Why Africa Will Get AIDS Drugs at Giveaway Prices

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It may be motivated as much by enlightened self-interest as by altruism, but the decision by five pharmaceutical giants to slash the price of AIDS drugs in Africa has the potential to be an important milestone in the battle against the killer disease. Bristol Myers Squibb, Glaxo Wellcome PLC, Merck and Co., Boehringer Ingelheim GmbH and Roche Holding AG are set Thursday to announce a program negotiated with the United Nations to cut the price of AIDS drugs by as much as 90 percent on a continent where more than 23 million people are infected with HIV. The business context for that decision was highlighted by Wednesday's announcement of an executive order by President Clinton that Washington would refrain from enforcing U.S. patents on AIDS drugs in African countries battling the disease. That would leave those countries free to license or develop far cheaper generic versions of the patented drugs — already in Brazil, for example, a generic version of AZT sells for about 10 percent of the patented drug's price on the U.S. market — which pharmaceutical corporations fear could eventually eat into their global market share.

Despite the dramatic cuts, though, neither the corporations nor the U.N. are under any illusions that the cheaper drugs alone will solve Africa's AIDS crisis. Even at the new prices, long-term treatment therapies could cost as much as $150 a month per patient, which would leave them still beyond the reach of most of the continent's HIV sufferers. And the medical treatment and training infrastructure necessary for the complex drug regimens to function effectively will require billions of dollars of investment. And then there's the question of awareness: The World Bank estimates that only 5 percent of Africa's infected population are actually conscious of their HIV-positive status — which means they're not even seeking treatment — and many of the governments in the worst-hit areas have been slow to acknowledge the depth of the crisis. Still, even if easing the access to AIDS drugs in Africa initially benefits primarily the educated and middle class, it may play a decisive role in preventing the disease from destroying the people on whom the future of many African countries depend.