South African Generic Drug Manufacturer Requests Permission to Pro-
duce Patented AIDS Drugs

Aspen Pharmacare, the largest generic drug producer in South Africa,
announced yesterday that it would "seek permission" from five other
companies to manufacture patented AIDS medications, the AP / Phila-
delphia Inquirer reports. Aspen has already obtained the raw materi-
als to produce the drugs but will not begin the process unless the
patent holders approve. The AP/Inquirer reports that Aspen has asked
Bristol-Myers Squibb, Boehringer Ingelheim, Roche, Merck and GlaxoS-
mithKline for permission to produce their AIDS medications. However,
some of the "major" companies have "voiced reservations" about allow-
ing generic production, saying their factories enable them to produce
drugs less expensively than small local companies. Vikash Salig, As-
pen's new business development director, said that the company has
two plants in South Africa, exports drugs to 30 countries and has the
capability to produce "enough drugs" to treat millions of patients.
Robert Lefebvre, senior director for project access at Bristol-Myers,
said the company is open to "negotiating licensing agreements." He
added that two of its AIDS drugs may already be produced generically,
as Videx does not have a patent and the firm does not plan on enforc-
ing its patent on Zerit. He added, "We are not going to let the pat-
ent stand in the way of making the medication accessible or afford-
able" (Cohen, AP/Philadelphia Inquirer, 5/17).

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'NewsHour' Continues Examination of AIDS in Africa, Addresses Distri-
bution of Antiretroviral Drugs in Botswana

In the third episode of a "NewsHour with Jim Lehrer" four-part series
on AIDS in Africa, reporter Elizabeth Farnsworth describes the Bot-
swana government's efforts to distribute antiretroviral drugs to its
people. In March, Botswana President Festus Mogae announced that the
government would try to provide anti-HIV drugs to all who need them,
regardless of their ability to pay. He also created a National AIDS
Council, a multi-sectoral national committee that is working to in-
stall similar committees in each town and suburb. In addition, mining
giant Debswana, owned in part by the government, announced it would
subsidize 90% of patient costs for employees living with HIV. Farns-
worth explained that the disease has become a "growing threat" in the
country's largest diamond mine, as the mine is "highly mechanized and
dependent on skilled labor." But with 30% of the workforce HIV-
positive, the company may lose many of its skilled laborers to the
disease. Dr. Kobus Erasmus explained, "We're going to be in trouble
in this mine if we don't treat them. ... We're the first company
that's going to treat HIV patients on a large scale."

Help from Pharmaceutical Firms

National and corporate efforts to treat Botswanans have been assisted
by drug discount offers from large multinational pharmaceutical firms
like Bristol-Myers Squibb and Merck. Merck and the Bill and Melinda
Gates Foundation have begun a $100 million project to distribute the
drugs widely in Botswana. The Harvard AIDS Institute has also part-
nered with the Botswana government to research HIV type C at the pub-
lic hospital in Gabarone and is providing clinical care to patients
with HIV/AIDS. The program's "goal is to help develop models for pro-
viding antiretrovirals safely." President Mogae said, "The health
budget is growing by leaps and bounds. ... It's maybe three or four
times what it was three years ago, and we were under no delusion that
in another three years, it will be double or triple what it is today.
Without help, we couldn't possibly manage." But Dr. Banu Khan of the
National AIDS Coordinating Agency noted, "It's not just the price of
the drugs. It's the overall package, the testing for viral load, for
the CD4 count ... these are costly and also the training of health
care workers to prescribe these drugs." Further, Khan added that "if
you don't correctly administer the drugs in the right combination,
and you don't counsel people to take it correctly and for a long
time, then the virus is able to develop resistance and the drugs are
not that effective." A "high tech laboratory" to analyze patient re-
sponse and adherence to the drugs is being built in Gabarone with
funding from the government, Harvard and Bristol-Myers Squibb, but
Farnsworth noted that "more facilities will be necessary" (Farns-
worth, "NewsHour with Jim Lehrer," PBS, 5/16). To read the full tran-
script of the report, click here. To listen to the segment in Real-
Audio, click here. Note: You must have RealPlayer to listen to this
report.

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Bianca Jagger Works to Fight 'Human Catastrophe' of AIDS in Africa

In a London Independent profile yesterday, Bianca Jagger, former wife
of Rolling Stone Mick Jagger, answered the public's questions about
her involvement with charity group Christian Aid's work with AIDS in
Africa, saying, "I realized that I could not close my eyes, look the
other way, and pretend [the epidemic] was not happening. I want to
draw attention to the human catastrophe that is ravaging the sub-
Saharan region of Africa." She added her concern that "an entire gen-
eration of orphans is growing up without role models" and said, "It's
no coincidence that it is in the poorest countries in Africa where
the AIDS epidemic has its strongest grip. Many African governments
are no longer able to provide basic health care." She called the
failure of other countries to help fight AIDS in Africa "a moral out-
rage," saying, "The industrialized nations must help rebuild the
health care and education systems, which must become free of charge
for those who cannot afford it." Jagger said of Christian Aid, "It
has grass-roots, community-led care programs, and I believe this is
the most effective way of getting aid to those who need it. ...
Christian Aid is calling [for] governments of the industrialized na-
tions to increase the amount they give in overseas aid. Only with a
massive concerted effort can we hope to avert the decimation of a
continent" (Independent, 5/16).

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South African Department of Health Has Not 'Killed' Possibility of
AIDS Drug Provision, Letter Says

"It is incorrect to state [as a May 14 Guardian headline does] that
the South African government has 'killed' the possibility of ever
providing antiretroviral drugs for AIDS," Jo-Anne Collinge of the
South African Department of Health writes in the Guardian. "The text
makes it clear that, at present, South Africa's minister of health,
Dr. Manto Tshabalala-Msimang, believes there are other more pressing
priorities in AIDS care that are likely to claim the limited health
budget," she says. Due to the increasing threat of drug resistance,
the "questions of safety and efficacy are acute in respect of anti-
retroviral therapy," she writes, concluding, "The Department of
Health is responsible for ensuring that our interventions are safe,
effective and sustainable. Hence the minister's emphasis on the
training of health professionals and adequate health infrastructure"
(Collinge, Guardian, 5/16).

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The Kaiser Daily HIV/AIDS Report is published for kaisernetwork.org,
a free service of The Henry J. Kaiser Family Foundation, by National
Journal Group Inc. c 2001 by National Journal Group Inc. and Kaiser
Family Foundation. All rights reserved.