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
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
"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,"
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
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
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.