Developing countries in Africa and on other continents will be keeping a close watch on a trial set to start in SA in March
Sarah Boseley
Across Africa and the developing world millions will die of diseases that are treatable in the West, such as diarrhoea, meningitis, malaria, TB and Aids.
The hospitals do what they can, but their best efforts are like a sticking plaster on a haemorrhage. The Western drugs they need are unaffordable. Life is priced too high. In Pretoria a critical battle is about to begin. Case number 4183/98 in the Pretoria High Court is an action brought by 42 pharmaceutical companies, including the British giant GlaxoSmithKline, against the government.
The case is an attempt to block the government from importing cheap medicines. The drug companies have spent three years and millions of rands preparing the case. They have retained almost every patent lawyer in South Africa. On March 5 their lawyers will try to stop the government from buying the medicines its people so badly need from countries where the prices are lowest, on the grounds that it infringes world trade agreements. The rest of Africa will be closely watching the outcome of the trial. So will developing countries on other continents. With the death toll from infectious diseases inexorably rising, especially in Africa, a tide of outrage is swelling among local activists and international aid organisations which see medicines denied to the sick in the name of commerce.
There are more than 32-million men, women and children infected by HIV in developing countries. AZT and 3TC, the basic anti-retroviral drugs in the West, would keep them alive and well, but the price tag is R79 000 to R120 000 a patient a year. The majority of employed people in South Africa, with whole families to support, earn less than R20 000 a year, and by comparison with most of the rest of the continent they are rich. But there are now alternatives cheap copies of life-saving medicines called generics, made mainly in Brazil, India and Thailand. Thailand believes it could reduce the cost to R1 400 a patient a year. It is a price the government might be able to pay for the life of its people, but the drug companies, in Case 4183/98, afraid of the potential worldwide consequences if their prices start to be undercut, say no. In Cape Town on Monday at least 5 000 supporters of the Treatment Action Campaign marched on Parliament to demand the medicines. At the same time Oxfam launched an international campaign demanding help for developing countries that want to use legitimate measures to buy or make their own cheap drugs, but who are bullied into submission by the lawyers working for drug companies and by the Western governments who support them. The Pharmaceutical Manufacturers Association of South Africa, which is bringing the case with the international companies, says it supports any country’s right to buy supplies of drugs that are cheaper abroad ”in exceptional circumstances”. But it argues that Section 15c of the Medicines Act, passed in 1997 to allow it to import cheap copies of Western medicines, would give the health minister ”unfettered discretion to override patent rights for medicines in this country”.
And it was appalled when the South African delegation told a World Health Organisation meeting in January 1999 that the new legislation was a model that the rest of Africa should follow. After the period of apostasy, when President Thabo Mbeki upset the medical world by doubting that HIV caused Aids, the government seems willing to seek out and use cheap drugs if it is allowed to. Last year it opened an infectious diseases clinic code for HIV where people are offered counselling and treatment. In May they will take the most radical step of all and put 150 adults and 30 children who are at death’s door on a programme of anti- retrovirals the medication that keeps people in the West with HIV alive.
Dr Eric Goemaere, head of the South African mission of Mdcins sans Frontires, sees it as a marker for the future. ”We are here on the frontline to show that it is possible and it will change attitudes totally,” he says. South Africa could by now be in the relatively advantageous position of Brazil, he believes, making and importing cheap drugs.