Bush Administration Ready to Use Generic Antiretroviral Drugs to Fight AIDS in Africa

The United States plans to purchase low-cost generic antiretroviral drugs as part of President Bush's global AIDS initiative, U.S. officials said at a press conference during the International AIDS Society's 2nd Conference on HIV Pathogenesis and Treatment, Reuters reports (Hirschler, Reuters, 7/15). Bush in May signed into a law a five-year, $15 billion AIDS initiative (HR 1298), which aims to prevent seven million new HIV infections, provide care for 10 million people living with the disease and provide treatment to two million HIV-positive people. The House so far has approved a little more than $2 billion for international AIDS efforts for fiscal year 2004. The Senate on Thursday approved 78-18 a nonbinding resolution calling for $3 billion in FY 2004 to fight AIDS overseas, even if the amount exceeds the ceiling mandated in Congress' annual budget resolution (Kaiser Daily HIV/AIDS Report, 7/15). During his recent tour of five African nations, Bush said that the United States supports allowing developing countries to produce generic versions of antiretroviral drugs, but he did not change the country's position on a 2001 World Trade Organization proposal on the issue. WTO talks over generic drug access have been stalled since members missed a Dec. 31, 2002, deadline to reach an agreement. U.S. negotiators in February refused to sign a deal under the Doha declaration to allow developing nations to override patent protections to produce or import generic versions of drugs to combat public health epidemics, including HIV/AIDS, unless wording was included to specify which diseases constitute a public health epidemic. However, the United States last month made a concession by dropping its demand that the agreement apply only to a specified list of diseases (Kaiser Daily HIV/AIDS Report, 7/10).

Advocates' Concerns
Some advocates have expressed concern that the Bush administration would favor the brand name pharmaceutical industry in implementing its global AIDS initiative, a theory that "gathered pace" when Bush named Randall Tobias, the former chair and CEO of drug maker Eli Lilly, as global AIDS coordinator, the Financial Times reports (Dyer, Financial Times, 7/16). However, HHS Secretary and Global Fund to Fight AIDS, Tuberculosis and Malaria Chair Tommy Thompson and National Institute of Allergy and Infectious Diseases Director Dr. Anthony Fauci said that funds from the global AIDS initiative would be spent on the "cheapest good-quality drugs," London's Guardian reports. Fauci said, "We certainly want to get the highest quality at the lowest price," adding, "It may mean the (major) companies bringing their price low enough to be part of the program. It does not exclude generic drugs" (Boseley, Guardian, 7/16). Thompson also said that he is "confident" that Congress will appropriate at least $2 billion to begin the global AIDS initiative, AP/Long Island Newsday reports. "The process is working. It is moving faster than it has in a long time in Congress," Thompson said. He added that the full amount appropriated will likely be more than $2 billion, but he was uncertain if the funding would reach $3 billion, according to AP/Newsday. Thompson said, "I think we are going to be able to do a great deal" (Ross, AP/Long Island Newsday, 7/15).

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