March 17, 2001
Drugs and Africa: Profits vs. People
When Poor Nations Need Expensive Treatments
PRETORIA, South Africa (Zenit.org)
- Should pharmaceutical companies cede their patents to help AIDS victims in
Africa? Should the firms sell the drugs below cost?
Debate over these questions has intensified recently as activists, countries and
drug firms grapple with the problem of how to make AIDS treatments accessible to
people who normally could never afford them.
Pharmaceutical giant Bristol-Myers Squibb this week announced that it would no
longer try to stop other companies in Africa from making generic versions of one
of its drugs used to treat human immunodeficiency virus (HIV), the New York
Times reported March 15. Bristol-Myers holds the patent on d4T, or stavudine,
sold as Zerit, and said it would not use its legal rights to keep lower-cost
generic versions of this drug out of South Africa or any other African nation.
Bristol-Myers also said it would slash the price of Zerit and another AIDS drug,
ddI, or didanosine, sold as Videx, in Africa, to a combined price of $1 a day.
In the United States, one day's dose of the two drugs costs $18.
The decision was praised by many activists who have been urging the drug
companies to allow generic-drug makers to make cheap versions of lifesaving
medicines. "This is groundbreaking," said Kate Kraus, a member of ACT
UP Philadelphia, a group that has led protests around the world against the big
Bristol-Myers' announcement came shortly after U.S.-based Merck & Co.
decided it would offer Crixivan and Stocrin, its two anti-retroviral medicines,
for $600 and $500, respectively, per patient per year in the developing world.
"At these prices, it said, it would make no profit," the Financial
Times reported March 7.
The decision to reduce prices came just after a trial commenced in South Africa,
brought by 39 pharmaceutical companies who are challenging a 1997 law giving the
government power to produce or import cheaper versions of drugs still protected
by patent. South African authorities say that with up to 4 million HIV-positive
people in their country, the drug industry has not reacted sufficiently to help
meet the high cost of treatment for infected patients. The companies, for their
part, accuse South Africa of letting the AIDS problem get out of control.
Human rights groups say the case goes beyond legal matters, the Washington Post
noted March 6. The deeper question, the groups say, is to what extent the
property rights of prosperous Western corporations should prevail against the
developing world's need to curb a major public health crisis. It's estimated
that of the 36 million people living with HIV, more than 25 million are in
The pharmaceutical debate is not limited to AIDS treatments. The Guardian
newspaper in England reported Feb. 12 that sufferers of diarrhea, meningitis,
malaria and tuberculosis also go untreated because the drugs they need are too
expensive for them.
The cost of treatment for HIV is particularly high. AZT and 3TC, the basic
anti-retroviral drugs, carry an annual price tag of $10,000 to $15,000 per
patient. By contrast, most workers in South Africa earn less than $3,000 a year
-- and they are considered rich by the continent's standards.
Brazil, India and Thailand have started producing cheaper versions of anti-HIV
drugs. Cipla, an Indian firm, asked the South African government for permission
to sell inexpensive generic versions of eight of the 15 commonly used anti-HIV
drugs, the New York Times reported March 10. Cipla has said it could offer an
AIDS regimen for $600 per patient per year.
Recouping research costs
In their defense, the pharmaceutical companies argue that they need patent
protection to recoup the vast sum it costs to research and develop drugs. They
say it takes $1 billion to get a new medicine to market.
The Financial Times in a March 9 article considered that the decision by Merck
to lower prices "could set an extremely dangerous precedent for the drugs
industry" and lead to an "all-out price war." The same could
occur for other patented drugs. The newspaper quoted Trevor Jones,
director-general of the Association of the British Pharmaceutical Industry, who
said, "While the industry is more than willing to do what it can, it cannot
act as a sort of National Health Service to the world."
The Financial Times warned that if the industry cannot overcome the impression
that it is willing to place the sanctity of patents above the sanctity of life,
support for intellectual property on medicines could erode. "That would
undermine the entire foundation on which drug research is built," the
The same paper, however, pointed out Feb. 17 that the patent system, which
enables companies to recoup research costs and make profits, has a disadvantage:
The price of patented medicines bears no relation to the cost of manufacturing
them. And while companies claim that they operate in a competitive environment,
when a medicine finally goes off patent, generic manufacturers can charge a
tenth of the price and still make a profit.
Furthermore, the Financial Times argued, the industry's claim that it needs
"super-profits" to undertake risky research investments is undermined
by the huge amounts it lavishes on marketing. GlaxoSmithKline, the newly merged
Anglo-American company, boasts that it spends $500,000 an hour on research and
development. But it invests nearly twice as much in sales and marketing.
On the question of patent protection, the Guardian newspaper Feb. 12 contended
that "patents are killing people." Moreover, the British paper said,
intellectual property protection "has become a tool to make permanent the
growing inequality of the global economy." The Guardian observed that the
United States now accounts for 275,000 patent applications a year. By contrast,
26,000 patent applications were filed in 1997 to the African intellectual
property organization and only 31 came from resident Africans.
Even at much lower prices, relatively few Africans can afford anti-AIDS drugs
without outside assistance; the poorest nations have annual health budgets
equivalent to $10 per person. So the next step could be action by the Group of
Seven major industrial powers, the Wall Street Journal reported March 13.
Pressure apparently is building to announce an anti-AIDS plan at the G-7 summit
in Genoa, Italy, this June.
Italy, which is hosting the summit, has proposed creating a trust fund of at
least $1 billion -- part from governments, part from private companies -- that
would be managed by the World Bank and would fight AIDS, tuberculosis, malaria,
dysentery and other diseases.
A way has to be found whereby drug companies receive sufficient protection in
order to have a financial incentive to keep producing new products. At the same
time it is clearly unjust to charge Third World countries the same prices for
treatment that people in the richest nations pay.
and Motherhood: Still a Hard Balance
Opportunities Are Greater, But Risks Remain
NEW YORK (Zenit.org) - Women
are more successful in building careers, even if difficulties still exist.
The Wall Street Journal on March 1 reported on a study it did, looking at 30
influential businesswomen in Europe. It noted that among the top 50 business
schools worldwide, the European institutions' percentage of women students, 26%,
was catching up to the U.S. level of 30%.
Yet the number of women executives was limited. Ann-Kristin Achleitner, a
banking and finance professor at the European Business School, offered an
explanation: "To get into influential positions at big companies you have
to have been working for 10 to 15 years -- and there are few women over here who
have really done that."
In the United States, women also have difficulties in reaching the top. Business
Week magazine in its Nov. 27 issue observed that while 45% of all managerial
posts are held by females, only two of the nation's 500 biggest companies have
female chief executive officers: Carly Fiorina at Hewlett-Packard and Andrea
Jung of Avon Products.
The World Bank's Development Indicators for 2000 show a global average of female
participation in the work force of 40.5%. The study, however, warns this
underestimates the number of women in the labor force, because many work on
farms or in family enterprises without pay.
"A very poor bargain"
During the last decades frequent battles have been fought to achieve equality of
opportunity for women in the workplace. Many barriers to women have been broken,
although the situation varies greatly from country to country.
One issue now under examination is how women can find equilibrium between work
and the family. A survey conducted as part of the Wall Street Journal study
found that half of the women interviewed said they had enough time with their
children and an option to return to work. But another 36% who have children at
home feared missing out on advancement while on maternity leave.
These divisions were reflected in a debate in Australian newspapers over how to
balance motherhood and work. In the Sydney Morning Herald on Feb. 27, Bettina
Arndt argued that "women who trade having children for a career may find
they've made a very poor bargain."
Arndt observed that the desire to get ahead at work seems to be a major factor
why growing numbers of Western women are remaining childless. The danger in this
is that a growing number of women rely on career satisfaction as their major
source of lifetime fulfillment. In Arndt's opinion "this is likely to prove
a very risky course."
Arndt quoted several studies, of men, demonstrating that success at work often
does not fulfill their expectations of what constitutes the good life. Arndt
also enlisted the support of feminist Betty Friedan. In Friedan's book "The
Fountain of Age," recent research shows that older women who have combined
marriage, motherhood and work demonstrate the highest psychological well-being,
significantly greater than women who were neither married nor mothers.
In reply, Dorothy Cook, in The Age newspaper on March 8, argued that there are
many reasons for women's hesitancy about having children -- a principal one
being that "we live in an anti-child economy of long work hours and high
child-care, education and housing costs."
Even if women's emotional desires are important, "they are constrained by
the reality we see around us." Today's world, observed Cook, "is
faster, more fragmented, more bewildering, and consumer-driven. Intimate
relationships are harder to establish and maintain in the grip of a savage
consumer culture that is inherently anti-child and anti-intimacy."
Another opinion came from Catherine Keenan in the Sydney Morning Herald on March
9. Most women still want children in marriage, Keenan argued, but today marriage
and children are being put off until later in life, and relationships often end,
either in separation or divorce, before the kids come along. When families break
up, it is normally the women who keep the children -- and the specter of being a
lone mother leads many women to put off having children.
To resolve the problem, Keenan affirmed that "we need workplace conditions
designed for the needs of families, not individuals, and men who take more
seriously the responsibilities of fatherhood."
On a personal level, Amber Rust wrote about her experiences for The Sunday Times
on March 11. An Oxford graduate, she decided to forsake a career and now, aged
28, has two children. She noted that none of her friends has started a family,
preferring to dedicate themselves to work.
Rust observed that having kids first was financially difficult, because she was
still paying off her student loans. Moreover, finding a job now with the
necessary flexibility to care for children is difficult. She does not regret her
decision to start a family and sacrifice her job prospects. But she would like
to find a way to "do justice to myself and my education without working
long hours in an office."
In an earlier article, Bettina Arndt argued in favor of more opportunities for
part-time work. In the Sydney Morning Herald on Dec. 23, Arndt quoted research
by a London School of Economics sociologist, Catherine Hakim. The research
showed that while 10% to 30% of women opt for complete dedication to work, an
equivalent number leave the work force to dedicate themselves to the family. The
rest look for a way to combine the two.
Hakim's book, "Work-Lifestyle Choices in the 21st Century," finds that
women who wish to combine working with caring for their children are increasing
limiting their families to one child, particularly in countries such as the
United States and France.
The study points out that at some stages of their lives, when women don't have
children, they might work full time. But when they have children, they might
step back completely or go to part-time work.
Ann Crittenden commented in her recent book, "The Price of Motherhood: Why
the Most Important Job in the World Is Still the Least Valued," that
motherhood carries a steep price tag, mostly in lost wages and benefits.
Crittenden worked for about 20 years, the last eight of them at The New York
Times, before leaving to raise her son. Just looking at lost wages alone, she
figures motherhood has cost her between $600,000 and $700,000 for the 15 years
she devoted to her son.
Crittenden, according to a Business Week review March 2, is a "committed
feminist," but is disappointed that mainstream feminist organizations still
devalue motherhood and a woman's role in the family. Among the reforms
Crittenden supports is a shorter workweek, more generous leave policies,
family-friendly tax reform, and universal preschool for 3- and 4-year-olds.
The arguments over how to reconcile equality, work and the family are complex.
But an increasing number of women realize there is a need to fight for equality
not only in the workplace, but also in achieving greater recognition of the
value of motherhood.
Discrimination occurs not only when women are denied promotions or the ability
to enter in certain occupations, but also when they are not able to find a way
to remain in the work force part time when they have children, or return to work
after taking off a few years to raise a family.