Aids Drug Prices example essay topic

AIDS is caused by a virus called HIV, the Human Immunodeficiency Virus. If a person becomes infected with HIV, their body will make "antibodies", special molecules that are supposed to fight HIV. AIDS is transmitted by sexual intercourse with someone who is HIV positive, the use of a needle with someone who is infected or mother-to-child transmission. In the 1980's, getting a blood transfusion often was how AIDS spread. In the United States, there are about 800,000 to 900,000 people who are HIV-positive. Over 300,000 people are living with AIDS.

Each year, there are about 40,000 new infections. (McElrath, 201) In the mid-1990's; AIDS was a leading cause of death. However, newer treatments have cut the AIDS death rate significantly. To develop a new drug for AIDS can take 7 years or more. First, drug companies must find substances that are active against HIV. Most HIV drugs are identified by testing existing drugs for anti-HIV activity.

A newer method is rational drug design. In this process, scientists build drug molecules to fight HIV in specific ways. When a promising drug is identified, it goes through pre-clinical testing. The tests show whether the drug works against HIV and how it works. Also, shows how it can be manufactured, and make sure it is not toxic.

There are three legal ways to use drugs that the FDA has not approved to treat a specific health problem, one being "expanded access". Expanded access is a program where manufacturers provide unapproved drugs to people who cannot take part in a clinical trial. The drugs are usually offered at no charge, but a doctor will have to collect information on how a patient responds to the drug. Drug companies sometimes provide new drugs to people who are very ill and who have no other treatment options. This is called through Compassionate Use, also called a "Treatment IND Protocol". The AIDS epidemic claimed more than three million lives in 2002, and an estimated five million people acquired the HIV virus in 2002, bringing an estimated 42 million people, globally living with the virus.

(Ass. Press, website) One-third of the people living with HIV / AIDS are young people aged between 15-24 years. The new infections included an estimated 800,000 children over 90% of them infected through mother-to-child transmission (MTCT). About 90% of these infections through MTCT occurred in sub-Saharan Africa, but the number of such infections is increasing in other regions, particularly South-East Asia. (Mas land, 26) Close to six million people in developing countries have HIV infections that require antiretroviral treatment. But fewer than 300,000 are being treated.

In sub-Saharan Africa, where most of the people in need of treatment live, only 50,000 people are receiving it. (McElrath, 204) AIDS is taking lives in Sub-Saharan Africa, swallowing families, communities, and hopes. So far 17 million have died and at least 25 million may follow. "To deliver antiretroviral treatment to the millions who need it, we must change the way we think and change the way we act", said Dr Lee Jong-wook, Director-General of World Health Organization. "Business as usual will not work. Business as usual means watching thousands of people die every single day".

Sub-Saharan Africa is the hardest hit continent, with one out of ten adults; more than 28.5 million currently living with HIV / AIDS of a total adult population of 291 million. (Jackson, 1) Prevalence in southern Africa is particularly high, for example, Lesotho has HIV rates as high as 31% and Botswana as high as 38.8%. Of the estimated five to six million people in developing countries in immediate need of AIDS treatment, less than 300,000 now have access to ARVs. In Africa, just 1% of HIV positive people, 50,000 out of 4.1 million who need it, have access to treatment.

About twice as many young women as men are infected in sub-Saharan Africa overall. In 2001, an estimated six to 11% of young women were living with HIV, compared to three to six percent of young men. (Allen, A 03) In sub-Saharan Africa, the main mode of transmission is heterosexual sex. In such intercourse, there is a higher rate of transmission from male to female, than from female to male. Women and girls in Africa are also particularly vulnerable to infection due to their lower social, political and economic status.

In African countries, up to 80% of women aged 15-24 years old lack sufficient knowledge about HIV / AIDS. Even when they do know about HIV, the economic and social dependency of these women on men make it difficult or impossible to negotiate safer sex. Studies have shown that young African women tend to marry men several years older than they are. These men are more likely to be infected and to transmit that infection to their younger sexual partners or wives. In 2000, the UN Security Council made history by discussing a health issue for the first time, the HIV / AIDS epidemic and adopting Resolution 1308, which identifies the spread of HIV / AIDS as a threat to global peace and security. (Roberts, C 01) The epidemic itself constitutes a major crisis and where prevalence is high, it is plunging millions of people deeper into destitution and desperation as their labor power weakens, incomes lower, assets shrink and households disintegrate.

Weakened by AIDS, traditional coping strategies become too frail to cope with. Since HIV / AIDS affects both rich and poor citizens in both developed and developing countries, it is not a disease of poverty Poor people once infected are also more vulnerable to the impact because they cannot afford ARVs nor often even access less expensive treatment and care. The failure to deliver ARVs to the millions of people who need them is a global health emergency. AIDS is robbing communities and countries of their greatest asset; their people.

Increasing activism to lower AIDS-drug prices has forced some positive changes in government offices. Last May President Clinton, over resistance from the Republican Congress, issued an Executive Order promising that the U.S. would not challenge laws in African countries that seek to improve access to AIDS drugs. (Donnelly, website) For five years, UNAIDS (the Joint United Nations program on HIV / AIDS) fought with the companies to set lower prices for developing countries. Finally, just before the international AIDS conference held last July in Durban, South Africa, five major pharmaceuticals joined an "Accelerated Access" program to negotiate 60% to 80% reductions in AIDS-drug prices for poor nations.

(Roberts, C 01) In October 2003, the United Sates Senate agreed to add $289 million to foreign aid spending for 2004 to fight AIDS, tuberculosis and malaria in sub-Saharan Africa and Caribbean countries but most of the money is targeted for prevention and treatment of AIDS. The Senate approved increase means the United States can "meet our obligation in providing at least $2 billion in bilateral aid and meet our current matching requirement to the global fund" that has been set up to fight AIDS, tuberculosis and malaria, said Sen. Mike DeWine chief sponsor of the proposal. (Stiglitz, 86) It will save "thousands and thousands of lives", he added. In May of 2003, the Senate passed a $15 billion bill to stop the spread of AIDS in Africa, with a third of the prevention funds set up for programs that stress sexual abstinence. Now with the $289 million added to the program hopefully the people of Africa will have some hope in battling AIDS. In June of 2003, the Global Business Coalition on HIV / AIDS 2003 awards dinner was held at the Kennedy Center, where the idea is to praise companies that are doing the right thing, urge them to do more and convince everyone else that multinational corporations are serious about tackling the international health crisis of AIDS.

"We " re not here to congratulate ourselves but to say business has only scratched the surface of its responsibilities", said Holbrooke, who serves as GBC president. These companies are finally coming together to help prevent other countries besides the United States, in the fight against AIDS. The big issue use to be how are we going to pay for it, now it's how are the companies going to make the medications for AIDS available. The Global Business Coalition mission is to increase significantly the number of companies committed to tackling AIDS, and to making business a partner in the global efforts against the epidemic. GBC makes companies respond to the epidemic because of the direct impact of AIDS on businesses resulting from increased costs, loss of productivity and overall threats to the foundations of the economies in which they operate. "The current and future workforce is placed at increasingly high risk as the epidemic disproportionately affects people during their most productive years".

(GBC, website) The Global Business Coalition has many companies all working together to fight the war against AIDS. For example, the Africa Commerce (Africa), American Express, Bristol Myers (NY), Bajaj Auto Ltd (India), Volkswagen (Germany), and Tele par (Brazil) are just a few of the companies all a part of GBC trying to make a difference. Many private foundations and companies are donating money in the fight against AIDS. For instance, the Bill and Melinda Gates Foundation announced that it will give $100 million to the global fund for AIDS and other infectious diseases. (Kristof, website) The foundation, backed by the wealth of Microsoft founder and software pioneer Bill Gates, stated AIDS prevention as its top global health priority.

In the announcement of its own donation, the Gates Foundation also called on other corporations, foundations and governments to support what will be a UN-administered fund. "Governments, the private sector and the nonprofit community all have to redouble efforts so that together we can break this chain of [HIV / AIDS] transmission", said Patty Stonesifer, co-chair and President of the Bill & Melinda Gates Foundation. "As we reflect on 20 years of AIDS and the 22 million lives it already has claimed, we believe that there is no higher priority than stopping transmission of this deadly disease", said Bill Gates, co-founder of the Bill & Melinda Gates Foundation. (GMAX, website) "We are pleased to join those who have already contributed and those who will in the weeks and months ahead".

President Bush announced a U.S. commitment of $200 million to the fund, and Annan has set a fundraising goal of $7,000-10,000 million. The program's HIV / AIDS focus is the goal to reduce and ultimately stop HIV transmission, improve access to care for those infected, and improve conditions for children affected by HIV / AIDS. The National AIDS Fund (NAF) is the leading business to help prevent HIV / AIDS. NAF's mission is to reduce the amount of people and impact of HIV / AIDS by promoting leadership, and generating resources for effective community resources for the disease.

In their first 10 years, the NAF have raised more than $70 million to fight HIV / AIDS. In 1997, more than 1000 companies, foundations, non-profits and individuals have contributed to the fund. (NAF, website) One of the non-profit organizations involved with NAF is the Elton John AIDS Foundation. The Elton John AIDS Foundations mission is to provide funding for educational programs targeted at HIV / AIDS prevention and the elimination of prejudice and discrimination against HIV / AIDS-affected individuals. Also, for programs that provide services to people living with or at risk for HIV / AIDS. The Foundation has distributed $17 million in grants in North America and $13 million internationally.

In North America, over 80 percent of all money raised goes directly to patient-care grants, making the Elton John AIDS Foundation one of the largest public non-profit organizations in the AIDS fight. (John, website) Just this passed year the Elton John AIDS Foundation granted $30 million for their total grant distribution. The AIDS pharmaceuticals that combine various drugs often slow down the progression from HIV positive to symptomatic AIDS. These pharmaceuticals have reduced AIDS death rates in the U.S. and other rich nations, but they are too expensive elsewhere. This is why pharmaceutical companies have come under enormous international pressure to supply their drugs to poor nations at a much smaller price then the cost in the West. Some of these countries have also begun to permit cheap generic copies that violate international patent agreements.

As a result, most pharmaceutical companies have recently reduced the prices. The problem is profit-oriented companies will not invest the billions of dollars that are required to research and develop effective drugs for major diseases if they cannot price them high enough to replace their investments. A better strategy than pressuring companies to essentially give away their drugs is for international organizations such as the World Bank to negotiate with drug companies to buy large quantities of the AIDS drugs. They would arrange to have them resold cheaply to the people who are HIV positive in Africa.

This approach would provide adequate compensation to drug companies. Prof A moa Sakai, Ghana Aids Commission says there are two major reasons on why is it so hard for the Ghanaian government to make anti-retroviral drugs available to people living with HIV / AIDS. He states: "There are two major reasons. The first is that the cost is still very high.

Pharmaceutical companies say they have reduced the cost to about $60 a day. How many Ghanaian's can afford $60 a day for the rest of their lives? The second critical reason why the government is not rushing to make the drugs available is because the drug is so potent. If you put somebody on it and they are not able to continue taking it for the rest of their lives then you are only hastening their death". On anti- retroviral drugs, he says, "The government has received money from the Global Fund to be able to procure drugs that could serve about 2,000 patients living with HIV / AIDS in Ghana. The contract has been signed and the Global Fund has already approved $4.5 million for the acquisition of drugs.

The second thing the government wants to do is to see whether the generic drugs can be produced locally. A contract was signed with one of the World Health Organization's pharmaceutical firms but since World Trade Organization regulations did not allow for the generic production of anti-retroviral drugs, the program was suspended. Then a few weeks ago the WTO approved the contract for generic drugs to be produced. So it is now possible for Ghana to start local production". Local production of pharmaceuticals will not solve the problem but will help the fight against AIDS. This project will not just cut the price of the drugs, but will make sure that ARVs are continuously available, and can be planned for, unlike now where the countries will have sporadic imports of the products.

A South African pharmaceutical company called Aspen Pharma care announced the first production of the first cheap, generic copies of a major AIDS drug in Africa and are working on versions of several more AIDS medicines. Aspen-Stavudine, is a version of Bristol-Myers Squibb's, which is located in the United States, produced Bristol-Meyer's version of Zerit. Zerit is one of the many drugs available in the U.S. for AIDS patients but just recently became available in Africa. Under the terms of Aspen's licensing agreement with Bristol-Myers, it can sell its version of the drug to both public and private patients across Africa, said Stephen Saad, CEO of the company. Aspen, invested two years and several hundreds of thousands of dollars in Zerit, which offers a month's supply for anything from 24 rand (about US$3) to 33.60 rand (more than US$4), depending on the size of the doze. "For South Africa, for health care and for our pharmaceutical industry, this is the start of a great process", Trade Minister Alec Erwin said.

A new drug to help treat HIV / AIDS is Glaxo Wellcome's Trizivir, it combines three anti-HIV medicines into one tablet, and is U.S. Food and Drug Administration approved. Trizivir tablets combine the two widely used HIV medications, Epi vir, also known as 3 TC, and Retro vir or AZT, along with Zia gen. "Trizivir offers some patients the possibility of a regimen as simple as one pill twice a day. For others, it offers them the possibility of simplifying the rest of their existing regimen", said Dr. Peter J. Ruane of Tower Infectious Diseases Medical Associates Inc. in Los Angeles. (Sylvester, website) Many people being treated for HIV take as many as 20 tablets a day. Some of the drugs have food or water restrictions or requirements, or require complicated multiple dosing throughout the day.

"There are two main benefits of Trizivir. The first is it provides simplification of dosing", said Amy Keller, International Project Team Leader for Trizivir at Glaxo Wellcome. "So they " re getting three anti-retroviral medicines in a single tablet taken twice a day. The second benefit is that you can take that single tablet without any restrictions around food or water.

So you don't have to take it with a meal, you can take it with a meal if you want to, and you don't have to drink volumes of water while you " re on this medicine". Although this pill is available in the United States, the countries in desperate need such as Africa probably will never see this pill, due to the prices being too expensive. Although a lot more developing still needs to be accomplished for pharmaceutical companies in Africa, but these companies are trying to accomplish the goal of fighting AIDS. Africa in the future, I believe the rates of people with AIDS will drop significantly. To be accomplished the African government needs to keep forcing the world to see that AIDS is a problem, and continue to produce their own pharmaceuticals for the patients. With the help of private companies, and companies like the Global Business Coalition all helping with the fight against AIDS, the epidemic should come under control with all the money donated for research and production of drugs.

Hopefully, within the next few years, the outbreaks will be under control, and maybe a cure for AIDS will be found..