Economist: Rich should spend billions on AIDS

Ed Susman, UPI Science News

A leading economist called on the world’s richest nations Sunday to spend $5 billion a year to treat the 35 million people infected with the AIDS virus. Most of those infected live in the world’s poorest nations and cannot afford the necessary medications.

"That would amount to just $5 a year per person living in nations such as the United States, Canada, Europe and Japan," said Jeffrey Sachs, professor of economics at the Harvard University Center for International Development, Cambridge, Mass.

In a keynote address at the 8th annual Retrovirus Conference in Chicago, Sachs said that while the situation in the developing world — and especially in Africa — is bleak and could lead to international instability "it is quite easy to do something about it."

Immediately, he said, the World Bank should initiate large clinical trials in two or three countries in Africa to determine the feasibility of providing combination drug therapy — the treatment approach that has changed the face of AIDS in the Western world — to these people. Combination therapy can cost a patient in the United States $10,000 or more a year, but Sachs said that drug companies could produce the medications for distribution in developing countries for much less — possibly for as little as $500 a year.

Once those trials prove that the drugs can be delivered to patients who are ill and will not be diverted, that the drugs can be safely and appropriately administered and that they dramatically reduced AIDS death rates, then, Sachs said, governments and pharmaceutical companies should work together to provide drugs at cost to everyone suffering from the disease.

About 36 million people in the world are believed to be infected with HIV, the virus which causes AIDS, and more than 90 percent of these people live in developing countries — 25 million in Africa alone.

"It would take a vanishingly small amount of money to provide this treatment," Sachs said, but he said it would require the leadership of the Bush Administration to make the plan work. He said he has seen hints that the administration is interested in participating, but he is concerned that fighting AIDS does not appear to be a first-line priority with the new administration. Part of that concern centers on the fact that the new administration has yet to name anyone to head the White House Office of National AIDS Policy. Calls to the White House regarding the fate of the office were not returned.

Sachs said that his talks with representatives of pharmaceutical companies indicate the drug firms are anxious to get involved in the program rather than taking countries such as South Africa and Brazil to court over the production of generic AIDS drugs. "I find it quite horrendous for drug companies to be going after Brazil," he said, "and I think for drug companies, from a public relations point, it is non-sensical for them to be suing South Africa. They will put themselves in the worst possible circumstances."

"We would all be better off," Sachs said, "if we agreed in principle that the intellectual property rights could be respected but also accommodate the needs of the poor people — by providing drugs at cost — within the system."

"The problem is they cannot make a deal by themselves and if the US government does not lead we are going to end up in an unfortunate and tragic situation," said Sachs adding, "this requires that President Bush get interested in this and get interested in this fast."

"No matter what people say about the feasibility of it," said Dr. Kevin DeCock, director of the Centers for Disease Control and Prevention’s programs in Kenya, "we cannot stay away from the issue of antiretroviral therapy in developing countries."

"The world’s response to this epidemic has been astonishingly small compared to the magnitude of the problem" DeCock said. "This is the greatest catastrophe in Africa since the slave trade."

However, DeCock added, no treatment program in Africa should be planned without credible policies for disease prevention as well. Sachs said his proposed costs of treatment would also include prevention programs.

"We are our brother’s keepers," said Dr. Kathleen Squires, associate professor of medicine at the University of Southern California. "We can’t live our lives as if we don’t have a responsibility to less fortunate societies. We are a global society and we can’t hide behind national boundaries."

Source: http://ww2.aegis.org/news/upi/2001/UP010202.html