WASHINGTON - February 23 - Ambassador Randall Tobias, Bush's Global AIDS Coordinator and former pharmaceutical company executive, today released a plan for the President's Emergency Plan for AIDS Relief (PEPFAR). Health GAP, the AIDS activist organization, criticized the plan, accusing the Administration of undermining its own program with funding contributions far below those promised, and spending years to set up a new bureaucracy for a new bilateral program while underfunding the cash-strapped Global Fund to Fight AIDS, Tuberculosis, and Malaria.
Activists are also critical of the Bush administration efforts to block the use of affordable generic drugs in the program. "Candidate Bush is AWOL on AIDS," said Asia Russell of Health GAP. "Compared to Kerry and Edwards campaigning on a $30 billion pledge and a commitment to use affordable generic drugs, the Bush White House has proven itself to be a subsidiary wholly owned and operated by big drug companies. Bush's half-measures on AIDS are going to hurt him in his election efforts."
The Administration, working with the U.S. pharmaceutical lobby, is expected to require poor countries to purchase brand name AIDS drugs with PEPFAR funding, rather than cheaper generic antiretrovirals. The administration is also aggressively pursing stricter patent protection on expensive medicines through multiple new free trade agreements. These agreements, say activists, will drive up the costs of medicines and block access to life-saving treatment.
In attempt to set aside World Health Organization (WHO) sanctioned standards for drug quality and safety, the Administration plans to host a debate on the safety of generic 3-in-1 antiretroviral drug combinations medicines. These fixed-dose combinations (FDCs) of antiretrovirals are efficacious and preferred over any single pill regimen available in the United States and by brand-name companies in poor countries because their ease of use helps to increase adherence and lower cost facilitates treatment scale-up. Brand-name companies have not permitted similar co-formulation of their proprietary medicines.
If Bush is successful in blocking the procurement of generic FDCs, this will result in approximately four times fewer people on life-saving treatment than would gain access using more affordable generic equivalents. The best world price for WHO's recommend first line of treatment from originator companies is US$562 per person per year (in the form of 6 pills a day) compared with the generic equivalent 3 in one pills taken twice a day which costs as little as $138-$270 per person per year.
The five-year, $15 billion program Bush announced over a year ago is only half of the US's fair share of what UN experts estimate the cost of fighting AIDS will be by 2008. While the Bush administration has budgeted $2.8 billion in FY 2005, at least $5.4 billion is needed to meet the goals the Administration agreed to at a UN Session on AIDS in 2000. At least $15.3 billion in donor funds are needed in FY 2005 to fight the three diseases according to UN agencies.
"Three million people have died waiting for a new bureaucracy to be set up at the State Department, while President Bush denies the already existing Global AIDS Fund of the cash needed to actually fight AIDS and save lives," stated Health GAP's Paul Davis. "Bush's challengers in the 2004 election have pledged to beat him on AIDS, pledging the $30 billion that is our fair share of the global cost, and contributing half to the Global Fund."
President Bush's budget request for fiscal year 2005 includes only $200 million for the Global Fund -- a 64% reduction in funding from the previous year. The Global Fund has been providing financing to poor countries for programs since its launch in January 2002. "Unlike what the Bush administration and Ambassador Tobias claim, Europe which makes up less GDP per annum is giving more to the Global Fund," said Asia Russell of Health GAP.