Delivering Hope By Another Route; HIV Activists Collect Drugs for the Needy Outside the US

Jesus Aguais started Aid for AIDS in 1996 after a woman from Venezuela walked into his office at St. Vincent's Manhattan Hospital in need of expensive AIDS medications. Aid for AIDS today collects donated medication from various sources across the United States and Canada, including from people with HIV who change prescriptions, stop taking a certain medication, or die. The drugs are inspected and then sent overseas to people with HIV who would otherwise not have access to medications. Other sources of the drugs are social workers and doctors. The organization says it is now helping 300 people from Ecuador to Ethiopia through its shipments and efforts to find local health care. "With an overhead of just $150,000, we sent over $3.5 million worth of AIDS medication last year," Aguais said.

Although the program has been praised by UNAIDS and the World Bank, it has been operating in a legal gray area. According to the Food and Drug Administration (FDA), the program violates the Food, Drug and Cosmetic Act, which forbids the delivery or receipt of drugs from any source other than the manufacturer, processor, packer or distributor. "There is no quality assurance once the medication has left the pharmacy," said Richard Klein, the HIV/AIDS program director at the FDA. "It's a humanitarian program, but there is no guarantee of the drugs' integrity." While the FDA questions the legality of drug recycling, it has not received any reports of tainted drugs that have lost their potency being processed through Aid for AIDS and has not tried to stop its work. Klein said that it was unlikely that the agency would receive complaints since the recipients are from other countries and, thus, outside its jurisdiction.

Aid for AIDS is aware that its drugs can end up on the black market, but it is assured that what it is doing is better than doing nothing. "In the U.S. and Canada there are six or seven groups that collect medication and send them to developing countries," said Hans Binswanger, an AIDS activist and director of the rural, social and environmental development program for Africa at the World Bank. "Aid for AIDS is the biggest and the best."

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