/ 25 June 1999

World Bank woos Aids drug

Larry Elliott in Cologne

The World Bank is wooing the world’s biggest drugs companies with a multibillion dollar package of guarantees to encourage the development of a low-cost Aids vaccine for poor countries. Alarmed by the relentless spread of the HIV virus, the bank is proposing the creation of a global health insurance programme to enable it to underwrite the search for affordable anti- Aids drugs.

The bank is seeking a partnership with the pharmaceutical firms to end the industry’s reluctance to invest in vaccines for developing countries, while those nations lack the means to pay for them.

Drug companies have developed expensive anti-HIV treatments for rich Western markets, but argued that the failure of cash-strapped developing countries to buy vaccines for diseases such as hepatitis means they would not be able to recover the high cost of Aids drugs.

A special bank task force has expressed a willingness to kick-start research and, in collaboration with the World Health Organisation and other international bodies, guarantee a market for a vaccine in developing countries. The bank believes that an outlay of up to $5-billion might be enough to encourage the drug industry to start work.

Officials estimate that between 500-million and 1,5-billion people would benefit from a vaccine, and that the market could be worth $50-billion to the big drug firms.

“Our aim is to change incentives sufficiently to induce a much greater effort in developing a vaccine,” one bank insider said. “Our message is that if a vaccine can be developed, there will be the money to buy it.”

The move underlines the bank’s concern that the rapid spread of HIV – which infects 16 000 globally, daily – poses a real threat to attempts to eradicate poverty.

James Wolfensohn, the World Bank’s president, wrote to the leaders of the G7 industrial nations last month, warning them that the Aids epidemic was “reversing decades of progress in improving the quality of life in developing countries”.

The G7 was told that more than 33-million men, women and children are already affected with HIV worldwide, more than 90% of them in developing countries.

In the hardest hit African nations, such as Zimbabwe and Zambia, life expectancy is 10 to 20 years shorter than it would have been without Aids.

“Aids has therefore become a core development issue,” Wolfensohn said. “Confronting the Aids epidemic in developing countries has become critical to all our efforts for poverty reduction, growth, and improved quality of life.”

Officials at the bank stressed there was a need to ensure that any new vaccine for developing countries would provide value for money and be medically effective.

The bank is hoping that countries such as South Africa and Brazil – which both have a high incidence of Aids and a considerable science base – will take a leading role in the attempts to make a medical breakthrough in the treatment of Aids.

In his letter Wolfensohn said: “An Aids vaccine for low-income countries is an international public good which is not likely to happen without innovative international public action.

“Private industry must play the critical role in developing and marketing a vaccine, but the private sector currently does not have the incentives to develop an Aids vaccine for the strains of the virus and the health system capabilities of developing countries.”

Wolfensohn said there was a need for a global partnership to ensure that work on developing an Aids vaccine moved swiftly.