The fight against HIV/Aids – get on board with Unitaid
by Jill Filipovic, October 4, 2011
A group tackling HIV/Aids in developing countries is using innovative methods that even drugs companies could like
photo: Unitaid wants pharmaceutical companies to sign up to a drug patent pool. Photograph: Krista Kennell/ZUMA/Corbis
Daniel is six months old, and one of the more than a million children in Africa born of HIV-positive mothers every year. Without prenatal treatment, up to30% of these children will contract the virus. Daniel is one of the luckier ones, so far. His mother, Elise, found out she was HIV-positive eight months ago, while she was pregnant with him. She took the necessary antiretrovirals to decrease the risk of transmission. But Elise lives in rural Cameroon, and since she was diagnosed has travelled two hours by car every month to the closest clinic to get the drugs necessary to prevent transmission to her child. The travel is expensive, but she wants her son to be negative, and she wants to be healthy. The type of drugs she takes require consistent usage; if they’re taken intermittently, she can develop resistance, which requires moving on to different (and more limited) treatment options.
When she showed up at the clinic last month, there weren’t any drugs in stock. When she took Daniel in to be tested, she was told she would have to wait a month to find out whether her baby had HIV.
We’ve heard the statistics. A baby born in a developing country is 13 times more likely to die before she reaches the age of five than a baby born in an industrialised country. A woman dies every minute from pregnancy-related causes. Three-quarters of all women with HIV live in sub-Saharan Africa. Sub-Saharan Africa shoulders 25% of the world’s disease burden, but represents only about 10% of its population and has 1% of its health workers. Ninety per cent of babies born with HIV are born in sub-Saharan Africa.
In the US and Europe, antiretrovirals for pregnant women are widely available; an incredibly tiny number of children in Europe and the US are born HIV-positive. And if you walk into a clinic in Paris or San Francisco, you can find out your HIV status that same day. Elise and Daniel are still waiting.
Billions of dollars have been pumped into ending the HIV/Aids crisis, and yet the most basic resources remain unavailable for millions of people. Aid from the global north, while well intentioned, has allowed the leaders of developing nations to funnel their own country’s money away from public health and into military development. Trade agreements between India and Europe have also opened up commerce, but put the kibosh on cheap generic copies of Aids drugs, making them even less accessible for those in the poorest countries. And American funding of HIV/Aids programmes has been ensnared in our increasingly vitriolic and illogical culture wars, with “pro-life” and “family values” leaders tying cash to ideological evangelism rather than proven public health strategies.
I met Elise and Daniel on a clinic visit with the leaders of Unitaid, an organisation dedicated to increasing access to HIV/Aids, malaria and tuberculosis treatments for people in developing countries. Unitaid is largely funded through innovating financing methods, including a tax on airplane tickets – about $1 for economy class tickets – in 14 countries. France was the earliest adopter, and the tax was the first in French history to bypass the government, going directly to a non-governmental organisation. Several countries that receive assistance from Unitaid, including Cameroon, now levy a similar tax on plane tickets. Unitaid, then, isn’t just western aid stepping in; it’s also recipient countries doing it for themselves.
Unitaid is also hoping that desire to change for the better extends to drug companies – it is pushing pharmaceutical companies to sign on to “patent pools”, where they suspend the patents on the most necessary HIV/Aids drugs only for the poorest countries, allowing those drugs to be produced generically and combined with other companies’ drugs. The drug companies would be awarded royalties, and would maintain the patents in wealthier nations.
The idea behind the patent pool is that everyone wins. People in developing countries who need drugs (and particularly second- and third-line treatments) get them on the cheap, and pharma companies aren’t losing profits, since the people purchasing the drugs manufactured in the patent pool wouldn’t be buying them if they were full price.
It won’t come as a surprise to learn that most of the big pharmaceutical companies have not signed on to the plan. One, notably, has – Gilead Sciences, one of the largest manufacturers of HIV/Aids drugs in the world. It’s a victory not just for the Unitaid model, or for the possibilities of corporate philanthropy, but also for basic human decency, where someone realises they can extend and save millions of lives with the stroke of a pen, and so they do.
It’s a fairly simple moral calculus, but it remains to be seen if other big pharma companies will follow suit. In the meantime, Elise still drives the two hours every month to the clinic, and hopes meds are available when she gets there. She’s only 21, and wants to watch her son grow up.
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