New advocacy coalition demands emergency funding from rich governments for Global Fund
A coalition of public health advocacy organisations has announced the launch of “Fund the Fund,” a campaign to pressure governments of wealthy countries to contribute resources to the Global Fund to Fight AIDS, TB, and Malaria.
The advocates say that none of the world’s wealthiest governments has contributed an amount on par with the size of their economies. Instead, the US, Japan, France, Germany, Britain, Canada, Italy, and other countries have all given far less than their fair share.
Forty representatives from non-governmental organisations and activist groups from Europe, US, Japan and Canada held a two-day summit in Paris in March. The meeting heard that the Global Fund was facing a budget shortfall of $1.6 billion to meet the anticipated need in the third round of grants in October. Launched in January 2002, the Global Fund has disbursed $1.5 billion in grants to 160 programmes in 85 countries.
“People with AIDS and their advocates – at the frontline of the AIDS crisis – and Fund the Fund, will not allow the rich governments of the world to walk away from the Global Fund and betray the hopes of the 42 million people now living with HIV/AIDS,” said Khalil Elouardighi of ACT UP-Paris. “Heads of state must not turn their backs on millions of people in need only two years after authorising the Fund’s creation at the G8 summit in Genoa in July 2001.”
The meeting in Paris was organised by AIDES, France’s largest AIDS service organisation; Health GAP (Global Access Project) a US based activist group; and ACT UP Paris.
Source: Fund the Fund press statement
Two years ago treating poor people living with HIV in poor countries was a daunting prospect. The cost and the logistics seemed insurmountable. A few kind people collected unwanted drugs in rich countries, and sent them where they were needed; but it was hopelessly inadequate. Meanwhile, 39 companies, many with turnovers bigger than the GDP of entire nations, hired lawyers to stand up in a South African court and defend the rules that allowed the companies to keep their drugs from people who needed them. The companies said they wouldn’t lose control of their patents and they couldn’t enforce different prices in different parts of the world.
However, change was in the air for the pharmaceutical industry. Companies like Cipla and Ranbaxy in India produced generic antiretrovirals. Brazil showed that a medium-income country could provide generic drugs to its HIV-positive citizens. In July 2001 the Kenyan Parliament approved legislation that permitted the importation and manufacture of generic drugs in defiance of the global pharmaceutical industry. This time last year members of the South African Treatment Action Campaign and Medecins Sans Frontieres were infringing GlaxoSmithKline and Boehringer-Ingelheim patents to import generic drugs from Brazil. Last summer a major American healthcare provider barred GSK sales representatives from its clinics in protest at the prices GSK charged in developing countries. This mounting global anger at the prices and patent laws that were denying millions of people with HIV access to treatments sparked an extraordinary exchange of experiences and assistance at the International AIDS Conference in Barcelona last year. South African activists unveiled plans to force compulsory licences to permit the local production of generic antiretrovirals, Thailand offered the low-cost transfer to other poor countries of the technology for the production of generics, and 14 Caribbean countries signed an agreement for the purchase of cut-price antiretrovirals from six pharmaceutical companies. Importantly, many researchers reported to delegates on studies showing how to provide effective treatment in so-called resource-poor settings. The momentum of change had become unstoppable. The establishment of the Global Fund to Fight AIDS, TB and Malaria also held out the promise of $10 billion a year to fund treatment in poor countries.
After the conference, GSK announced that it would cut the prices of some of its ARVs and anti-malarial drugs by up to 38% for 63 countries. Last month we reported that the Pharmacia Corporation announced a pilot programme for expanding access to medicines in developing countries and that Boehringer, BMS, GSK, Roche and Merck had agreed to cut their ARV prices by an average of 55% – for six Central American countries. Now we report that Gilead is slashing the price of tenofovir for 68 countries.
The international campaign against the patent laws that let millions die from treatable illnesses has led to an anarchy in the pharmaceutical industry with governments passing laws to side-step international patents, and smaller companies manufacturing generic drugs.
The 6th International Congress on Drug Therapy in HIV Infection, held in Glasgow last November, heard evidence that a fixed dose combination pill of generic lamivudine, stavudine and nevirapine (Triomune) met bioequivalence criteria when compared with the branded drugs. There is speculation that Triomune could aid adherence by combining in one pill three drugs that in rich countries are made by separate companies.
Now the big players in the pharmaceutical industry are unpopular and they have rivals producing cheaper – and perhaps better – generics and so they risk missing out on business that will be paid for with the Global Fund’s billions. They are also losing control over their patents. These developments have shaken the multi-billion dollar, multi-national companies to the point where institutional investors fear for their share values. And nothing speaks louder to a multi-national company than share price, and no one speaks to them with more force than do institutional investors. This campaign is far from won; there are still millions of people untreated. But now we know that if a pharmaceutical company feels it is in its self-interest it can slash drug prices in poor countries.
Pressure is beginning to bring results. Now, the World Trade Organisation must act to liberalise the patent rules, and the governments of rich countries must fork out for the Global Fund.