which sets out protections for drug companies that spend millions developing new drugs. The protections basically prevent other companies from using their recipes to make the same drugs and sell them more cheaply.

"I hope they give the amendment as generous an interpretation as possible," said Stephen Lewis, a Canadian and UN envoy for HIV/AIDS in Africa. "You just can't have millions of people dying unnecessarily every year when their lives could be significantly prolonged."

There is concern that Canada will limit the number of diseases and drugs that qualify under the program. AIDS is the main concern, but there is hope drugs will be made available for other devasting diseases, especially tuberculosis and malaria.

"TB (tuberculosis) and AIDS often occur in concert," says Lewis. "People with AIDS often die of tuberculosis and malaria takes a grip on people whose bodies are significantly weakened by AIDS."

Additionally, there is worry that Canada might run into opposition from the United States and the brand-name pharmaceutical industry.

Trade officials from the United States, which could launch a challenge under the North American Free Trade Agreement, say they'll support Canada's plan as long as Canada plays by the trade rules. And a group representing Canada's top drug research companies also have expressed support.

Other industry spokes-people have not been as positive. They argue the plan will drain money from health research funded by the sales of brand-name medications.

Such criticism is illogical because Africa only accounts for about one per cent of global pharmaceutical sales, says Richard Elliott, speaking for the Canadian Legal AIDS Network. "Poor people, poor markets, don't represent any significant likelihood of profits," Elliott said. "It's (the criticism) intended to scare people in northern countries."

It wouldn't be the first time Canada has made exceptions to its patent law. At the height of the 2001 anthrax scare in the United States, the government awarded generic drug maker Apotex a contract to supply low-cost versions of Cipro, Bayer's anti-anthrax treatment.

Activists say if the government can move to safeguard the health of Canadians, there is a moral obligation to do the same for Africans who are in dire need of medication. The cost difference between brand-name AIDS drugs and generic ones is huge. The full cost of brand-name drugs can range from $8,000 to $15,000 US per patient each year. A similar regimen of generic AIDS medications costs about $250 to $300 US.

Although there is no cure for AIDS, generic versions of anti-retroviral drugs, or ARVs, can prolong the life of an infected person by up to 20 years. Studies have also shown that ARVs reduce the chances of pregnant women passing AIDS on to their unborn babies -- a huge part of the AIDS problem in Africa. Babies with AIDS usually die before their first birthday.

The desperate need for medications has forced some doctors to use illegally imported ARVs, says Dr. James Orbinski of Doctors Without Borders, which sends doctors to the Third World to provide medical help.

Even as the situation in Africa grows increasingly bleak, it is unclear whether other countries will follow Canada's lead. The most likely contenders are Britain and France, but not the United States because brand-name pharmaceutical companies there are too powerful.

"Whatever the reasons, Africa always seems to be an expendable continent," Lewis said.

"I'm never sure whether there is a quotient of subterranean racism or whether Africa just doesn't count any more in the geopolitics of this world. Africa always gets the short end of the stick in the distribution of resources."



Sources: U.N. World Population Prospects; UNAIDS; Associated Press

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