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December 01, 2006
Pharma Companies Need to Keep Improving AIDS Response, Says ICCR and Nigerian Doctor
    by Bill Baue

Chukwumuanya Igboekwu of Physicians for Social Justice adds his own critiques to the Interfaith Center on Corporate Responsibility study on pharmaceutical industry shortcomings in addressing AIDS.

Underscoring the gravity of the HIV/AIDS pandemic on this World AIDS Day is the release earlier this week of a study estimating that AIDS will move from fourth to third among top causes of death worldwide in the next quarter century, with almost 120 million deaths projected. Increased access to antiretroviral (ARV) drugs could help slice a quarter of this number, bringing global AIDS deaths down to 89 million. Future outcomes depend on what the international community does in the present, according to Colin Mathers, who co-authored the study with World Health Organization (WHO) colleague Dejan Loncar.

What is happening currently to increase ARV access? In August 2006, the Interfaith Center on Corporate Responsibility (ICCR) produced the most thorough study of pharmaceutical company action on HIV/AIDS, documenting how the industry falls significantly short of best practice. ICCR, a coalition of 275 faith-based institutional investors and socially responsible investing (SRI) firms, recently reviewed pharma company action since the release of the report, and found real progress on some fronts, but little movement on other fronts.

On the progress side, pharma companies have increased licensing and technology transfer to generic drug companies and lowered some prices of life-saving medicines. On the stagnation side, ICCR found little improvement in the availability of pediatric ARVs, struggles over ARV access outside sub-Saharan Africa as the pandemic spreads, and lack of board-level attention to these pressing issues.

The very publication of the report likely prompted what progress occurred, according to Chukwumuanya Igboekwu of Physicians for Social Justice (PSJ) in Nigeria, home to 4 million HIV-positive people with only 50,000 of them having access to ARVs as of 2005.

"The report has created positive effects--some of the companies are beginning to listen to advocates saying, 'You cannot put your profit before public health,'" Dr. Igboekwu told Dr. Igboekwu is currently a fellow in the Human Rights Advocates Program (HRAP) at Columbia University. "The report has put pharmaceutical companies in the spotlight and forced them to react to it."

The Business and Human Rights Resource Centre posted the report along with company responses to it on its website. It recently added a paper by Dr. Igboekwu in which he identifies patent protection under the World Trade Organization Trade-Related Intellectual Property Rights (TRIPS) agreement as a persisting problem in pharma companies' response to AIDS.

"The net effect of TRIPS is its success in effectively blocking the availability of cheaper generic medicines," Dr. Igboekwu wrote. "By blocking access to life-saving medicines for millions of people all over the world, pharmaceutical companies and the governments who support them are in gross violation of international human rights law."

Dr. Igboekwu cites the case of Novartis (ticker: NVS) filing a lawsuit in India to protect patents covering certain of its cancer drugs from infringement by generics.

"Knowing full well that India supplies the bulk of generic drugs to most developing countries, Novartis aims to sever the pharmaceutical supply lifeline of these nations," he wrote in his paper. "The outcome of that suit is going to set precedent over whether these countries are going to have access to cheaper drugs or not," he told

The Business and Human Rights Resource Centre posted a response to this paper from Novartis in which the company points out that Novartis provides the cancer drug in question for free to 99 percent of all patients receiving the medicine in India.

"On the other hand, the generic versions of Glivec in India are priced at approximately 4.5 times the average annual income, putting them out of reach for most patients," states Novartis. "Clearly, this example illustrates that generics do not, and will not, sufficiently address the need for access to Glivec or other life saving medicines in many countries."

Dr. Igboekwu generally praised philanthropic efforts of pharma companies, but criticized the model's lack of sustainability.

"If somebody has AIDS and is on antiretroviral medicines, he is going to need that drug for the rest of his life--what if after five years, a new management comes on board and decides to stop the program?" Dr. Igboekwu asked. "The long term solution is for them to start looking at ways of reducing the price of these products."

Dr. Igboekwu also pointed to another solution: ignore intellectual property laws.

"Brazil offers universal antiretroviral therapy for all citizens because they have simply refused to obey patent laws--they argue that this is a national security issue," he pointed out, while noting the political reality that most developing countries cannot be so bold. "We have about 600,000 people who urgently need ARV medications in Nigeria, but the government is still struggling to offer 250,000 people with treatment because of the simple fact that some of the ARVs are too expensive."

Novartis chafed at the notion of flouting intellectual property law.

"We do not believe that denying patent protection for innovative medicines and promoting unlawful generic production and use in developing countries will help patients or increase their access to treatment," the company stated.

For Dr. Igboekwu, it boils down to prioritizing human rights.

"I started working in human rights advocacy because of the frustration I felt over having patients living with HIV that I couldn't help," he told "I was trained as a physician to save lives, not to watch people die."


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