Aids, Africa and Health Care
John Humphreys

On the face of it, the announcement that five major pharmaceutical companies are going to sell their anti-AIDS drugs to African countries at just pennies above the manufacturing costs is great news. These drugs are very, very expensive, and companies charge what they do partly to recoup the astronomical costs of getting a drug to market and partly, of course, because the market will stand it. In the US and Western Europe, the health care systems have plenty of money, so you can charge more. Still, they need to somehow get back the 250 to 300 million dollars it costs to develop a successful drug.
There are three aspects of this decision that open up a whole new jeraboam of annelids, as Lawrence Sanders once said. There is pressure to do the same in the West for ‘poor’ people, that is, those without good insurance policies. Yet if this were to be continued, the companies wouldn’t make enough money to be able to be innovative and take risks with the development of new no new medicines for difficult diseases (at the risk of indulging in simplistic tabloid journalism logic).Secondly, AIDS drugs are expensive, but so are a lot of other drugs (cancer drugs for one). Why shouldn’t we address those? (to be fair, some companies are – for instance Merck with ivermectin in the Third World).Thirdly, and most important: many argue that we would be better off attacking the root causes of the extraordinarily high AIDS rates in Africa: better education and preventative measures, to name two. Also, we think that only 5 per cent of HIV positive people in Africa are aware of their status...and you can only give drugs to those who know they’re sick. In addition, treating HIV is not a one-shot deal; it is worse than tuberculosis, as you have to treat long-term (indefinitely!) with a cocktail of drugs that have to be taken exactly as prescribed. This is difficult in the most compliant of cases, let alone in a country where theinfrastructure is in tatters and education very poor.Most crucial of all, AIDS is just one of the African nations’ problems. We need better infrastructure, more personnel, and a stable government in a country before the initiative works. Many are torn apart by war – look at Sierra Leone at the moment – so establishing an AIDS program there is impossible. In fact, many African governments spend more on arms than medicines.
And all are paying more back in debt repayments than their entire health budget – an obscenity in God’s eyes.I think it is true to say that local NGOs, religious groups and so on could do much more with the money that will be donated: getting clean water and preventing malaria would save more lives. Yet there is little political pressure on government or pharmaceutical company to do that. But it is a generous start. We need to utilize all weapons against the disease in Africa; it is our human and Christian duty. But let’s not forget the other needs the continent has, and pray that those in power there and here will rule in wisdom.John Humphreys

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