OUTRAGEOUS! SCANDALOUS! SHAMEFUL! UNCONSCIONABLE!

Funding Access-vs.-Prevention at 14th ICASA AIDS Conference in Nigeria

I was talking with a friend last night and discussing the current state of engagement (or lack there of) of the world in addressing the AIDS pandemic that is brutalizing a third of the worlds population either directly through infection or indirectly through the suffering of those who love them.

It was time to look in to this. What the heck is going on? Where are the millions that are promised?

This was a day of days to ask that question. December 7 can be known again as a day that will live in infamy for a more recent, but as shameless act.

With all its pseudo- compassion and promises the “help is on the way” The Bush Administration is again showing it’s true colors.

In Abuja, Nigeria this week, a six-day conference known as the 14th International Conference on AIDS and Sexually Transmitted Infections in Africa, is being attended by about 7,500 representatives from around the world, a majority of them from African nations. The theme of this conference is "HIV/AIDS and the Family."

With the world, and Africa in particular, at the center of a worldwide AIDS pandemic, it was shocking to hear that these developing countries are still having to beg for HIV/AIDS-related funding and access to treatment that is being held up and denied on over the argument of the value of emphasizing abstinence over condom use in prevention programs as well as a generic vs banded drugs issue.

At the conference, Assistant U.S. Global AIDS Coordinator Jimmy Kolker was berated by many heath groups on the ground in Africa who have not been able to receive funding from the five-year, $15 billion President's Emergency Plan for AIDS Relief because they work with health care providers who offer abortion services or refuse to denounce commercial sex work as U.S. policy requires.

YOU HAVE GOT TO BE KIDDING ME!

You are going dangle basic medical care and hospice relief in the face of already suffering, poor and impoverished people for the sake and promotion of extreme conservative policies of extreme conservative ideological agenda of the current administration of the United States of America?

That is shameless and sadistic!

In his State of the Union address on January 28, 2003, President Bush announced the $15 billion President's Emergency Plan for AIDS Relief (PEPFAR/Emergency Plan), the largest commitment ever by a single nation toward an international health initiative—a 5-year, $15 billion, multifaceted approach to combating the disease in more than 120 countries around the world, placing a special emphasis on 15 focus nations (Botswana • Cote d’Ivoire • Ethiopia • Guyana • Haiti • Kenya • Mozambique • Namibia • Nigeria • Rwanda •South Africa • Tanzania • Uganda • Vietnam • Zambia) in Africa, the Caribbean, and Asia, which represent approximately half of the world’s infections.

What is buried in the fine print, and not spoken aloud expect in trusted company, is that PEPFAR contains policies on prevention driven, by ideological motivations, which utterly disregard scientifically established beliefs and tried and true successful methods.

Examples of the overbearingly strict requirements that the Bush administration has tied to PEPFAR funding include mandating that 33% of prevention funds be spent on abstinence-until-marriage programs, and limiting condom distribution to narrowly-defined "high risk" groups, as well as demanding that grantees explicitly condemn sex workers.

It is abhorrent and unconscionable that any country with the overwhelming capacity and ability to strike a major blow in the fight against this devastating disease, would strong arm their personal and ideological beliefs, mindless of the counter productivity that digging their heels in the mud on these issues does to the establishment and prolongation of comprehensive prevention programs that have demonstrated their effectiveness in slowing the spread of HIV for years now.

Cited countless times as a blatant example in the news and all over the internet recently, is the situation in Uganda.

In Uganda comprehensive prevention efforts have been credited with dramatically reducing HIV incidence over the last 10 years. However, because of recent pressures from the Bush Administration and fear of not meeting the PEPFAR funding requirements, a noticeable shift in prevention approaches has been taking place in Uganda.

Ugandan President Museveni, and other leaders, have suddenly, without rhyme or reason, begun to vehemently endorse abstinence-only programs and increased anti-condom rhetoric in public announcements and state driven media. More surreal is that the Ugandan government has IMPOUNDED 32 million, WHO quality-approved, condoms in government warehouses. All this while the U.S. government hurriedly ramps up financing for their own pet abstinence-only approaches to HIV prevention.

It gets worse.

As sickening as it might seem, there seems to be a stacking of the deck for no other apparent purpose than to insist that AIDS drugs are produced in one place whose ONLY beneficiary can be the already powerful and über-wealthy U.S. Pharmaceutical industry.

Before you scream conspiracy theorist and log off, read on. These are undisputable facts. You make your own conclusion.

Although President Bush has already publicly acknowledged (State of the Union 2003) that lower-cost antiretrovirals (ARVs) would create an massive opportunity to extend the reach of treatment access to more people now living with AIDS, the prices that he cited as examples of lower-cost ARVs are available at those prices ONLY from generic manufactures.

It’s been nearly three years after that speech and well over two years after the official launch of the PEPFAR and there is little if any evidence that the Bush administration has begun to think about making the phone calls to set up the meetings to arrange for the opportunity for it to avail itself of these lower prices offered by generic producers or even the slightest bit of movement in the direction of procuring generic ARVs…..not even those ALREADY APPROVED FOR USE by the WHO with US government dollars.

WHY ! ?

The department of Health and Human Services (HHS) has been quite clear, very early on, that it would NOT purchase WHO pre-qualified generic ARVs, arguing that the WHO's process was not “as rigorous” as that of the Food and Drug Administration (FDA) in how it assesses the quality of drugs. HHS makes special note to point out the example of existing pre-qualified WHO treatments where up to 3 different drugs have been combined in a single pill.

So, rather than procuring affordable, bio-equivalent generics, that are already pre-qualified by the WHO and being used to treat hundreds of thousands of people living with HIV/AIDS, the United States Department of Health and Human Services is going to have an ideological argument about whose drug testing and qualifying process is better, while hundreds of thousands of people are dying horrific deaths?

THIS IS OUTRAGEOUS! SCANDALOUS! SHAMEFUL! UNCONSCIONABLE!

The most superficial research, readily available on the internet, seems pretty clear that argument has NO BASIS IN REALITY!

COUNTLESS national governments, international organizations who provide treatment (i.e. Doctors Without Borders) and known global initiatives (i.e. Global Fund to Fight AIDS, TB, and Malaria, the Clinton Foundation, etc) rely on the WHO’s Pre-qualification Project to certify the quality and efficacy of both generic and brand-named drugs that they recommend and purchase for their programs.

Herein lies the rub. This is where the American Pharmaceutical companies get their noses bent out of shape….and it’s all about marketing and money.

Ready?..OK here goes…..

The WHO's guidelines for ARV therapy RECOMMENDS 3-in-1 fixed-dose combinations for first-line therapy for the very basic reason that 3-in-1 fixed-dose combinations are easier to take and manage, especially in under developed countries.

OK, so let’s buy or make 3-in-1 fixed-dose combinations, right? Well, you see, the the thing you need to know is that these 3-in-1 fixed-doses are ONLY available from generic producers.

Get it? The large American Pharma Corporation DO NOT produce them.

Why?

Marketing and Money: Why make an all inclusive dosage at one price when you can charge three times that amount by marketing the same solution as three separate drugs?

In May of 2004, in their usual style and in an obvious attempt to deflect the ensuing international criticism challenging the refusal to purchase generic AIDS drugs and fixed-dose combination (FDCs), HHS announced a new FDA "Fast Track" process for reviewing generic and brand-name AIDS drugs whether FDC, co-packages, and a new process for single doses. This new FDA approval clears the product, albeit tentatively, "for consideration for purchase and use outside the United States, “ under PEPFAR guidelines.

Of course, these products are not allowed to be marketed in the U.S due to existing patents (ah here’s more $$$$) and/or data or marketing exclusivity (oh look…Mo Money!).

You’re seeing it right?

1. The Bush Administration’s insistence on abstinence-only programs to prevent AIDS is hobbling the developing world’s battle against the AIDS pandemic by ignoring and downplaying the role of condoms and other ‘non- abstinence-only’ efforts. The immeasurably destructive consequences that this policy is having on the people in Africa, Asia, the Caribbean and other developing nations of the world is nothing less than scandalous.
   

The FDA approval system for generic AIDS drugs has created an absolutely needless and pointless duplication of the WHO pre-qualification project, that brings with it new regulatory obstacles in accessing generic drugs, whose sole beneficiary is the US Pharmaceutical industry. While the impression is that the U.S. uses "more stringent" standards than WHO it is, in reality, is the standards of testing efficacy. The bottom line is that people are dying in places that don’t have electricity. They don’t care whose system is more stringent. They just need medical relief and help.

Both policies are inhumane in the fact that they deny BASIC treatment and the opportunity to live tox millions of people all over the world, which in turn denies human being the basic right to dignity and the natural rights of life and the pursuit of happiness, ideals President Bush claims were good enough to go to war over to give to the people in the middle east.

As always Brothers and Sisters, this is SPAM friendly. I leave open the option for you to email this to everyone in your address book. The way it is situated, if you have your Rich Text editor on you can cut and past it with all the pictures and links in tact as well.

This is beyond partisan politics. This about saving the world and this IS something that you CAN do something about.

First, educate yourself:

http://www.ansafrica.org/ ANSA Africa do not accept contributions from government agencies or corporate companies whose values compromise our work or the work of our partners. It is because of the support of dedicated and caring individuals like yourself that ANSA can effectively stand apart from bigger organizations that need to place diplomacy and political loyalties above making a difference.

http://www.healthgap.org/ HealthGAP is an organization of U.S.-based AIDS and human rights activists, people living with HIV/AIDS, public health experts, fair trade advocates and concerned individuals who campaign against policies of neglect and avarice that deny treatment to millions and fuel the spread of HIV

http://www.who.int/en/ The World Health Organization is the United Nations specialized agency for health. It was established on 7 April 1948 and it’s stated goal is the attainment by all peoples of the highest possible level of health

Now do this…and tell the world that is unacceptable!

Contact your elected representatives :http://www.congress.org/congressorg/homeLeague of Women Voters Media email database:Http://www.capwiz.com/lwv/dbq/mediaTV news addresses:http://digbig.com/4bqmqAddresses for major U.S. daily publications/wire services/weekly publications: http://digbig.com/4cqgeMajor publication addresses by state:http://digbig.com/4bwxw