Health Gap in Rich, Poor Countries

The health gap between rich and poor countries is stirring fierce passions among delegates at the 14th International AIDS Conference in Barcelona. While all agree that vast financial aid is needed, there is no consensus as to who should foot the bill of at least $10 billion a year. Some say industrialized countries bear the moral burden to do so; others say pharmaceutical companies should give up patents and allow generic copies; others insist African governments themselves should pay more.

More than 90 percent of the world's HIV-infected people live in developing countries; 70 percent live in sub-Saharan Africa. A study released at the conference predicts that in less than a decade, many southern African countries will have average life expectancies of about 30 years; in Botswana, the figure will be 26.7 years. "How can you create a future for a country when the life span is 27 years of age?" said Paul De Lay of the HIV/AIDS office of the US Agency for International Development.

Protesters -- some of whom disrupted a speech Tuesday by US Health and Human Services Secretary Tommy Thompson -- claimed that European countries contribute up to 25 times more per capita than the United States to the Global Fund to Fight AIDS, TB and Malaria. Responding to Thompson's suggestion that the United States was doing its share, Columbia University economist Jeffrey Sachs said, "For everybody to be doing their share is not enough."

An Oxfam study said that many of the hardest hit countries are spending more on foreign debt repayments than on health care. Study author Kevin Watkins said $1.6 billion in debt relief would free up significant revenues that could be spent on AIDS programs.

Some pharmaceutical companies have slashed prices on AIDS drugs but refuse to give up patents to allow manufacturers in poor countries to make generic versions. Martin Sutton of GlaxoSmithKline said scrapping patents would eliminate the incentive to do further research.

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