AIDS Drugs Not Enough

The Philadelphia Inquirer


While modern medicines can perform near miracles, even the newest and best drugs alone aren’t enough for a crisis as serious and widespread as the tragedy of AIDS in Africa.

Nonetheless, the pharmaceutical industry has become the target of activist groups and governments who claim drug companies are the villains and could solve the problem if only they gave their drugs free to the millions of victims.

The problem is much deeper, unfortunately, and rooted in poverty and culture. Taking and monitoring the combined AIDS drug therapies properly can be a full-time occupation, even with close physician supervision. Even when the drugs are donated, African countries and international relief agencies lack the resources and infrastructure to distribute, much less to monitor, drug treatment for even a fraction of the tens of millions of people infected with the AIDS virus.

The South African government acknowledged as much last week. The government and the drug industry had been locked in a court battle over a South African law passed in 1997 allowing the country to ignore intellectual property rights to make and buy cheap copies of patented AIDS drugs.

Outside the courtroom, companies offered to provide deep discounts on AIDS drugs in heavily stricken sub-Saharan Africa, selling the drugs at pennies above manufacturing costs in return for maintaining critical patent protection. Other companies offered to give away their drugs.

But that wasn’t enough. Last week, the companies agreed to settle the suit after scathing public pressure and after the U.S. government had said it would not back the companies in defending their intellectual property rights.

Yet a day after the court settlement was announced, the South African government said it had no plans to obtain the anti-retroviral drugs and had no immediate plans for obtaining or distributing them.

Both the companies and the countries know the solution is more complicated than loading boxes of medicine onto an airplane. Drugs alone aren’t enough.

The South African government won its case on principle and in the process undermined the very reason that the drugs even exist.

One of the most important advantages that the United States provides to research industries is strong patent protection. The research-based pharmaceutical industry relies on this to guard its intellectual property, in which it can invest $600 million to develop a single new drug.

But instead of defending patent rights, the Clinton administration announced last year it would turn the other way when other countries make cheap copies of the patented drugs. Not wanting to face the political pressure, the Bush administration did not challenge the Clinton order.

When the U.S. government doesn’t help U.S. companies to protect their intellectual property, fewer of the new miracle drugs that the world both wants and needs will be created. And if our government capitulates on drug patents, can other technologies be far behind?

There is yet another reason the United States is in the crosshairs of this problem. We are the only major developed nation that does not have a dominant government-run health-care system, and as a result we don’t have a universal system of price and utilization controls on pharmaceutical products. But this means that U.S. consumers often pay a disproportionate share of the research and development costs for new drugs.

While European nations point the finger of blame at the United States, they should look at their own cultures of cost containment that keep prices and utilization artificially low and force other countries to pay more than their share. Yes, the United States can afford to pay more, but so can many other countries and they should share the burden.

U.S. consumers already are subsidizing the development of the new drugs that help alleviate the suffering of patients in the lesser-developed countries; if we didn’t pay the prices that permit the research to continue, there would be fewer new drugs available.

Instead of spending so much time pointing the finger of blame, companies and countries should work together to get a more precise diagnosis of the problem and then bring their best resources together toward solutions.

Health education and a better health-care infrastructure are needed in Africa, and public policies that protect intellectual property and lift price controls are needed in developed countries. Drugs alone aren’t enough.

Grace-Marie Arnett is president of the Galen Institute, a not-for-profit public-policy research organization based in Alexandria, Va., that focuses on free-market ideas for health reform.

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