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Pfizer Puts 'Life Before Profit' with New AIDS Clinic


KAMPALA, Jun 11 (IPS) - After their shaming in the South African courts, the multinational drug companies are doing their best to prove that they do put 'life before profit'.

US pharmaceutical giant Pfizer is spending 11-million-dollar funding -- the first large-scale state-of-the-art HIV/AIDS clinic in Africa, which opens in Kampala, the capital of Uganda, in late 2001.

Each year, 80 clinicians, including medical practitioners, nurses, lab technicians and counsellors will come from all over Africa to receive training.

They will learn about diagnostics, treatment and management of Aids patients - including the latest anti-retroviral (ARV) drugs - so that they can return home to train others.

The costly ARVs, or protease inhibitors, are combined with anti- fungals and other drugs that fight Aids-related opportunistic infections.

Less than one per cent of Ugandans can currently afford these drugs, which cost around 1,000 dollars a year. The clinic will be contacting all the major drug companies to ask for donations or reduced cost supplies of ARV drugs so that patients will only have to pay a token amount for treatment.

"We are not just going to use the one drug from Pfizer. We need a cocktail of drugs. This centre gives opportunity for all the drug companies to contribute towards the Aids care that is going to be based at this institution. We need ARVs from all these various companies," says Dr. Nelson Sewankambo, a member of the Academic Alliance for AIDS Care and Prevention in Africa that came up with the idea for the clinic.

The Alliance, headed by Dr Merle A. Sande from the University of Utah in the United States, will build the centre at Makerere University Medical School, and will be run by an advisory board of Ugandan Aids experts.

Alliance plans to treat 50,000 people over first two years.

The clinic will also be looking for cheaper and simpler ways to administer ARV drugs to Africans living in rural areas. Drug companies have long argued that there is no point lowering their prices as most African countries lacks the infrastructure to administer them safely and effectively.

Dr Sewankambo says they will be looking for ways to get round the expensive laboratory tests that are used in Europe and America. Patients' blood levels have to be measured every one to three months to make sure that the drugs are not harming them.

"The standard approach requires careful monitoring by measuring blood levels for various cells. Giving ARVs up to now requires complicated very costly laboratory tests which include viral loads estimation as well as determination of CD4 cell levels," he says.

CD4 are cells that circulate in our blood. When CD4 cell levels fall, patients become sick, as they are immuno-depressed.

"We know that is a handicap for our communities where the capacity to do those blood tests is not readily available. That is why is it critically important that one looks at how else you monitor a patient who is taking drugs to ensure that there is no toxicity or if there is toxicity it is easily identified and appropriate measures taken," says Dr Sewankambo.

"The question is whether we can still deliver high quality care to these patients without necessarily doing so much of these expensive laboratory tests.

There might be cheaper ways of doing these various dimensions, particularly CD4. We want to find out so that they are readily accessible to the majority of our people," says Sewankambo.

"The state of the art clinic gives us the standard against which we may be able to assess other approaches which may not involve very complicated and very frequent lab testing," he says.

Alliance hope to expand their service to rural areas through satellites or existing health clinics. But this will not be without further hurdles.

"We need to look at how to deliver treatment to patients wherever they are in the countryside. People are often far from various health clinics. How can we deliver treatment to those people who are far away? How can we ensure compliance with prescriptions? Because we know taking treatment daily and several times a day is not easy," says Dr Sewankambo.

Drug companies are making an effort to demonstrate a sense of social responsibility in the wake of widespread criticism that they put profit above life by refusing to lower their drug prices.

Pfizer also recently announced that it would be providing free and unlimited supplies of its drug Diflucan to the world's 50 poorest countries. Diflucan is an anti-fungal drug used to treat cryptococcal meningitis, a potentially fatal brain affliction that affects 10 per cent of Aids sufferers.

"I think they are doing it probably for their image partly," says Dr Sewankambo.

"But also I think drug companies are changing their attitude in that they want to do good for mankind, given the accusations that they've been just exploiting populations by charging their drugs so highly. They are beginning to change their attitudes and therefore will want to do more good that anything else." Paula Luff, director of Pfizer's International Philanthropy division, says the company has been involved in philanthropy since it was founded in 1849.

"On the US front, we have a number of access programmes as well as grant programmes in the areas of health and education. And on the international side we began to work in international health in 1996 when we founded the international trachoma initiative. This Kampala clinic is really part of our evolving programmes in global philanthropy," she says.

Luff says Pfizer chose Uganda because of its excellent record in tackling the HIV/Aids pandemic. "We felt that Uganda was a great place to work. The partners at Makerere University and the Academic Alliance are very experienced, very strong. And Uganda has done really an amazing job of dealing with the Aids epidemic from the beginning. And so we felt that supporting something in Uganda might serve as a model for other countries," she says.

An estimated 820,000 people are living with HIV/AIDS in Uganda, a country with a population of 23 million. The adult prevalence rate is now about eight per cent.

Analysts say the opening of the clinic indicates that multinational drug companies are accepting as inevitable that prices will have to come down so that ARVs are accessible to some 25 million HIV positive Africans.


Copyright © 2001 -Inter Press Service, Publisher. All rights reserved to Inter Press Service. Reproduced with permission.Reproduction of this article (other than one copy for personal reference) must be cleared through the Inter Press Service, IPS-ONLINE, World Desk via Panisperna 207 00184 Rome, Italy. Email IPS visit Inter Press Service.

Information in this article was accurate in June 11, 2001. The state of the art may have changed since the publication date. This material is designed to support, not replace, the relationship that exists between you and your doctor. Always discuss treatment options with a doctor who specializes in treating HIV.