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March 24, 2006
White House and Interfaith Center on Corporate Responsibility Address Pediatric AIDS
    by Bill Baue

Bush Administration launches a new public-private partnership on Pediatric AIDS, an area where ICCR engages pharmaceutical companies in shareowner advocacy.

A pregnant woman in Cape Town, South Africa recently asked Babalwa Mbono to tell her family she is infected with HIV. Ms. Mbono is a senior site coordinator for Mothers 2 Mothers 2 Be (M2M2B), an organization that connects HIV-positive mothers to HIV-positive pregnant women. Far from the rejection the young woman expected, her family instead praised her courage--her five older brothers and sisters all admitted that they were hiding their HIV-positive status as well!

Ms. Mbono recounted this story at the White House last week during the launch of a new public-private partnership on pediatric AIDS treatment to illustrate how the stigma against HIV in South Africa can prevent women from seeking treatment to minimize chances of infecting their babies. The partnership, part of the President's Emergency Plan for AIDS Relief (PEPFAR) launched in 2003, links the US government with innovator and generic pharmaceutical companies as well as with the multilateral organizations UNICEF and UNAIDS.

"Today, we further our commitment to helping children with a new pediatric AIDS treatment initiative--a groundbreaking and historic alliance," said First Lady Laura Bush, who met Ms. Mbono during a visit to South Africa last July. "This alliance between public and private partners will promote better, more effective treatments for children living with HIV/AIDS"

Interestingly, all six innovator companies have been engaged on the issue of pediatric AIDS by the Access to Healthcare Working Group of the Interfaith Center on Corporate Responsibility (ICCR), a coalition of 275 faith-based institutional investors that conduct shareowner advocacy. ICCR members have dialogued and filed shareowner resolutions with Abbott Laboratories (ticker: ABT), Bristol-Myers Squibb (BMY), Gilead Sciences (GILD), GlaxoSmithKline (GSK), Merck (MRK), and Pfizer (PFE).

"ICCR members see the ravages of HIV and AIDS in their daily work in Africa, India, and China," said Sister Vicki Bergkamp of the Adorers of the Blood of Christ and chair of ICCR's HIV/AIDS Caucus. "Our experience on the ground in these regions has convinced us that leading pharmaceutical companies can--and must--do more to make their life-saving products accessible to the people who desperately need them."

ICCR focuses on advancing three core objectives regarding pediatric HIV/AIDS and the antiretroviral (ARV) drugs used to treat its symptoms: reduce, research, and register.

"First, drug companies should commit to holding pediatric prices at adult prices--right now pediatric drugs are more expensive than adult drugs," said Lauren Compere, chief compliance officer of ICCR member Boston Common Asset Management.

According to Doctors Without Borders, second-line ARVs cost almost three times as much per year for children ($3150) as for adults ($1096). And according to information distributed at the White House event, the US Food and Drug Administration (FDA) has approved for use by children under two years old only a third (7) of the 21 ARVs approved for adult use that the innovator companies produce.

"Without treatment, mortality approaches 60 percent in the first two years of life, whereas children who get ARVs can lead healthy lives," said Dr. Shaffiq Essajee of the AIDS Research and Family Care Clinic in Kenya to ICCR Access to Healthcare Director Dan Rosan. "That means, in plainer English, that over half of kids with AIDS are dead by age two, unless they get ARVs," Mr. Rosan added.

According to UNAIDS, every single day 1,350 children with HIV die and 1,900 children become infected with HIV--a vicious cycle.

The second of ICCR's policy recommendations to pharma companies is to direct research energies to develop pediatric formulations including chewable tablets, fixed-dose combination syrups, and smaller pills, as well as conducting more research on dosing.

"Any research in pediatric formulations also needs to address the real-world issues of little or no refrigeration or clean water sources in the areas most impacted by HIV/AIDS," Ms. Compere, who attended the White House event along with other ICCR representatives, told "And third, all ARV drugs in all formulations should be registered in all countries."

ICCR notes that pharma companies have failed to register all available dosages and formulations of their products with national drug regulatory agencies, making price discounts offered to least developed nations illusory because unregistered drugs cannot be prescribed. ICCR also chides pharma companies for limited action on voluntarily licensing and patent relaxation, both of which would greatly increase accessibility of ARV drugs. Of the six innovator pharma companies, only GlaxoSmithKline and Lilly have voluntarily licensed their ARVs to generic producers, and only Bristol-Myers Squibb has promised generic companies it would not enforce its patents on ARVs in sub-Saharan Africa.

While ICCR applauds the pharma companies for differential pricing (charging lower prices in markets with reduced abilities to pay), it criticizes them for limiting this program geographically to sub-Saharan Africa.

"It is clear that poor patients in Haiti or Thailand have the same right to medicine as those in Mozambique," stated Mr. Rosan.


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