African countries spurn free Aids drug
By Geoff Dyer in Paris
Financial Times, published: July 13 2003 21:58
Only two African countries have over the past three years taken up an offer by a German pharmaceuticals company to make free donations of an important Aids prevention drug to poor countries.
Boehringer Ingelheim said that only Uganda and Botswana had taken delivery of supplies of nevirapine, the drug it offers free for use in preventing mothers from infecting their babies with HIV/Aids.
The revelation follows President George W. Bush's trip to Africa last week, which helped to highlight the devastation being wrought in the region by Aids. It comes ahead of a meeting of donor nations in Paris on Wednesday to discuss Aids funding.
The low take-up of the Boehringer offer highlights that, in addition to more funds and cheaper drugs, an effective response to the Aids epidemic also requires strong political will from African countries.
But some Aids activists have criticised the way drugs companies run donation programmes.
Boehringer began offering free supplies of nevirapine, which is sold under the brand name of Viramune, three years ago for use by mothers. The drug is also offered at a reduced price for treatment of Aids patients.
Many doctors consider the drug to be the most cost-effective way of preventing newborn babies from becoming HIV-positive because the mother only needs to take a single dose of the drug during labour.
The company said that 44 countries were now taking part in the initiative and that it was working with a number of non-governmental organisations in Africa, but only two national governments in the region were involved. Four South African provinces had also applied for donations.
"We are not at all satisfied with how it is running," said Rolf Krebs, chairman of the private German company. "It is very frustrating."
Heavy customs charges, poor logistics and lack of the necessary healthcare infrastructure were some of the reasons why many African countries had not taken part in the programme, he said.
But Daniel Berman at Medecins Sans Frontières, the medical aid agency, said excessive bureaucracy often deterred African governments from participating in drug donation programmes. "Because of the high level of administrative burdens, some African countries prefer to just buy the drugs," he said. "My advice would be to sell the drug at a cheap price [through normal business channels] and then you will see the orders skyrocket."
Aids activists say developing countries would only have a reliable flow of cheaper medicines if trade rules on drug patents are made more flexible. Boehringer has been criticised for the complicated bureaucracy of the programme and Prof Krebs said steps were being taken to simplify the application process. He added: "We often work beautifully with NGOs in the third world and then they accuse us in the first world."
President Bush's Aids initiative could galvanise more support from rich governments, he hoped. "What we really need is more funds from the developed world to buy drugs in poor countries," he said.
Nevirapine was the subject of a bitter political battle in South Africa where the constitutional court last year ordered the government to make it available to HIV-positive pregnant women following legal action taken by Aids activists.
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