Office of the Vice President

August 20, 1999

Ralph Nader
P.O. Box 19312
Washington, D.C. 20036

Dear Mr. Nader:

Over the last several months, there have been a number of open letters - some circulated by the Consumer Project on Technology, some by other groups- expressing concern about U.S. trade policy and about the Vice President's role in efforts to resolve our differences with South Africa over trade in pharmaceuticals. I am happy to take this opportunity to give you an update on efforts to resolve the issue.

First, let me express the Vice President's profound agreement with your concerns on the worldwide AIDS crisis. This is a humanitarian crisis of staggering dimensions. Young lives are being lost; families torn apart; and millions of children are left crying for their lost mothers and fathers. Forty million African children will lose one or both parents to AIDS over the next ten years.

The AIDS crisis is not only causing horrible pain for families; it multiplies the pressure on their governments, and threatens to wipe out the economic, social and political gains made in so many developing countries over the past several decades. That makes this epidemic a national security concern for the United States, and our national interests and our national values converge on this point: we must reach around the world and work harder to save lives.

Last month, the Vice President released the report of the Presidential Mission to Africa and announced our proposal for a $100 million increase in the next fiscal year to fight AIDS in Africa, and around the world. This largest-ever increase will double the U.S. commitment in Africa for AIDS awareness and prevention, for home and community-base care, for the care of children orphaned by AIDS, and for development of the infrastructure necessary to assist all three efforts. We will challenge our G-8 partners and other donors to match America's increased financial commitment. Next month, First Lady Hillary Rodham Clinton will convene a meeting of donors to discuss how we can enhance our AIDS effort world wide.

Meanwhile, we need to do more to assist the efforts of individual governments. Under the leadership of Presidents Nelson Mandela and Thabo Mbeki, South Africa has been responding to the AIDS crisis and to their country's broader health care needs. As part of this response, the South Africa government has established a goal of providing access to adequate and affordable healthcare to all of its citizens. The Vice President personally supports this goal - as does the United States Government.

In 1997, as part of its effort to enhance health care for its citizens, the South African National Assembly passed an amendment to the Medicines and Related Substances Act of 1965. This Amendment was intended to help make medicines more affordable for South Africans. Unfortunately, the language of Section 15(c) gave rise to concerns that the law might be applied in a manner that, contrary to international agreements, would undermine intellectual property rights. The United States Government expressed its concern to the South African Government and sought a clearer understanding of how this legislation would be implemented.

As you know, there is a well-established international consensus for the need to extend appropriate protections to intellectual property, including pharmaceuticals. So our challenge - as part of our effort to provide not just treatment for AIDS, but ultimately a cure for AIDS - is to work to provide lower-price medicines without undercutting the intellectual property protection that led to the development of those medicines in the first place.

President Mbeki and the Vice President discussed this matter in August of last year. They agree - along with other officials of the U.S. and South African governments - that enhancing public health care and ensuring the supply of affordable medicines can and should be achieved in a manner consistent with these international commitments. As a result, Mr. Mbeki and the Vice President have agreed on a framework for resolving our concerns over section 15(c) that would include parallel importing and compulsory licensing, consistent with international agreements. Within this framework, we have asked our trade, health and intellectual property experts to do the technical fine-tuning necessary to define an agreement. Discussions have been slowed by pending litigation, but I believe an agreement along these lines is close at hand.

The Vice President will continue to encourage the Administration to consider a wide-range of views, perspective, and experience as it works toward resolution of this and related issues. He hopes to be able to work with you in building the world-wide partnership that can lead us to the end of this epidemic.


Leon Fuerth
National Security Advisor
to the Vice President