Saving Grace 
Defeating Aids needs a global approach 
Leader
Tuesday February 18, 2003
The Guardian 

There is another war to fight, but few appear ready to pick up weapons for the cause. Ranged against some of the poorest people in the world is a determined killer which is slowly claiming millions - and the list of its potential victims is getting longer. Aids is a disease that is turning back the clock in many countries. Nations which should be seeing life expectancy going up, instead witness lives cut short. In others more teachers are dying each week than can be trained. The shadow cast on Africa has seen more than 2 million people die in the last year. Three of the world's largest countries, India, China and Russia, are on the edge of outbreaks that, if not tackled, will dwarf the scale of the current crisis, which already affects 40 million people. There are many roots, but where there is destruction there should now be salvation. 
With the Guardian today is a supplement, Saving Grace, which poses the question: why can the poor not get the drugs to live with Aids when the rich can? The Grace in the headline is Grace Matnanga, a 30-year-old shoeseller with HIV. She has already lost her husband and child to the disease but cannot afford the $28 a month for pills to treat her condition. There are no easy answers. Poor nations often have too small a health budget. Developing countries do not have enough doctors and nurses. Diseases are shaped by human behaviour and many politicians have not said loudly enough that prevention would be more effective than cure. But, running through the debate, is an argument which pits the rich world against the poor and asks for sacrifice from the drugs industry to save lives. Asking pharmaceutical companies to forgo profits is a request that until recently dared not speak its name. High prices, said the firms, are needed to develop new drugs. 
This argument faltered, partly because the price of medicines matters in the war against want, but mostly because it was the wealthy world which saw new treatments appear. Though under pressure from domestic lobbying, the pharmaceutical industry remained reluctant to cater for customers without the income to pay for drugs costing millions of dollars to develop. This became increasingly untenable as profits rose in London and New York and bodies fell in sub-Saharan Africa. Competition from copycat drug producers such as the Indian chemical firm Cipla has also helped to lower prices. GlaxoSmithKline's HIV drug treatment used to cost $12,000 a year. It is now priced at $727, still more than double Cipla's alternative, World Health Organisation-approved, remedy. Even this exceeds current per capita health spending in low income countries, which average $23 a year. So aid from rich countries will be required to buy medicines to cope with epidemics that threaten to overwhelm nation states. 
It is encouraging that money is forthcoming, especially from George Bush, who last month pledged $15bn over the next five years. It is less inspiring to see this cash bypass UN attempts to fight Aids, thereby undermining it. Even worse is Mr Bush's sabotaging of global trade talks. These were designed to allow poor countries to import cheap drugs in the event of epidemics. This was to be a significant victory for the developing world, acknowledging that patent rules created for today's rich nations should not apply to countries whose income is only that of early 19th-century Britain. Yet this has not happened. Firms which lavished the US Republican party with $63m worth of donations have Mr Bush fighting their corner, not the poor's, in trade negotiations. Aids is not the only illness that can be alleviated by access to cheap medicines. Respiratory tract diseases such as bronchitis affect the elderly in the developed world but end the lives of 1.5 million children in the developing world before their fifth birthdays. Yet continuing protection for pharmaceutical firms will stop cheaper generic treatments emerging, and deny drugs to the poor that are available to the rich. Unlike Aids, many diseases have cures, and the moral imperative to do something is greater. The solution for salvation is not unattainable, but it will be made harder unless both the US and the global responses get more generous. 
[http://www.guardian.co.uk/aids/story/0,7369,897818,00.html]