The Wall Street Journal - November 29, 2000
Rachel Zimmerman, Staff Reporter

The announcement comes at the same time that the United Nations and World Health Organization reported the latest global toll from HIV/AIDS. The report said that in sub-Saharan Africa, the hardest-hit part of the world, there were 3.8 million new HIV infections this year, bringing the number of people with HIV in the region to 25.3 million, or 70% of the adults world-wide living with HIV.

The Pfizer drug giveaway also comes as activists continue to press pharmaceutical companies to respond to this growing health crisis by significantly reducing the prices of their AIDS medicines. In releasing the new HIV/AIDS statistics, Peter Piot, executive director of UNAIDS, said only limited progress has been made in negotiations with several other major drug makers that had offered to slash their prices in May.

Even so, Dr. Piot said reduced prices "are not going to solve the problem." He added: "Let's remain realistic," noting that even if the drugs were provided without charge, "the economics and infrastructure" in these nations "are severely handicapping us in our efforts."

If Pfizer's offer is accepted by South Africa, it will represent an important concession by a drug maker, but it probably won't end sharp criticism of the company. As part of the deal, Pfizer is expected to provide its antifungal drug, Diflucan, without charge to treat people with cryptococcal meningitis, as well as a form of meningitis of the esophagus resulting from thrush, which affects 20% to 40% of all people with AIDS.

But activists in South Africa and the U.S., along with international health advocacy group Doctors Without Borders, called the Pfizer offer, coinciding with World AIDS Day this Friday, a public-relations ploy that will produce a limited benefit. "We do not accept [the deal] on the terms it is presently being made," said Mark Heywood, deputy chairman of the South Africa-based AIDS activist group Treatment Action Campaign, which has campaigned since last year to get Pfizer to reduce the price of Diflucan.

Speaking from Johannesburg, Mr. Heywood noted that Pfizer will probably impose restrictions on the donation, such as which doctors can prescribe it, and, therefore, access will be severely curtailed. "Even if the agreement is signed Dec. 1, it won't result in pills being made available to all," Mr. Heywood said.

A spokesman for Pfizer, which disclosed its plans to donate Diflucan in March, said the company is continuing to work closely with the South African Ministry of Health and hopes for an announcement shortly. The company confirmed its intention to offer the drug to a smaller patient population in March but has been locked in negotiations since then. A ministry official said the government won't comment on details of the agreement until later this week.

However, people familiar with the negotiations said the New York pharmaceutical company is planning to donate $50 million, or about a two year's supply, of Diflucan to the South African government. Activists said Pfizer's offer is limited because the free drugs are expected to be available only to patients treated by government programs and not by private doctors or nongovernmental organizations.

The value of the giveaway is based on a reduced price that Pfizer is currently charging the South African government of about $4 a pill. The retail cost of the drug in South Africa is about $12 to $13 a pill. Nonetheless, the activists say that even at $4 a pill, Pfizer is still selling the drug at a sizable profit, noting that a generic manufacturer in Thailand sells each pill for significantly less, about 29 cents a pill.

The Pfizer controversy in South Africa and the release of the latest AIDS data are expected to renew pressure on the drug makers that have yet to finalize their offers made earlier this year. Dr. Piot said one company, Boehringer Ingelheim Gmbh of Germany, has provided free nevirapine to the Republic of Congo to help prevent the transmission of the virus from pregnant women to their babies. Also, the United Kingdom's Glaxo Wellcome PLC has reached an agreement with Senegal to cut the price of its two AIDS drugs to between $950 and $1,800 a year, down from about $10,000.

But Anne Kaninda, medical adviser for Doctors Without Borders, said the drug companies haven't done enough. "We are calling on the drug companies to immediately reduce the price of AIDS drugs by 95% by the first week of 2001," Dr. Kaninda said. She said her organization will lobby Glaxo Wellcome to sell its two AIDS drugs, AZT and 3TC, for $1 a day, even lower than the price it is offering to Senegal. She said Bristol-Myers Squibb Co. of New York should charge 49 cents a day for its drug, D4T, and Merck & Co., New Jersey, should charge 65 cents for efavirenz.

Overall, the UNAIDS report said, 5.3 million people were newly infected with HIV this year and 36 million are infected world-wide, up from 34.3 million last year. Since the epidemic began, 21.8 million people have died of AIDS, including 4.3 million children. In Africa alone, 2.4 million people have died from AIDS this year, up from 2.2 million in 1999.

While sub-Saharan Africa continues to be the most ravaged region, the former Soviet bloc is a growing trouble spot. UNAIDS said it expects the number of HIV cases to rise 60% this year in that region, with 250,000 new cases in Eastern Europe and Central Asia, bringing the total number of cases to 700,000, mostly caused by intravenous drug use.

"In Eastern Europe, what we predicted and feared is now happening," said Dr. Piot. "An explosion of HIV."

Write to Rachel Zimmerman at rachel.zimmerman@wsj.com3
001129
WJ001102

Copyright © 2000 - The Wall Street Journal. Reproduction of this article (other than one copy for personal reference) must be cleared through the WSJ Permissions Desk.

Always watch for outdated information. This article first appeared in 2000. This material is designed to support, not replace, the relationship that exists between you and your doctor.

AEGiS presents published material, reprinted with permission and neither endorses nor opposes any material. All information contained on this website, including information relating to health conditions, products, and treatments, is for informational purposes only. It is often presented in summary or aggregate form. It is not meant to be a substitute for the advice provided by your own physician or other medical professionals. Always discuss treatment options with a doctor who specializes in treating HIV.

Copyright ©1980, 2000. AEGiS. All materials appearing on AEGiS are protected by copyright as a collective work or compilation under U.S. copyright and other laws and are the property of AEGiS, or the party credited as the provider of the content. .