Crackdown on Thai drug usersAt least 1,400 drug users have already been murdered in Thailand so far this year, reports Julian Hows from the 14th International Harm Reduction Conference in Chiang Mai. HIV is undergoing a resurgence in the country due to a new wave of methamphetamine injection among drug users. Vigilante squads are said to be responsible for many of the killings. A Thai government clampdown on drug users has led to the arrest of 30,000 suspects so far and ‘unofficial’ government killing squads are now taking the law into their own hands. HIV and drug campaigners at the conference joined together to condemn the killing. Some activists are now calling into question the holding of the next World Aids Conference in Bangkok next summer. An estimated one million people in Thailand are infected with HIV. Join the protest outside the Thai Embassy, 29 Queen's Gate, London SW7, on 12 June at 2pm. |
 Jean-Pierre Garnier, CEO of GSK |
British pharmaceutical giant GlaxoSmithKline (GSK) last month cut the price of the anti-HIV drug Combivir (the combined pill AZT/3TC pill) by nearly a half for the world’s poorest countries.
This means that the drugs will now be available to patients for as little as 90 US cents a day, or £206 a year, a price comparable to some cheap generic copies of the HIV medications.
GSK chief executive Jean-Pierre Garnier said the company was now selling anti-HIV drugs on a non-profit basis to developing countries hit hardest by the epidemic and was able to cut prices because of improvements in the manufacturing process and economies of scale.
“These price cuts demonstrate our commitment to making vital medicines more affordable through sustainable preferential pricing,” he said.
Garnier promised further price reductions for GSK HIV drugs if demand for the drugs increased.
The GSK move was generally welcomed. But some Aids activists said that the price reductions were still not enough for the 30 million people with the virus living in sub-Sahararan Africa.
Clare Short, former UK Secretary of State for International Development, said: “I look forward to other companies making similar efforts to bring down prices of much needed drugs.”
Daniel Berman, of Médecins Sans Frontières, said: “Glaxo say they have found some new way to bring down the price...but two years ago generic companies had already figured out how to make it at a much lower price.”
Richard Feacham, director of The Global Fund to Fight Aids, TB and Malaria, welcomed the move but added: “This must be matched by increased resources to finance the purchase of these medications.”
GSK’s drug price cut follows pressure not just from Aids activists but also from investor pressure. Last month institutional investors in the US, including the biggest pension fund in the country, called on the company to make access to HIV drugs easier by cutting prices and easing patent controls.
Meanwhile, Garnier is himself is under pressure as head of Britain’s largest pharmaceutical company and is reported to have been offered a £22 million redundancy package. Sceptical investors questioned the remuneration deal at the GSK AGM earlier this month.
GSK reported a pre-tax profit of £2.5 billion last year and a turnover of over £2 billion on antiretrovirals.
 Photo: Flick Thorley |
The stigma of Aids and the nightmare logistics of getting the drugs to the patients are frustrating programmes to deliver antiretrovirals to patients in Botswana, the country with the world’s highest HIV prevalence.
Two million of Botswana’s six million people have HIV, and 120,000 are suffering from Aids. Without treatment Aids will cut the average life expectancy to the stone-age level of 26 by 2010.
About 5,000 of the 120,000 people with Aids are currently taking HIV drugs. This is a vast improvement already on treatment access compared with a year ago. But one of the two drug-company sponsored programmes in the country, which between them aim to treat 19,000 people, has so far only got 753 actually on treatment in its first year.
Dr Chloe Orkin is currently working in the programme, which is sponsored by the Bill and Melinda Gates Foundation and Merck. It provides HIV treatment and care in four towns in the sparsely-populated desert country, which is the size of France. Dr Orkin works in Francistown, a mining community where every second person has HIV.
She said: “There is still a huge stigma against Aids. Patients are very ashamed of being ill, and families of talking about HIV. A previous campaign to get HIV drugs to pregnant women had a very poor uptake, with only 73 treated.”
Logistical and training problems also make it difficult to get programmes off the ground. The group arrived to find no office, no HIV ward, and no clinic space.
The size of the country is a problem, too. Quick checks to see if treatment is working are impossible, as blood samples have to be flown 300 miles to the lab in the capital, Gaborone, twice a week. Half of the patients do not live in Francistown itself and walk many miles through the bush to get to their clinic.
Botswana’s President, Festus Mogae, has undertaken personal responsibility for a campaign against the high level of stigma. A collection of three 15-minute videos designed to educate people about the impact of HIV/AIDS and ARV therapy on their lives will be played in patient waiting areas and used in health education talks in up to 120 hospitals and clinics with video facilities.
Despite the logistical problems, the programme is worth it, said Dr Orkin. “Less than three per cent of patients given the HIV drugs have dropped out of the programme, and in the first year less than five per cent of these Aids-affected patients developed any further illness.”
Gus Cairns at the British HIV Association Conference and Stam Predrag in Harare
International day of action to pressurise South Africa
UK HIV activists descended on South Africa House in London last month as part of an international day of action to pressurise the South African government to step up its response to the HIV pandemic in the country, Martin Leigh reports. Five million South Africans are estimated to be living with HIV, and 200,000 will die from the disease this year alone, yet only 25,000 have access to HIV medication. Despite the Treatment Action Campaign’s victory in the courts last year to enforce treatment access, the South African government is still blocking the use of antiretroviral drugs in state hospitals. Six hundred empty pairs of shoes were placed outside the embassy in Trafalgar Square to signify the 600 people who die from HIV in South Africa every day. Similar demonstrations were also held in Cape Town, Washington DC, Los Angeles, Amsterdam, Milan, Paris and Tokyo. |
