Timidity on AIDS
3 April 2001
The past month has brought a welcome shift in the pharmaceutical industry's attitude to AIDS in poor countries. Having long resisted pressure to provide AIDS drugs at a discount, the industry has reconsidered in the face of adverse publicity and competition from cheap generic drug makers in Brazil and India. Last week Merck Co. agreed to cut by two-thirds the cost of two AIDS medicines in Brazil, which may save Brazil's government $39 million annually. Earlier in March, Merck made a similar offer to Africa and another firm, Abbott Laboratories, said it would sell two AIDS drugs and its HIV diagnostic test at no profit to the continent. Meanwhile Bristol-Myers Squibb has offered Africa two drugs at prices below the cost of manufacture. The industry needs to move further. Some firms, notably Pfizer Inc., have yet to offer serious discounts. Moreover, previous encouraging announcements have proved less significant than they seemed; the drug makers attached so many conditions to the new prices that they made almost no difference. This may prove true again. Abbott, for example, says it will only offer its drugs after negotiating with each country that wants them, which threatens lengthy delays, and the company has not spelled out its definition of "no profit." In contrast to the more encouraging statements from Bristol-Myers, Abbott wants to condition its discounts on undertakings by recipients to forswear generic drug imports. Still the industry is getting to the point where responsibility for the next step will fall to the Bush administration and other leading governments. Even at new reduced prices, the cost of AIDS drugs exceeds the ability of poor countries to pay, and the cost of the clinics and training necessary to deliver the drugs makes the challenge even tougher. The United Nations recently called for developed countries to provide between $7 billion and $10 billion toward the cost of treating AIDS. That is not very much next to the cost of fighting other big threats to global security, and yet there is little sign that industrialized countries are responding. The nearest thing to a response has come from Italy, which has proposed that governments and private donors create a trust fund of $1 billion or more to fight AIDS and other killer diseases. But it is not clear that this idea has the support of the U.S. administration. Secretary of State Colin Powell has spoken out about AIDS, but the new National Security Council is less focused on the issue than the previous team. And the administration is said to be considering an increase in its $370 million global AIDS budget of perhaps 10 percent. That would represent only one dollar for each case of HIV. The administration should be bolder. - THE WASHINGTON POST.