Published on Thursday, May 11, 2000 in the San Francisco Chronicle
Clinton Defies Congress; Issues Executive Order For Cheaper AIDS Drugs For Africa
by Marc Sandalow
President Clinton issued an executive order
yesterday to make inexpensive drugs more available in AIDS-ravaged Africa,
rejecting a plea from pharmaceutical companies to protect their profitable
The order would allow countries to produce or import generic AIDS drugs, without fear of trade retaliation, in a region that accounts for one-tenth of the world's population and more than 70 percent of its AIDS cases.
The action came after an amendment containing nearly identical language was stripped from a larger Africa trade bill that is likely to pass Congress this week. California Senator Dianne Feinstein, author of the amendment, threatened to filibuster the bill unless steps were taken to make affordable medication more available.
Feinstein applauded the president's action during an emotional speech on the Senate floor, in which she detailed the toll of AIDS on Africa, where more people have been infected with HIV than reside in the state of California.
``How can we provide economic growth and opportunity to sub-Saharan Africa if we ignore the fact that the region is facing its worst catastrophe of this century?'' Feinstein said, tears welling up.
Pausing periodically to compose herself during a 90-minute address, Feinstein recalled San Francisco's tribulations with AIDS from her days as mayor and excoriated the drug companies for trying ``to squeeze every last drop of profit from the suffering of millions of HIV/AIDS victims in sub-Saharan Africa.''
``Why, given that it represented a commonsense approach . . . did my amendment meet such stiff opposition?'' Feinstein wonderered aloud, before placing the blame on drug company lobbyists.
``After long and hard consideration, I have concluded that there can be only one possible answer to that question -- profits and corporate greed.''
The high-stakes debate pits the need of poverty-stricken Africans for drugs against the entrepreneurial rights of the drugmakers who have spent hundreds of millions of dollars to develop them.
The president's order, which mirrors Feinstein's legislation, states that the United States will not seek to overturn ``any intellectual property law or policy'' imposed by a sub- Saharan African government that promotes access to HIV/AIDS pharmaceuticals and medical technologies. In other words, a country that seeks to produce or import a generic version of a patented AIDS drug will not face trade sanctions from the United States.
``Given the devastating impact of AIDS, the United States will not require or negotiate restrictive rules in the intellectual property rights area,'' said U.S. Trade Representative Charlene Barshefsky.
``This executive order is intended to help stop the spread of HIV/AIDS in sub-Saharan Africa by making AIDS-related drugs and medical technologies more accessible and affordable,'' she said.
Alan Holmer, president of the Pharmaceutical Research and Manufacturers of America, criticized the executive order for adopting a ``discriminatory approach to intellectual property laws'' and focusing exclusively on pharmaceuticals.
``We recognize that AIDS is a major problem,'' Holmer said in comments quoted by the Associated Press. ``But weakening intellectual property rights is not the solution.''
Feinstein noted that the $1,000-a- month cost of AIDS treatment in the United States is many times higher than the annual income of many African victims, a problem she said is exacerbated by an industry blindly driven by profits.
She used the example of one drug, fluconazole, used to treat a common fungal infection in HIV- positive people, which is available as a generic drug in Thailand for $1.20 a day but sold in March for $17.84 a day in Kenya and South Africa, where the only supplier is Pfizer. (Pfizer however, she noted, has recently agreed to provide free fluconazole to South Africa).
``Simply put, the pharmaceutical companies which manufacture HIV/AIDS drugs would prefer to be able to sell drugs for $18 a dose rather than $1 per dose, with the additional $17 going straight to fattening the bottom line.''
Representatives from the pharmaceutical industry did not return phone calls to respond to Feinstein's criticisms. But they have previously insisted that their intellectual property rights must be protected to provide the incentives necessary to encourage costly research and development of AIDS-fighting drugs.
Some drug manufacturers have also maintained that the free distribution of drugs will lead to misuse and might spur the growth of a drug-resistant strain.
``I don't know how they sleep at night, I really don't,'' Feinstein said of the drug company lobbyists who blocked her amendment. ``I'm sorry for my show of emotion, but I've seen people die of AIDS.''
``I remember, as mayor of San Francisco, trying to manage this disease in its early days, when cause, let alone treatment, was unclear,'' she said. ``When HIV/AIDS was devastating our community, and many, many promising young people -- many of them my friends -- were struck down in the prime of their lives.
``So in some small way, I think I understand what policy makers in any sub-Suharan African countries are going through now.''
©2000 San Francisco Chronicle