The decision by the international pharmaceutical companies to abandon their action in the South African courts and agree to let the government import cheap copies of their own treatments is both a moral and a legal milestone. It must surely mean that a similar action in the Brazilian courts will be dropped. In the longer run, the threatened US sanctions against countries such as Egypt and India, which manufacture low-cost copies of proprietary medicines, will be withdrawn, perhaps after some sort of accord sponsored by the World Trade Organization (WTO).
When the news broke that the drugs companies had thrown in the towel in South Africa, there were huge celebrations, not least among the 4.7 million local HIV/AIDS victims for whom, until now, treatment has generally been unaffordable.
But the hurrahs could be premature. Those who might be led to believe that this key development, however momentous, is going to solve the scourge of AIDS in Africa are probably doomed to be disappointed. The South African government is not itself without blame, because of its long-standing refusal to recognize the burgeoning extent of the AIDS curse. The delays in admitting the growing crisis in their midst meant that though hospitals and doctors were providing irrefutable evidence of the danger, until last year, the government failed to take the issue with due seriousness.
But now that the door has been opened to the purchase of drugs which can slow the advance of AIDS, the South African authorities have some tough decisions ahead. This is because, the most important part of the ground-breaking judgment does not really concern AIDS treatment. The key point is that as a result of the cave-in by the world’s pharmaceutical giants, the door is open to the use of copycat drugs for a whole range of illnesses, not simply AIDS.
Tuberculosis, once thought to have been destroyed, is making a comeback, often in more virulent forms which are resistant to traditional drugs. Malaria too, far from being eradicated, is on the increase. There is a whole host of diseases for which the developing world needs to buy treatments. But they cannot afford to buy every drug to cover every disease.
Choices have to be made and they are not going to be easy, especially in Africa which has the highest concentration of AIDS victims. Any government, looking at the available health budget, must prioritize spending. If caught early enough, tuberculosis can be cured. The condition of malaria victims can be radically improved and the threat of death removed. The same is true of a host of other diseases where the availability of cheap medication will produce lasting cures.
But unfortunately there is still no cure for AIDS. Despite the expenditure of hundreds of millions of research dollars, there is still no way of arresting its progress. All the treatments which have suddenly become affordable, only ease symptoms and provide a slowdown in the advance of the virus.
The literally life-and-death dilemma that South Africa is faced with now is: is it right for the poor country to devote a significant part of its medication budget to treatments that will not save life, while there are plenty of affordable medications which will actually bring about cures?
