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IN HIS CRAMPED OFFICE, situated off a courtyard on the grounds of Nakuru Provincial General Hospital in Kenya's Rift Valley, Sammy Kariuki counsels distraught souls who have been handed a death sentence: test results confirming they're HIV positive.
The work keeps him busy. In Nakuru, as in the rest of Kenya, the HIV/AIDS pandemic is exacting a horrific toll. In recent years, one in four expectant mothers in the Nakuru area has tested positive for HIV. Kenya, you'll hear it said in this nation of 30 million, buries 700 people a day because of AIDS. The East African nation has 1 million children who have been made orphans by the disease; that figure is expected to double by 2010.
But Sammy doesn't view his country's AIDS crisis in terms of these staggering numbers. He brings a personal knowledge to his vocation: Seven years ago he found out that he, too, belonged to the legion of the HIV positive. Today, he says, his clients draw strength from his example. "It creates hope that they can still live, can still make it."
Yet Sammy, like the people he counsels and like millions of other Africans, can't afford the antiretroviral drugs (which cost between $1,000 and $2,000 per year in Kenya) that can slow the progression of AIDS. And so as I wrap up my visit with Sammy, he asks for my notepad and writes down his contact information--so that if I learn of someone in the States who's able to send antiretroviral medicines, I'll know how to reach him, he explains. I respond with a feeble nod and take my leave.
Just days after I met with Sammy last month, it looked like the members of the World Trade Organization had beaten a fast-approaching deadline and worked out a deal to allow poor countries to disregard patents and import less-expensive generic drugs for treating diseases such as AIDS, tuberculosis, and malaria.
But at the last moment, the London Guardian reports, Big Pharma's hatchet man, Vice President Dick Cheney, stepped in to block the agreement--against the opposition of all 143 other members of the WTO. The White House said it generally supported the deal, but wanted to limit its scope to drugs for AIDS, TB, and malaria and not let poor nations use the agreement to gain access to a wider range of cheaper medications. Whatever the case, the likely upshot of the Bush administration's stonewalling is that life-saving and life-prolonging drugs will remain beyond the reach of many people in Africa, Asia, and Latin America.
In all fairness, it should be noted that it's not just Republicans who have been preventing poor people from getting medications they so desperately need.
The Clinton administration leaned on Thailand to put restrictions on its manufacture of generic drugs and ban their import. Thai doctors said those moves reduced the country's ability to fight AIDS. And then-Vice President Al Gore was dispatched to South Africa twice--in 1998 and again in early 1999--to pressure the South African government to rethink a law it passed in 1997 to enable import of cheap bulk drugs and compel domestic drug firms to produce generic versions of certain treatments. Several pharmaceutical multinationals filed suit against the South African government to protect their profits.
The Bush administration has kept up pressure on governments that incur the wrath of Big Pharma. In 2001, the United States filed a complaint with the WTO against Brazil, which had made the outrageous decision to offer free AIDS drugs to its citizens and was contemplating producing generic AIDS drugs and exporting some of them to Africa.
What have been the results of the United States' arm-twisting and foot-dragging on AIDS treatments? Brook K. Baker and Michael Hochman, in an excellent article last month in The American Prospect, report that of the 6 million people who should be on antiretroviral medications in the developing world, only 300,000 are; of those who are receiving antiretroviral therapy, a third get it through the Brazil program that Washington opposed.
Big Pharma and its army of apologists will tell you pharmaceutical companies spend billions a year on research and development, which will taper off if generic versions of their drugs are sold at low prices.
But under the cheap-drugs agreement the WTO was working on, cut-rate medicines would be sold only in countries that can't afford to buy them at current regular prices--meaning the pharmaceutical multinationals wouldn't see their markets shrink.
Another inconvenient fact Big Pharma has tried to bury all these years is that some of the most important drugs for fighting AIDS and AIDS-related illnesses--such as ddI, ddC, Taxol, and Norvir--were developed by the National Institutes of Health or with other federal assistance. Private firms were subsequently granted marketing rights to these drugs. In other words, the pharmaceutical companies are all for socialism when it comes to financing R&D, but they're free-market fundamentalists when it's time to reap the profits from drugs U.S. taxpayers paid to create.
Their vaunted free market, however, has failed the world's poor and sick--and not just those with HIV/AIDS. There are more malaria deaths today than there were 40 years ago, and TB cases are increasing at a rate that will leave 35 million people dead of the disease over the next decade, according to Doctors Without Borders. Yet R&D into new medicines for malaria and TB are "woefully inadequate," the Nobel Peace Prize-winning group contends.
A few of the biggest pharmaceutical companies cut the prices of their AIDS treatments to polish their image after the South African lawsuit. But antiretroviral drugs remain way too expensive for people like Sammy and are beyond the means of African governments that would have to buy millions of the pills each day to treat all of their HIV-positive citizens. And though the governments of the wealthy nations have made a commitment to help poor countries purchase badly needed medicines to treat AIDS, TB, and malaria, so far they've ponied up only a sliver of the $7 billion to $10 billion needed annually just to combat AIDS.
Right after the breakdown of the WTO talks last month, the Bush administration announced it would refrain from filing suits against countries that export generic drugs to poor countries in violation of patent restrictions.
That's a laudable gesture (even if it was perhaps an exercise in damage control), but both the Bush and Clinton administrations--not to mention the pharmaceutical companies--have spent the better part of a decade working to keep life-sustaining drugs out of the hands of countless numbers of people. Such sins are not so easily absolved.
RICK MERCIER is Viewpoints editor for The Free Lance-Star. His visit to Kenya was made possible by a World Affairs Journalism Fellowship awarded by the International Center for Journalists. The fellowship program is funded by a grant from the John S. and James L. Knight Foundation.