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ANALYSIS-S.Africa drug case highlights AIDS tragedy
Steven Swindells
March 7, 2001
JOHANNESBURG, March 7 (Reuters) - An angry face-off over patents between the world's biggest drug firms and the South African government has turned attention back to the desperate plight of the millions of Africans with AIDS.

Thirty-nine of the largest pharmaceutical firms began a court challenge this week against legislation that would allow Pretoria to import generic AIDS drugs at a fraction of the price charged by the major drug makers.

The case has been delayed to allow activists, who say the pharmaceutical industry is growing fat on the fruits of human misery, to present evidence of the terrible cost of AIDS and to allow the drug firms to prepare an answer to that testimony.

Drug companies say their patent rights are protected under the South African constitution and a vital source of funds for future research. They say firms have already offered cut-price AIDS drugs to African governments.

What is not in dispute is that in Africa, the poorest continent where most people earn less than the cheapest dollar-a-day cost of HIV treatment, HIV-AIDS threatens most cruelly to destroy the social fabric.

The United Nations estimates that 25.3 million people are living with HIV-AIDS in sub-Saharan Africa and that close to 2.5 million Africans died of the disease last year.


The landmark case in the Pretoria high court was postponed on Tuesday to April 18 to allow testimony by the leading AIDS activist group, the Treatment Action Campaign (TAC).

TAC and government lawyers are expected to give moving testimony on how drug pricing policies have deprived people suffering from AIDS of a chance of living longer.

Stakes in the case have risen since Kenya announced on Tuesday it was introducing legislation to import generic AIDS drugs -- exactly the domino effect the drug companies fear if South Africa gets the go-ahead to import cheaper generics.

Drug companies have been acutely aware of the potential damage if public opinion blames them for failing to help to fight AIDS.

Hundreds of thousands of HIV-positive orphans are the tragic legacy of a disease that will curb population growth, destroy prospects for economic growth and even threaten food security.

U.S. drug maker Merck and Co Inc on Wednesday said it was slashing the price of two key AIDS drugs in developing countries.

Behind staggering statistics are endless cases of abject human misery and grinding poverty where few suffers can afford blankets, let alone drugs to deal with the disease.

From Botswana to Zimbabwe and Kenya, AIDS has unleashed the biggest health crisis Africa has seen in modern times.


At 35.8 percent, Botswana's is the highest HIV prevalence rate in the world, reducing life expectancy to 44 years from 69 and expected to leave one in five children orphaned by 2010.

African governments have been slow to move against the disease and few if any can afford to deal with what threatens to emerge as an AIDS pandemic over the next ten years.

Meanwhile, hospitals across the continent are beyond breaking point, their rickety beds packed with victims living final tragic days ostracised and beyond the help of drugs.

South Africa, with the continent's most advanced economy, has been unable to deal with what is now developing from an HIV epidemic to a full-blown AIDS crisis.

"The flood is coming. The number of people falling ill and dying is increasing dramatically. Two years ago, that was not the case," said Alan Whiteside, an AIDS authority from the University of Natal in Durban.

Whiteside, who works in the most badly affected province of KwaZulu-Natal, warns South Africa is now experiencing a major upturn in AIDS deaths after HIV spread like wildfire over the last 10 to 15 years. HIV rates in the province are 33 percent.

Official estimates put the number of South Africans with HIV at 4.2 million, or one-tenth of its people. This compares to an infection rate of around 0.6 percent in the United States.


"It's quite frightening. We're now getting increasing numbers of mothers from the townships who are HIV-positive," said Colleen Jacob, manager of home-based care at South African Red Cross Society.

Jacob's patients are nursed on the floor in shacks outside Cape Town made of wood and metal. The fortunate ones get blankets and a food parcel that will last up to five days.

The Pretoria judge's decision to admit the aids activists' testimony has been welcomed by aid groups because the drug companies will have to respond in detail to each of the TAC's arguments on patent abuse and pricing policies.

Aid groups say this is an unprecedented opportunity to understand how drug firms price their drugs.

"It's going to open up a Pandora's box. For the first time the drug firms have a responsibility to open their books," said Matthew Grainger with the British charity Oxfam.

"It's going to open up the issue of who actually funded the initial research into AIDS drugs, which was done with public funding, to the economics of the industry," he said.

The TAC has already identified and campaigned against four firms it says earned excessive profits from patented AIDS drugs.

They are Pfizer's fluconazole drug, Bristol Myers Squibb's ddI and d4T, GlaxoSmithKline's ABC, 3TC and AZT and Boehringer Ingleheim's nevirapine treatment.

Medecins sans Frontieres has estimated that if South Africa were to import generic versions of Pfizer's fluconazole from Thailand, the cost of treating 10,000 patients would fall to $2.1 million a year from $34.8 million.