AIDS Patents Vs Patients' Pleas

To AIDS activists, the case is quite simple: The pharmaceutical industry is trying to stop the developing world from getting cheap, generic AIDS drugs.

Pharmaceutical manufacturers say the case is simply about an unclear South African law that could violate their patent rights.

The lawsuit brought against the government of South Africa by more than three dozen pharmaceutical manufacturers has stirred up strong emotions ahead of its scheduled start Monday in Pretoria's High Court.

"This case is one of the most important things that is going to happen in Africa and for countries in Asia and Latin America," said Zackie Achmat, chairman of the Treatment Action Campaign, a South African AIDS activist organization.

More than 25 million of the 36 million people infected with HIV live in sub-Saharan Africa, one of the world's most impoverished regions. In 2000, 2.4 million people in the region died from the effects of AIDS.

With little access to the medicines that have turned AIDS from a fatal to a chronic disease in the West, the overwhelming majority of these people - and the millions infected in other poor countries - will die from the disease.

To help fight the disease, which now afflicts about 10 percent of South Africa's 45 million people, the country passed a law in 1997 giving the health minister a limited right to import generic versions of patented drugs or license their domestic production.

The law has never been used.

The pharmaceutical manufacturers sued in 1998, arguing the law was too broad and unfairly targeted drug manufacturers over other patent holders. The case could take a year to resolve.

"This is a narrow fight," said Mirryena Deeb, head of the Pharmaceutical Manufacturers Association of South Africa, a trade group that is part of the lawsuit. "It's the arbitrariness and uncertainty we are fighting. It's got nothing to do with access" to AIDS medication.

Government officials say the law would not be applied broadly and South Africa would continue to respect its international trade agreements that offer protection for companies with patents, but allow exceptions in emergencies.

Both sides view the other as intransigent and unwilling to compromise.

The pharmaceutical industry points to South Africa's refusal to widely distribute any AIDS medication to its people, even a relatively inexpensive course of anti-retroviral medication that has been shown effective in preventing mother-to-child transmission of HIV.

Deeb also said the government has declined to take advantage of several pharmaceutical companies' recent offers of vastly reduced prices for their AIDS drugs.

South Africa says it has been negotiating, but the reduced prices would still bankrupt its health budget.

Representatives for several humanitarian organizations said few countries would be able to afford to implement wide-scale treatment programs even at the reduced prices.

"Those reductions are simplnot enough," said Ellen 't Hoen, head of Doctors Without Borders' campaign for access to essential medicines. "Companies are gaining a lot in terms of goodwill and PR, but the effects on the ground are actually very, very little,"

If the pharmaceutical companies win their suit and the law is overturned, the government will work to pass a new law that will conform to the court's ruling, said Dr. Ayanti Ntsaluba, director general of South Africa's health ministry.

"We're dealing with a very enormous challenge and success is not going to be easy," he said.

To Father Angelo D'Agostino, who cares for over two dozen HIV-positive orphans at his clinic in Kenya, the issue is nothing more than life and death.

D'Agostino tells CBS News Correspondent Lee Cowan that the medication for five of his children is paid for by overseas sponsors - leaving most of the orphans without the drugs they need.

"The other twenty will just go without it - and inevitably develop fatal infections or whatever, and die," says D'Agostino, who isn't content with that scenario and has begun his own importation of tiny amounts of cheaper, generic AIDS medications.

It isn't enough, but it is - something.

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