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Africa Policy E-Journal
Africa: Lines Drawn on Global AIDS Policy Africa Policy Electronic Distribution List: an information service provided by AFRICA ACTION (incorporating the Africa Policy Information Center, The Africa Fund, and the American Committee on Africa). Find more information for action for Africa at http://www.africapolicy.org +++++++++++++++++++++Document Profile+++++++++++++++++++++
Region: Continent-Wide SUMMARY CONTENTS:
This posting contains (1) a call from over 150 Yale University
deans, faculty and student leaders for President Bush to change his
policy and do more on AIDS, (2) a brief news report on U.S. and
European successful efforts to weaken a Brazilian-sponsored
resolution at the World Heath Assembly on May 19, and (3) excerpts
from the Brazilian resolution presented to the Assembly. These
documents clearly delineate contrasting views on how to address the
global health emergency, which will be again debated at the UN
General Assembly Special Session (UNGASS) on AIDS at the end of
June. For additional background material and updates,see
http://www.hdnet.org (includes archive of discussion leading up to
UNGASS), http://www.globaltreatmentaccess.org, plus previous
postings and other links at +++++++++++++++++end profile++++++++++++++++++++++++++++++ Yale AIDS Network May 19, 2001 FOR IMMEDIATE RELEASE CONTACT: Eric Poolman at (203) 589-8925 or Tyler Crone (203) 589-8876 BUSH'S ALMA MATER URGES AIDS AGENDA: DEANS, FACULTY AND STUDENTS SAY TO BUSH, LEAD THE FUND AGAINST GLOBAL AIDS SUPPORT AIDS TREATMENT AND PREVENTION The Yale AIDS Network, a coalition of Yale students, faculty and administrators, has released a letter urging President George W. Bush to show leadership in the fight against global AIDS. Signed by over 150 Yale University deans, faculty, and students, and supported by President Richard C. Levin, the letter calls for the US to invest in the Global Fund for HIV/AIDS in proportion to our share of worldwide GNP, to support a strengthened version of the UN General Assembly Declaration on HIV/AIDS,and to commit to treatment, prevention and care as inseparable aspects of a comprehensive response to AIDS. When President Bush speaks at Yale's tercentennial commencement ceremony on Monday, he will face a sea of red ribbons worn by graduates, faculty, and family, symbolizing the need for US leadership in the fight against global AIDS. In the coming weeks the Bush administration has a unique opportunity to turn the tide of twenty years of inadequate responses to HIV/AIDS. Members of the administration will meet with international delegates in New York next week, and again in June, as part of the UN General Assembly Special Session on AIDS, where the future worldwide goals and responses to AIDS will be determined. One signatory, Harold Hongju Koh, Professor of International Law and Former Assistant Secretary for Democracy, Human Rights and Labor, said: "The fight against global AIDS is the biggest human rights challenge to the world today. It is a fight that requires both serious money and serious diplomacy. The United States has far too much at stake in this battle to wait for others to lead." Network co-founder Elizabeth Tyler Crone, MPH, said: "Students, Deans, Yale's AIDS experts, and even President Levin himself have spoken out in support of the recommendations of this letter. We hope President Bush heeds our call, and provides a dramatic increase in funding for AIDS, and an approach to the pandemic which recognizes the need for both treatment and prevention." Attached is the Yale AIDS Network letter. Signatories include Dean Michael Merson, Dean of the School of Epidemiology and Public Health, previously head of the World Health Organization (WHO) Global Program on AIDS; Dean David Kessler, Dean of the School of Medicine and former FDA commissioner; Dean Anthony Kronman, Dean of the Law School; Dean Catherine L. Gilliss, Dean of the Nursing School; Dean James Gustave Speth, Dean of the School of Forestry and Environmental Studies; and Professor Ilona Kickbusch, Epidemiology and Public Health Division Head for Global Health. Background on the Yale AIDS Network The Yale AIDS Network was formed in the spring of this year as an outgrowth of student and faculty pressure upon Yale to respond to the need for cheaper HIV/AIDS treatment in South Africa by relaxing the University's patent on the antiretroviral drug d4t there. The Network joins students, faculty, and researchers from different disciplines with the purpose of coordinating and extending Yale's collective response to the global AIDS crisis.
May 19, 2001
The Honorable George W. Bush Re: United States leadership in the fight against the global AIDS pandemic Dear President Bush, We, faculty and students of Yale University, are deeply concerned about the global HIV/AIDS crisis. We write to express our conviction that the United States must exhibit leadership at this critical juncture by coming forward as the lead contributor to the Global Fund for HIV/AIDS, and by signing a strengthened version of the Declaration of Commitment on HIV/AIDS at the June 25-27 United Nations General Assembly Special Session. We have worked internationally in the prevention and treatment of HIV/AIDS, and in the formulation of laws, policies and ethics associated with HIV/AIDS. Our response to the growing pandemic includes providing comprehensive care to large numbers of adults and children with HIV/AIDS; discovering antiretroviral drugs; leading the World Health Organization Global Program on AIDS; initiating needle exchange programs; establishing community-based prevention and treatment programs around the world; addressing the human rights and legal implications of HIV/AIDS; serving on the editorial boards of leading medical journals focused on HIV/AIDS; and serving as consultants to the National Institutes of Health, Centers for Disease Control and Prevention, National Academy of Sciences, President's Commission on AIDS, and World Bank, among others. Most recently, Yale University has taken strong action to address the issue of access to treatment by negotiating with Bristol-Myers Squibb to relax the patent on the antiretroviral drug d4T in South Africa. The world is now poised to take dramatic steps to combat the HIV/AIDS pandemic. United Nations Secretary General Kofi Annan has called for $7-10 billion annually for a Global Fund for HIV/AIDS. Two important conditions for the effective use of such a fund have crystallized in the last year: strong international and national leadership on HIV/AIDS, and a dynamic spirit of public/private partnership. As countries around the world join forces toward productive measures to combat the pandemic, the United States appears to be moving in a disappointing direction, unworthy of our role as a global leader. Even as the Administration has recognized AIDS as a threat to our national security, we have not provided a commensurate response. The United States has chosen to emphasize intellectual property rights over human rights, and to pit prevention against treatment. At this formative moment, the United States should support an approach to combating the pandemic based upon two basic principles. First, treatment and prevention are inextricably linked, and the United States should fully support both. A false dichotomy between treatment and prevention will prevent progress on both fronts. As the "Harvard Consensus Statement on Antiretroviral Treatment for AIDS in Poor Countries" shows, treatment is necessary to optimize prevention efforts, to sustain the fabric of societies, and to continue global economic development. Second, increased respect for human rights is a necessary part of the response to the HIV/AIDS pandemic. Failure to protect the rights of people living with AIDS and other members of societies affected by the pandemic undermines prevention and treatment efforts, as well as prospects for healthy economic and social development. We should use the United Nations General Assembly Special Session to affirm respect for human rights as central to fighting the pandemic. Following these principles, the Administration should approach the United Nations General Assembly Special Session with the following goals: The United States should take the lead and support the Global Fund for HIV/AIDS fully and immediately. Costs associated with HIV/AIDS have risen exponentially, and every year it costs more to contain the crisis. An international consensus is emerging that a global fund of $7-10 billion per year is needed to fight AIDS, starting now. Recently, the Administration announced that the United States will initially contribute only $200 million to the Fund, just two percent of the total needed. A reasonable contribution, reflecting our share of the world's GNP and our firm commitment to halting the pandemic, would be twenty-five percent of the total, or $2.5 billion. This figure should be considered a sensible investment, since the costs of confronting the epidemic will only increase if we fail to act decisively now. The United States should also significantly increase official development assistance to combat inadequate education, poor nutrition, weak health care systems, and other aspects of poverty that contribute to the devastation of HIV/AIDS. The United Nations General Assembly Special Session on HIV/AIDS Draft Declaration must be strengthened if it is to have any real impact. It must reflect the urgent need for collective action to bring about substantial and immediate change, and include explicit goals and timelines for prevention and treatment that correspond at a minimum with those set in the UNAIDS five-year plan. The United Nations General Assembly Special Session gives you a unique opportunity to demonstrate world leadership and to turn the tide of the twenty-year HIV/AIDS pandemic. The sudden availability of low cost anti-retroviral drugs in low-income countries has focused the world's attention and provided an opportunity to raise the resources and achieve the political commitment needed to stop HIV/AIDS. We will not have this opportunity again. The United States must therefore take the lead in building the Global Fund for HIV/AIDS and galvanizing a collaborative international response to HIV/AIDS. Sincerely,
Nadia Abdala, DVM, PhD
Susan S. Addiss, MPH, MurS
Frederick L. Altice, MD, MPH
Warren Andiman, MD
Nancy R. Angoff, MD, MPH, MEd
S. Kelly Avants, PhD
David Bartlett, PhD
Frank J. Bia, MD, MPH
Ann J. Biersteker, PhD
Kim Blankenship, PhD
John Booss, MD
Elizabeth Bradley, PhD
Martha Buitrago, MD
Kent Buse, PhD
Dom Cicchetti, PhD
Scott Clair, PhD
Kamari Maxine Clarke, PhD
Elizabeth L. Cooney, MD
Harlon L. Dalton, JD
Robert M. Donaldson, Jr., MD
Gail D'Onofrio, MD
Michael R. Dove, PhD
Ravi Durvasala, MD
Margaret A. Farley, PhD
William J. Foltz, PhD
Brian Forsyth, MB, ChB
Jonathan M. Freiman, JD
Gerald Friedland, MD
Catherine L. Gilliss, DNSc, RN, FAAN
Judith Bograd Gordon, PhD
Lauretta E. Grau, PhD
Robert Heimer, PhD
Michele E. Horne, MD
Deena Hurwitz, JD
Keith A. Joiner, MD
L. Serene Jones, MDiv, PhD
Gilbert M. Joseph, PhD
Paul W. Kahn, PhD, JD
David A. Kessler, MD, JD
Kaveh Khoshnood, PhD
Ilona S. Kickbusch, PhD
Harold Hongju Koh, JD, MA
Michael Kozal, MD
Jean E. Krasno, PhD
Anthony Townsend Kronman, PhD, JD
Forrester A. Lee, MD
Andres Martin MD
Peter McPhedren, MD
Michael Merson, MD
Christopher L. Miller, PhD
Alexander Ortega, PhD
David Paltiel, PhD
Kim-Thu C. Pham, MD
William H. Prusoff, MS, PhD
Gustav Ranis, PhD
John K. Rose, PhD
Letty M. Russell, PhD
Mark Russi, MD, MPH
Nancy L. Ruther, PhD, MA, MIA
Peter Salovey, PhD
James C Scott, PhD
Kathleen J. Sikkema, PhD
James J. Silk, MA, JD
John G. Simon, LLB, LLD
James Gustave Speth, MLitt, JD
Lynn E. Sullivan, MD
Diana Swancutt, PhD
David P. Watts, PhD
Margaret R. Weeks, PhD
Madeline Wilson, MD
Brian Wong, MD
Eric Worby, PhD STUDENTS
Glenn Adamson (School of Arts and Sciences) On behalf of the Yale AIDS Network.
WHO Waters Down Brazilian Proposals For Cheap Drugs The World Health Organization, meeting in Geneva for its annual assembly, Saturday approved a US- and EU-sponsored resolution urging global cooperation to fight the HIV/AIDS pandemic but fell short of approving Brazilian proposals to make inexpensive generic drugs more widely available. The approved resolution asks WHO Director-General Gro Harlem Brundtland to "maintain close collaboration with the international community and the private sector with the aim of improving the availability of medicines for HIV/AIDS, including anti-retroviral therapy." The European Union, the United States and other countries objected to the Brazilian proposals, saying the WHO has neither the authority nor the resources to tackle trade and patent issues. Countries objecting to the Brazilian plan called instead for the World Trade Organization to continue to handle the issues. Health activists accused authorities of placing commercial interests before people's lives. "This is almost like a step backward," said Ellen't Hoen of Medecins Sans Frontieres. "It doesn't add anything to what was adopted two years ago," she said. "What I find very peculiar is that so many countries expressed their concerns about intellectual property, patents and drug prices, but none of that is reflected in the resolution." An early Brazilian proposal had called for the WHO to actively promote HIV/AIDS drug access around the globe and set up a price databank that would allow countries to compare prices Brazil also sought to have AIDS treatment recognized as a human rights issue ( http://cnn.com/2001/WORLD/americas/05/19/brazil.aids.reut).
DRAFT RESOLUTION Proposed by Brazilian Delegation to the Fifty-fourth World Health Assembly, May 14-22, 2001 HIV/AIDS The Fifty-fourth World Health Assembly: Considering that the AIDS epidemic has become one of the biggest threats to public health in the world, that this has reached pandemic levels, involving over 36 million people and that the poor and developing countries are the most seriously affected by it, as noted in Resolution 54/283 of the United Nations General Assembly; Considering moreover that AIDS has caused: 1. The loss of countless human lives and countries'productive capacity; 2. Orphanhood (13 million orphans so far at least); 3. Lower life expectancy (up to 3 decades less); 4. Despair and unhappiness; Considering that AIDS was judged by the UN Security Council in Resolution 1308 of 17 July 2000 as a question of national security; Recalling that the 53rd World Health Assembly considered that prevention and health promotion activities are as important for confronting the epidemic as those focusing on care and treatment of people living with HIV and AIDS and; Having moreover been considered by the Declaration of the Head of African States in Abuja, Nigeria, on 27 April 2001, which in its paragraph 29 calls upon the International Community to put into operation a Global Fund against AIDS with the aim of inter alia providing access to antiretroviral therapy for populations affected by the epidemic; Considering that the Heads of State and Government of the Americas emphasized in paragraph 25 of the Declaration of the 3rd Summit of the Americas that good health and equality of access to medical care and to health systems, together with medical drugs at accessible prices are vital for human development and the implementation of new political, economic and social objectives; Bearing in mind that new techniques, especially those related to new antiretroviral drugs, must be considered as a Human Rights issue and therefore should be available on an equitable basis for all countries and for the universe of people living with HIV and AIDS, as was agreed at the 57th World Human Rights Conference; Considering that treatment of HIV/AIDS provides a positive incentive for individuals to submit to voluntary counseling and HIV testing, which in turn dramatically increases the efficacy of anti-HIV prevention and education efforts necessary to retard the advance of the pandemic. Considering that HIV/AIDS affects women with special severity. Considering that levels of international aid finance to support HIV/AIDS programs in poor countries has been greatly incommensurate with the prevalence of the pandemic, at approximately $5 annually per HIV-infected person in poor countries. Emphasizing the key role that the WHO has performed at the world level, especially in developing countries and in those relatively lesser developed countries, to establish and implement policy initiatives centred on health promotion, on prevention of relevant diseases, on organization of services, on assembling and making available appropriate information to assist the formulation of health policies, technical and financial support for national health services, and on the development of ways and means of negotiating better prices for the procurement of medical drugs; Reiterating at the same time the forthright performance of UNAIDS in combating the AIDS pandemic, through its support for National AIDS Programmes, including for the least developed countries, and in the organization of the Special Session of the UN General Assembly on HIV and AIDS, and especially in the drafting and dissemination of documents which have facilitated thoughtful appraisal of the most relevant issues concerning the pandemic; Ratifying: 1. The Declaration of the 3rd Summit of he Americas, which in its paragraph 25 states that good health and equality of access to medical care and to health systems, together with medical drugs at accessible prices, are vital for human development and for the implementation of new political, economic and social objectives; 2. The Declaration of the Head of African States in Abuja, Nigeria on 27 April 2001, which in its paragraph 29 calls upon the International Community to put into operation a Global Fund against AIDS with the aim inter alia of providing access to antiretroviral therapy for peoples affected by the epidemic; 3. The 57th World Human Rights Conference which declared that access to medical drugs and especially access to antiretroviral drugs was a question of Human Rights; Calls Upon Member States to: 1. Make every effort in order to guarantee that the access to antiretroviral and anti-opportunistic infection drugs should have as its point of reference the principle of equity, thus guaranteeing supply and prices compatible with the social and economic circumstances of individual countries as well as the degree of HIV prevalence in each country 2. Make every effort to guarantee access of the population to currently available techniques in the areas of health promotion, of prevention of the main diseases and of care and treatment, with a view to reducing the negative impact of the HIV and AIDS epidemic around the world. 3. Seek all available ways and means at both international and national levels to increase access by populations to antiretroviral and anti-opportunistic infection drugs; 4. Establish health policies which promote access to drugs through: a) Policy initiatives which embrace the right to use technical and intellectual capacity for the in-country production of AIDS drugs, under the auspices of the agreements reached within the bounds of international law, such as the TRIPS agreement; b) Support for the establishment and financing of an International Fund for the promotion of access to antiretroviral and anti-opportunistic infection drugs, based upon the principle of equity; c) Implantation of a policy to facilitate the supply of drugs, including the production and distribution of generic drugs and the negotiation of prices with pharmaceutical drugs companies, in accordance with the social and economic development profiles of each country. 5. Guarantee participation by people living with HIV and AIDS in the formulation of national policies as regards access to drugs. 6. Promote social control at the national level so as to guarantee better quality control over antiretroviral drugs. 7. Provide international aid finance against HIV/AIDS as grants, not loans, to the least developed countries. Requests the Director General to: 1. Support, and participate in, the creation of an international Fund to guarantee access to antiretroviral and anti-opportunistic infection drugs, particularly for poor and developing countries, based on the principle of equity. That this Fund should make drugs available at different prices in line with Social Development Indices and according to the prevalence of HIV in different countries, so that a policy based upon the principle of equity can be attained. 2. Establish an expert committee under WHO auspices, consisting of an expanded membership of physicians, scientists, public health practitioners, and non-governmental AIDS advocates (including people with AIDS), drawn from both developed and developing Member States, to review and assess on a case-by-case basis the scientific, medical and operational feasibility of proposals submitted by developing country Member States for funding payable out of the International Fund. 3. Oppose any international proposals which would provide funding out of the International Fund on the basis of interest-bearing loans, rather than outright grants, to least developed Member States or other Member States needing significant financial assistance because of he scale of the HIV/AIDS epidemic in relation to their domestic wealth. 4. Create a Drugs Prices Data Bank, containing information about drugs procurement and manufacturers, with a view to providing data for the management of national policies in respect of access to antiretroviral drugs and anti-opportunistic infection drugs. 5. Create parameters jointly with the Member States and the drugs industry, including producers of generic drugs, in order to establish a worldwide policy of differentiated prices for drugs according to social, economic, and epidemiological indicators, with the principle of equity as a basic reference point. 6. Create ways and means to permit better monitoring and quality control of antiretroviral drugs. 7. Foster inter-country exchanges and international technical and legal cooperation, with a view to establishing a global policy for the production of generic drugs, as well as to implement care, treatment and prevention policies in respect of AIDS, implying the strengthening of links between public authorities and civil society. 8. Regard the access to antiretroviral drugs and those for treating opportunistic infections a matter of the highest priority, and to develop policies for: a) Reducing the suffering of men, women and children living with HIV and AIDS throughout the world; b) Reducing mortality caused by AIDS, especially in the socially and economically less developed countries; c) Increasing life expectancy particularly in those countries where it has been falling as the result of AIDS; d) Helping to restore the process of social development in poor countries by means of maintenance of productive capacity and the labor force.
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Africa Policy E-Journal
