Russell Mokhiber and Robert Weissman

With

the announcement of a billion-dollar-a-year U.S. government loan program for

African countries to buy AIDS drugs, the fight to deliver affordable drugs to

people with HIV/AIDS in Africa and elsewhere in the developing world has entered

its third phase.

If

the drug companies’ current kill-them-with-kindness scheme fails, many of the

more than 20 million people with HIV/AIDS in Africa may finally receive access

to the treatments that could save their lives.

In

phase one of the dispute (Deny, Deny, Deny), the world’s leading drug companies,

through their pricing policies, simply refused treatment to people with HIV/AIDS

in Africa. With per capita incomes in many developing countries at less than a

dollar a day, people with HIV/AIDS were simply unable to pay the $12,000 a year

or so required for the AIDS drugs cocktails that enable many or most people with

HIV/AIDS in the United States to survive. If any developing country made noises

about finding ways to provide the drugs more cheaply, the U.S. government —

operating at the behest of the big drug makers — threatened trade sanctions and

forced them to back down.

In

phase two (Who Me?), the U.S. government resigned from its bullying role. AIDS

activists forced the Clinton administration to reformulate its policy,

culminating in an announcement that the U.S. government would not challenge

African countries’ efforts to make generic AIDS drugs available to their people,

so long as the countries complied with World Trade Organization rules.

Now,

in phase three, the industry and the Clinton administration are conspiring to

kill Africans with kindness.

Through

the United Nations, the industry has offered to provide discounted AIDS drugs to

Africa — but at prices that remain wildly inflated over the cost of production,

and far too high to be affordable by most Africans. Although no one seems to

know exactly what those rates will be, many published reports suggest discounts

will be in the 80 percent range. Such price levels almost surely will enable the

pharmaceutical companies to continue to profiteer from drug sales.

Then,

last month — in a move immediately denounced by a wide range of organizations

working on drug access and debt issues, including Doctors Without Borders, Oxfam

and the Health GAP coalition — the U.S. Export-Import Bank, a government

agency, announced it would loan a billion dollars annually to African countries

for the purchase of HIV/AIDS drugs.

The

high-interest Ex-Im loans would pile new debt obligations on African nations at

a time when existing debt burdens are undermining the countries’ ability to

prevent and treat HIV/AIDS, and when the AIDS epidemic is itself already

undermining their economic capacity to make interest payments on foreign loans.

The

African countries’ pain will be the drug manufacturers’ gain. The Ex-Im loans

are be used to buy drugs made by U.S. companies, apparently at the highly

profitable "discount" level provided to the UN.

Organizations

like Doctors Without Borders believe that efficient procurement of generic drugs

could drop the cost of HIV/AIDS medicines an additional 90 percent from the

estimated drug industry "discounts." That would put the cost of

combination HIV/AIDS drug therapies at approximately $200 per person per year.

The

most insidious aspect of the Ex-Im proposal is how it will work to preempt

efforts by African and other developing nations to lower costs through purchases

of generic versions of AIDS drugs

As

the New York Times reported, "It seems unlikely that Brazil, India or other

nations that produce such drugs for home consumption would have the export

financing available to help African nations buy the goods. The American loans,

along with a recent commitment by the World Bank to provide at least $500

million to help African nations set up anti-AIDS initiatives, give added

incentive to African nations to treat many of their AIDS cases with Western

medicine." ("Western" medicine means expensive, brand-name drugs,

as opposed to lower-cost generics.)

But

the momentum for African countries to buy generic versions of the drugs, or to

acquire the technology to make their own generics, may be too great for the

industry’s killer-kindness ploy to succeed.

Already,

South Africa and Namibia have reportedly indicated their refusal to accept the

Ex-Im loans, a welcome sign that African nations may be ready to take serious

measures — irrespective of the drug industry’s or the U.S. government’s desires

— to provide treatment to the horrifyingly large population with HIV/AIDS.

Russell

Mokhiber is editor of the Washington, D.C.-based Corporate Crime

Reporter. 

Robert Weissman is editor of the Washington, D.C.-based Multinational Monitor

and co-director of Essential Action, a corporate accountability group that is

part of the Health GAP coalition. 

Mokhiber and Weissman are co-authors of Corporate Predators: The Hunt for

MegaProfits and the Attack on Democracy (Monroe, Maine: Common Courage Press,

1999.)