(This column first appeared in LGNY)
You know, it's strange. I keep reading that ACT UP is dead or I read references to AIDS activists in the past tense. And then there are all the stories about robust guys with HIV happily living with their manageable disease. I even saw a new TV commercial by DuPont where, on a list of things they want to accomplish for the good of the world, they include something like "making drugs to control HIV" with the footnote "(done that)." But I see a very different reality. And what I've just seen accomplished by dedicated, smart, caring AIDS activists is a story that I think deserves a fuller telling than it's getting in the mainstream press.
Some months ago, the U.S. State Department issued a report on various activities, which included bragging that Vice President Al Gore, in his role as the U.S. leader of a committee to negotiate issues with South Africa, had taken a very hard line against that country's attempt to obtain AIDS drugs at cheaper prices than usually charged by the major pharmaceutical companies that make them. South Africa, of course, can't begin to afford these drugs, especially for the several million of its citizens who are HIV-infected. People in the United States can't afford these drugs either, but we, of course, have insurance companies and governments that buy them for us. Anyway, the State Department was very proud of our Vice President for standing up for the pharmaceutical companies and their profits. Why, Gore even imposed trade sanctions on South Africa to punish it for trying to make or import cheaper versions of these drugs.
Lest you start weeping for the drug companies, let me hasten to assure you that international law, as promulgated by the World Trade Organization, explicitly allows countries facing emergency situations to do just that. And, as the new president of South Africa, Thabo Mbeki, has pointed out, the U.S. made no complaint to the WTO about anything South Africa wanted to do. This was just a power move, a decision by our government to play hardball, to choose the financial interests of the pharmaceutical companies (the most profitable non-munitions industry in the world) over the lives of South Africans. Charming, eh? And all done in our name by our elected representatives.
And for those of you wondering at this moment why you should care about the lives of South Africans? I believe you should care because I believe that this is just the latest example of the value system that rules our rulers and has gotten us in the fixes we're in right here at home -- be those over wealth or race or health or education or hate or whatever problem you care to pick. Those who "lead" us, I believe, do not care about anything but their own comfort and power. Period. And more particularly, any "leaders" who care more about money than lives are not to be trusted to do anything radically helpful for those with HIV/AIDS in this country, as they have proven repeatedly. And if we are not willing, as the richest country in the world, to help stop an epidemic that threatens the entire world, what hope is there for any of us? I don't mean to get carried away, but I do believe that, if we care about AIDS, we have to care about everybody who has it, for our own self-interest, as well as theirs. So -- on with our story.
A small group of people who do care decided to fight for the rights of South Africans to receive life-saving drugs, and all the support systems necessary to make them effective. Not many of us thought it could be done. You want to take on the U.S. government over getting complex drugs to millions of people in South Africa? What planet are you on? Luckily, the smart ones paid no attention to the naysayers. Instead, they went to work. To oversimplify, there were two stages.
First, they assembled a strong coalition, the HealthGap Coalition. It includes groups that have worked for years on AIDS internationally, AIDS activists here and in South Africa, and, very importantly, a Ralph Nader subgroup that works on technology and consumers issues. As this wide-ranging group began to discuss the issues publicly, they gained some important, unexpected allies, like Arianna Huffington, who wrote very strongly against the greed of the drug companies and the ties of Al Gore to them as campaign contributors.
Second, direct action. A couple of dozen experienced AIDS activists, mostly from New York and Philadelphia, with a few others from here and there, started attacking Gore publicly. They hit him in Tennessee at his opening presidential campaign announcement. They hit him in New Hampshire and New York the next day. When he went to the west coast, more activists, ignited by the success of the east coast demos, hit him again. He was totally blindsided, totally confused and totally furious. These activists were throwing a huge monkey wrench into his dream campaign. He freaked. And he put his team to work immediately to get this to stop, to get these loud, rude activists off his back.
As the public demos continued, the HealthGap Coalition was in place to provide strong credibility to the activists. As the press tried to figure out what the hell was going on, the Coalition was there to provide authorities from Doctors Without Borders or from consumer rights groups or international experts who all backed up the activists and explained the issues directly. Amazingly enough (and we were continually shocked by this), the press did a good, solid job of reporting most of this. That, too, put big pressure on Gore and everybody else. The New York Times, for heaven's sake, editorialized in our favor.
Okay, Ann, cut to the chase. Well, the end of the story, but not really the end, is that Gore and the U.S. caved, sort of. The United States and South Africa have agreed to accept South Africa's statement that it has no intention of violating international law as an excuse to end hostilities. The U.S. will stop threatening and punishing South Africa. The drug companies will not pursue the suit they had brought to stop South Africa from making or buying cheap versions of their drugs. A stunning, almost unbelievable win. So unbelievable, in fact, that we're still not sure they've actually all agreed to something real. Which is why I went to the United Nations a few days ago, got myself into a press conference President Mbeki was holding and asked him directly whether this agreement would actually provide South Africans sufficient access to an adequate supply of drugs. He sort of dodged the question, while reasserting their right to do what they plan to do.
Here's what you need to know. This is not over. While we have embarrassed the United States into backing down over AIDS drugs for South Africa (maybe), our government is still threatening and punishing lots of other countries over the exact same issues. And the countries we're fighting, of course, are precisely the ones who are so poor they can't afford the drugs, unless they can get cheaper generic versions. The rich countries seem happy to continue to fill drug company coffers (so politicians can continue to get kickbacks in the form of campaign contributions?). Here's a partial list of countries we're currently fighting over access to drugs: Argentina, Brazil, the Dominican Republic, Egypt, Israel, Costa Rica, Hungary, Jordan, Korea, Oman, Pakistan, the Philippines, Qatar, Thailand, United Arab Emirates, Vietnam.
My favorite amusing note of the week is that a member of the U.S. House of Representatives, Sherrod Brown, now wants to introduce a bill in Congress to allow the U.S. to make or purchase cheaper versions of these drugs. What's the administration's position on that!?!
Here's a hint, and the dropping of the other shoe. President Clinton spoke to the United Nations, too. You may have seen the excerpts of his speech in The New York Times. You may even have been impressed that he talked about the need to end the AIDS crisis in Africa. What you didn't read, because it was not included in the Times' excerpt, was Clinton going on to say that he "will ask public health experts, the chief executive officers of our ["our"!] pharmaceutical companies, foundation representatives and members of Congress to join me at a special White House meeting to strengthen incentives for research and development, to work with, not against, the private sector, to meet our common goals." Boy, that says it all. A White House meeting to figure out how to protect the profits of the drug industry, and announced by the President of the United States at the United Nations. The mind boggles. I had been amazed at our success in forcing the U.S. government to respond to our demands. I knew we had gotten awfully lucky with the confluence of the State Department bragging publicly, the Vice President feeling particularly vulnerable because of his own ambitions, and the South African president due in New York for meetings with Gore and appearances at the U.N. All of that fell into place incredibly neatly.
But in the end, it turns out their capitulation was, yet again, merely strategic. They looked at the same set of circumstances and made a decision to follow the path of least resistance, which they have clearly calculated was the best they could do at the moment. But the price for their moving on this, and getting the pharmaceuticals to back off, is a renewed commitment to drug company profits. And the drug companies are so angry about this that they made the President of the United States stand up for them publicly at the United Nations.
The war has just begun. Because the activists are not backing off, either. First, we want to make sure this deal with South Africa actually pays off for people there who will otherwise die. And then we want everybody in the world with HIV to have access to the same drugs that people with HIV in the United States now take for granted. And, as a matter of fact, we'd like a lot of other things to happen on behalf of those living with war and disease and poverty everywhere. So, Mr. Clinton and Mr. Gore and all the rest of you, watch out. We're going to get even scarier.