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Contributions from
the Column
Facts and trends
AIDS: auditors criticise Bush administration
WTO disapproves of EU sugar subsidies
Demobilisation in Afghanistan a success
Additional funds for German civil peace service
Kemal Dervis next head of UNDP
New World Bank data on governance
Monetary fund for Asia under preparation
New leaders for WTO and UNCTAD
Canada concentrates development aid
The failure of Plan Colombia
06/2005
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[ Fighting AIDS ]
US congressional auditors
criticise Bush administration
The US Government Accountability Office (GAO) has expressed criticism of the US programme for the global fight against AIDS. The inspectors do not approve of the programme exclusively relying on expensive brand pharmaceuticals. The Bush administration started the initiative two years ago and wants to make a total of US$15 billion available by 2008. So far, the aid organisations that receive support have only been allowed to use patented drugs, rather than cheaper copycat products (generics). Depending on the treatment, the costs per AIDS patient have accordingly turned out US$40 to US$368 more expensive, according to the GAO data, with treatment costs for 100,000 patients rising by $170 million.
The administration bases the present restriction to brand-name products on the fact that only medication with the highest safety standards should be used. However, generics are also thoroughly tested before the World Health Organisation (WHO) recommends their application. Aid organisations suspect, therefore, that the US government actually wants to boost the nation’s pharma industries. The GAO also refers to quality control processes of other initiatives, without discussing them in detail. The US State Department, that runs the global AIDS programme, accused the GAO of only caring inadequately about safety issues. The State Department bemoaned that the GAO report fails to point out that the WHO temporarily took Indian AIDS generics off the recommended list because their effectiveness had not yet been proven beyond any doubt (D+C/E+Z 2004:8/9, p. 315, and 2005:1, p. 6).
However, the US administration is apparently not sticking strictly to its original stand. According to the GAO, the AIDS Coordinator’s Office is working on expanding the selection of permitted medications – including generics. Generics manufacturers were called upon to have their products tested by the US Food and Drug Administration (FDA) and the FDA issued its first safety certificate for a foreign AIDS generic in January (D+C/E+Z 2005:3, p. 95).
Nevertheless, the assessors point out a further hurdle. Even generics that fulfil the required safety standards may only be bought in the context of the US Emergency Plan if the patent holder grants permission to do so. This rule is in accordance with the Foreign Assistance Act of 1961, the US law on the use of aid funds. Therefore, the drug from South African manufacturer Aspen Pharmacare that was tested by the FDA may not be used in the framework of the US AIDS programme yet (contrary to what we incorrectly reported in D+C/E+Z). While the State Department can, in principle, ignore this requirement, the GAO report doubts that it is prepared to do so. (ell)
On the Internet:
The GAO report: http://www.gao.gov/new.items/d05133.pdf
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