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Africa: Global Heath Fund Update, 2
Africa: Global Heath Fund Update, 2
Date distributed (ymd): 020130
Document reposted by Africa Action
Africa Policy Electronic Distribution List: an information
service provided by AFRICA ACTION (incorporating the Africa
Policy Information Center, The Africa Fund, and the American
Committee on Africa). Find more information for action for
Africa at http://www.africaaction.org
++++++++++++++++++++Document Profile+++++++++++++++++++++
Region: Continent-Wide
Issue Areas: +economy/development+ +health+
SUMMARY CONTENTS:
The Global Fund to Fight AIDS, TB and Malaria held its first board
meeting in Geneva on January 28-29, and announced funding criteria
for grants to be decided in April. Simultaneously President Bush
announced his budget proposal including a U.S. contribution to the
Fund for Fiscal Year 2003 (beginning October 2002) at the same low
level of $200 million as for this fiscal year. President Bush's
State of the Union address contained no mention of AIDS, global
health, poverty, or any other global or African issue except
terrorism.
This posting contains three action-related documents concerning the
current status of the fund.: (1) an organizational sign-on letter
addressed to President Bush and Congress (open to organizational
sign-ons by both U.S. and non-U.S. groups), (2) a press release
from Treatment Action Campaign in South Africa concerning their
initiative importing antiretrovirals from Brazil (a good example of
what the Global Fund should be funding), and (3) a memorandum by
Health Gap Coalition on critical issues in the first months of the
Global Fund's operation.
A related posting also sent out today includes a brief introductory
note by Africa Action executive director Salih Booker, the press
release from the Global Fund calling for funding proposals to be
submitted, and a note from the selection committee on the NGO
members chosen for the Global Fund board.
+++++++++++++++++end profile++++++++++++++++++++++++++++++
Stop Global AIDS Campaign
Updated Sign-On - Jan 28, 2002
100 Organizations Signed On: More Needed
Call for Urgent Action by President George W. Bush and Congress to
Fully Fund the Fight Against AIDS
- Read the Statement below to see if your organizational can
sign-on. If yes, please an email to pzeitz@globalaidsalliance.org;
Please provide the name of your organization and its location
(state and country);N
- Please pass this email on to your listserve, consider posting on
your website, and encourage as many organizations as possible to
sign on to this statement;N
- This statement will be used by advocacy groups who are meeting
members of Congress in their Districts and in Washington Offices.
It will also be sent to the President and all key Administration
officials. The statement is designed to demonstrate the broad-based
coalition that is supporting increased US government funding to
stop global AIDS;N
- Updated versions of this organizational "Call for Action" will
be posted at http://www.globalaidsalliance.org
FOR MORE INFORMATION:
Dr. Paul Zeitz, Executive Director, Global AIDS Alliance
Box 820, Bethesda MD 20827-0820
tel: 301-765-2046, cell: 267-254-5857, fax: 301-765-6091
pzeitz@globalaidsalliance.orgN
http://www.globalaidsalliance.org
http://www.yahoogroups.com/group/global-aids-alliance
CALL FOR URGENT ACTION TO STOP GLOBAL AIDS
(Update as of 28 January 2002)
Our organizations are humanitarian, religious, and other groups
committed to a full-scale effort to stop the global AIDS pandemic
and its related causes, particularly in the impoverished regions of
the world, which have been the hardest hit by the AIDS crisis.
Because of the unprecedented impact of the crisis, we call on
President George W. Bush and the US Congress to provide $2.5
billion in FY 2003 resources to the Global Fund to Fight AIDS, TB,
and Malaria and to bilateral AIDS programs.
Without bold investment now, projections are that 100 million
people will become infected by 2007. The AIDS pandemic and its
related causes in Africa, Asia and elsewhere threaten to
destabilize nations and undermine global security. We believe
taking immediate action to ensure adequate resources to combat
AIDS, TB, and Malaria is one of the best ways the US can exert
leadership in a troubled world.
Respectfully,
[The list of more than 100 signatory organizations, including
Africa Action, will be provided on-line at
http://www.globalaidsalliance.org]
Treatment Action Campaign, Medecins Sans Frontieres, and Oxfam
29 January 2002
TAC AND MSF IMPORT GENERIC ANTIRETROVIRALS FROM BRAZIL IN DEFIANCE
OF PATENT ABUSE
Joint Press Release
- Zackie Achmat: (27) 83 467 1152 or (27) (21) 788 5058
- Mark Heywood: (27) (11) 717 8634
Additional background information is available on the websites of
MSF and TAC: http://www.tac.org.za and
http://www.accessmed-msf.org
Generic AIDS Drugs Offer New Lease on Life to South Africans
Importation of generics cuts price in half
29 January 2002, Johannesburg - Yesterday, three members of the
Treatment Action Campaign, (TAC) returned to South Africa from
Brazil carrying generic drugs manufactured for use in an AIDS
treatment program in Khayelitsha. At a press conference today, TAC
and MSF explained that the drugs carried from Brazil were the
second shipment of Brazilian drugs and that as of today more than
50 people are already taking the Brazilian medicines in
Khayelitsha.
To guarantee the quality of these drugs, an authorisation from the
Medicines Control Council (MCC), the South African drug regulatory
authority, was obtained prior to their use.
"Last week in Brazil we saw what happens when a government decides
to tackle HIV/AIDS. The Brazilians' decision to offer universal
access to antiretroviral therapy even in the poorest areas of the
country is keeping tens of thousands of people alive," said Zackie
Achmat of the Treatment Action Campaign. "Central to the success of
Brazil's AIDS programme is their willingness to do anything
necessary to source the lowest cost quality ARVS. The South African
government should pursue compulsory licensing to ensure that
generic antiretrovirals can be produced and/or imported in South
Africa."
At a press conference today, the NGOs said that the court victory
of the South African government against multinational
pharmaceutical companies had opened the door to improved access to
affordable medicines. "The South African government may need
international financial help to provide treatment, but these needs
will be dramatically reduced if the government takes steps to use
the most affordable drugs available on the worldwide market, as the
multinational pharmaceutical companies are still charging
exorbitant prices for these drugs," said Dan Mullins of Oxfam.
Despite the national government's refusal to provide antiretroviral
treatment, three clinics run by Medecins Sans Frontieres (MSF)
within the government primary health care centres offer a
comprehensive package of services to people living with HIV/AIDS,
including antiretroviral therapy. This project is part of an
agreement between MSF and the government of the Western Cape,
signed two years ago with the express intent to test the
feasibility of generic antiretroviral therapy. These clinics,
located in Khayelitsha, a sprawling township of 500,000 people
outside Cape Town, were opened in April 2000 and have provided
treatment for opportunistic infections for over 2,300 people living
with HIV/AIDS.
In May 2001, combination antiretroviral therapy was introduced for
a group of people in advanced stages of AIDS. To date, 85 people
have received antiretroviral therapy and 50 of these are receiving
Brazilian medicines. Using generic antiretrovirals offers the
possibility of treating twice the number of people with the same
amount of money.
"I have personally benefited from the MSF antiretroviral programme,
and I have gone to Brazil to bring back generics so that more
people like me can have access to these medicines," said Matthew
Damane, a person living with AIDS who is receiving antiretroviral
therapy as part of the MSF programme in Khayelitsha. "The
government should publicly accept the effectiveness of these
medicines and make them available to people with AIDS in South
Africa."
"Our project shows that antiretroviral therapy is feasible in a
resource-poor setting, contrary to those who insist that poor
Africans are not able to successfully take these drugs. Patients
who were critically ill are now returning to their normal lives,"
said Dr. Eric Goemaere of MSF South Africa. "We have seen firsthand
that these drugs can be used safely and effectively here in South
Africa. As medical professionals, it is our duty to offer these
benefits to as many patients as possible."
Similar initiatives are springing up elsewhere around the country
as medical staff become increasingly frustrated by the lack of
action from the national government. Nonetheless, the price of
medicines continues to be a critical problem.
MSF has signed agreements with the Brazilian Ministry of Health
(MoH) and Fiocruz, a public research body funded by the Brazilian
government. The former established a cooperative agreement
involving technical collaboration on the response to HIV/AIDS, so
that MSF and the Brazilian MoH can collaborate to improve the
delivery of treatment in resource-poor settings. The agreement with
Fiocruz allows MSF to purchase antiretroviral drugs produced by
FarManguinhos, the Brazilian national pharmaceutical producer,
which is part of Fiocruz.
An innovative aspect of this arrangement is that the money MSF pays
will go directly into research and development for AIDS and
neglected diseases such as sleeping sickness, Chagas Disease and
malaria (all diseases for which current treatment options are
inadequate). MSF is currently using the antiretroviral drugs AZT,
3TC, co-formulated AZT/3TC, and nevirapine produced by
FarManguinhos. By using these drugs the price per patient per day
falls from US$3.20 to US$1.55.
In 1996, in response to pressure from civil society, the Brazilian
government began providing free access to antiretroviral therapy to
people with HIV/AIDS. This policy has allowed more than 100,000
people to receive antiretroviral therapy and reduced AIDS-related
mortality by more than 50%. Between 1997 and 2000, antiretroviral
treatment has saved the Brazilian government $677 million on
hospitalisations averted and treatment for opportunistic infections
averted.
South Africa could launch a similar programme. To do so, the
government needs to have access to the lowest cost medicines,
whether they come from multinational pharmaceutical companies or
from generic producers. This means both taking advantage of offers
from multinational companies and being willing to seek compulsory
licenses. These licenses can be used to produce these drugs locally
or import them and are an important way to stimulate competition,
which is a powerful tool to reduce prices.
COSATU Statement on the Importation of Generic Antiretrovirals from
Brazil
The Congress of South African Trade Unions (COSATU) and the
Treatment Action Campaign (TAC) have returned from a visit to
Brazil. The delegation included Joyce Pekane, Second Deputy
President of COSATU, Zackie Achmat, Chairperson of TAC, Nomandla
Yako, and Matthew Demane, a person who is living with AIDS and
currently being treated with anti-retroviral therapy.
The delegates, hosted by Medecins sans FrontiFres (MSF), looked at
Brazilian HIV/AIDS treatment programmes, visited factories which
manufacture generic anti-retroviral medicines and met government
officials and people living with AIDS. The Brazilian government has
formally offered the South African government help in fighting
HIV/AIDS.
On their return the delegates brought back a batch of generic
anti-retroviral medicines for use by MSF in a treatment programme
in Khayelitsha. The Medicines Control Council (MCC), having studied
the safety of these medicines, has given a Section 21 exemption
which allows for them to be imported and used by MSF.
The equivalent drugs are in fact available in South Africa,
produced by GlaxoSmithKlein (GSK) and Boehringer Ingelheim. But
they cost approximately R1000 per month compared to the cost of
R450 for the medicines being brought from Brazil.
The importation of these drugs for use under strict conditions by
MSF has been approved by the MCC. We are aware that it may infringe
patent rights. However, we believe that faced by an emergency
caused by AIDS, and in face of overwhelming support for the
government's view that patent rights should not be used to deny
people access to life-saving medicines that this importation is in
line with government and international policy.
COSATU, TAC and MSF stand by their belief that the government and
society as a whole must get anti-retroviral medicines to the people
who need then as quickly and cheaply as possible and must not let
the vested interests of multi- national pharmaceutical
manufacturers to prevent this.
This is why these medicines are being brought in. The MSF programme
in Khayelitsha is already improving the lives of over 80 people.
With affordable medicines many more people could be reached, not
only in the Western Cape but throughout SA.
Patrick Craven and Moloto Mothapo
Acting COSATU Spokespersons
011 339 4911 0r 082 821 7456
siphiwe@cosatu.org.za
082-821-7456; 339-4911
Critical Issues For The Launch Of The Global Fund
Health Gap Coalition Issues Brief, 24 Jan 2002
(Contact +1 215.833.4102, pdavis@critpath.org)
Health GAP Coalition:
P.O. Box 22439 Philadelphia PA, 19143, USA *
+1 215.474.6886 tel * +1 215.474.4793 fax
http://www.globaltreatmentaccess.org
Global Fund to Fight AIDS, Tuberculosis, and Malaria
The Global Fund to fight AIDS, TB and Malaria has a limited amount
of time to succeed or fizzle. To inspire the invest-ments needed to
mount a meaningful response to the global AIDS disaster, the GFATM
must produce dramatic results in its first year. Saturating a
measurable population sector with effectively delivered ARV
treatment can drop mortality 25-40% in a single year, with roughly
correlated decreases in rates of new infection. Yet most of the
GFATM negotiators place little priority on treatment for the 8000
people who die each day without access to AIDS medicines.
Key issues:
1. Demand that Board spend money quickly and fully.
Some TWG [Technical Working Group] members are reluctant to spend
all of the money contributed to the global fund, in order to extend
the window of the fund. Such a limited vision both accepts the
current small levels of funding, and assumes that the fund will not
ever grow to meet the $9.3 billion need. The fund must prove itself
by quickly spending every penny available, leveraging dramatic
results for greater contributions.
2. Work with board, TRP [technical review panels] and applicant
countries to ensure treatment for people living with AIDS.
Many of the TWG and board members see treatment for PWAs as not
'cost effective'. The political momentum the created the fund has
been driven largely by a demand to provide treatment for people in
impoverished nations. To refuse medicine for the 8000 people a day
dying without access is immoral, and dooms the fund to a slow
fizzle. At the December ICASA conference in Burkina Faso, NGOs
representing hundreds of thousands of people with AIDS issued the
"Ouagadougou Appeal", which calls for a minimum of 30% of the
global fund's resources to be spent on AIDS treatment in the first
year.
3. Work with recipient countries and TRP panels to work to ensure
maximum market entry for generic drug manufacturers.
Treatment access advocates have always seen the global fund partly
as a tool to jumpstart market entry of affordable generics into
developing countries. The availability of affordable medicine
within reach creates social demand for medicine, which can change
the domestic priorities of nations. The economic mechanism of
generic competition exerts a constant downward pressure on prices.
Economies of scale in the raw materials market and in manufacturing
can bring costs down substantially lower than has already been
seen. Once launched on a meaningful scale, this economic process is
difficult to reverse, irrespective of the future existence of the
global fund.
4. Work with board members to revitalize the Quickstart proposal:
A "Quickstart" to the global fund has been negotiated and
re-negotiated until, unfortunately, almost everything 'quick' or
innovative has been removed from the current language. The Board
should immediately issue an RFP [request for proposals] open to any
qualified provider demonstrably able to deliver treatment services
to people with AIDS, TB, or malaria. Recipients would then join the
country coordinating mechanism (CCM), broadening and strengthening
these bodies at the launch. This proposal addresses opposition to
treatment, and puts immediately puts resources into the hands of
NGOs and private sector workplace clinics. By building strong CCMs
from the start, results can be delivered faster than if the
eventual country proposal comes only from CCM members hand selected
by government.
5. Place strong advocates for treatment on the TRP: Submit via any
contacts on the TWG or board available. Access advocates should
share their candidates information, to enable support for a
'slate'.
Actions:
- Push former TWGs & board members to spend all the resources in
the fund, with at least 30% of grant resources spent for AIDS
treatment, delivered largely to 'Quickstart' recipients in the
first year
- Work with applicant countries to submit proposals that
prioritize treatment for PWAs and include affordable generics
wherever possible
- Lobby governments and donors for money for Global Fund.
This material is being reposted for wider distribution by
Africa Action (incorporating the Africa Policy Information
Center, The Africa Fund, and the American Committee on Africa).
Africa Action's information services provide accessible
information and analysis in order to promote U.S. and
international policies toward Africa that advance economic,
political and social justice and the full spectrum of human rights.
Africa Action
110 Maryland Ave. NE, #508, Washington, DC 20002.
Phone: 202-546-7961. Fax: 202-546-1545.
E-mail: apic@igc.org.
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