CONFLICT OVER AIDS MEDICINES FOR AFRICA

Lawmakers Try To Block Selling Cheap Versions Of U.S. Patented Drugs

WASHINGTON -- When President Clinton announced in December that the United
States no longer would block poor African nations from getting access to
cheap versions of AIDS drugs, gay activists and consumer groups claimed
victory over the powerful U.S. pharmaceutical industry.

It turns out their celebration was premature. The conflict has simply moved
to the back rooms of Congress, where influential lawmakers are trying to
erect barriers to countries that want to manufacture or import inexpensive
versions of drugs patented by U.S. pharmaceutical giants.

In closed-door meetings of a House-Senate conference committee, Sen. William
Roth, R-Del., is circulating a proposal that would compel African nations to
meet several conditions before they would be allowed to acquire cheaper
versions of patented drugs for treating AIDS, which is a pervasive health
crisis in sub-Saharan Africa.

AIDS activists and consumer groups want to carve an exception in U.S. trade
law, ending sanctions against African countries that manufacture or import
cheap versions of drugs protected by U.S. patents. But conservatives and
pharmaceutical groups flatly oppose any such attempt. Roth aides say the
senator's proposal is a compromise.

Some experts say that even making cheap AIDS drugs available wouldn't make
much difference in most of sub-Saharan Africa because nations lack
distribution and medical systems to take advantage of them.

Despite such shades of gray, anti-AIDS activists and consumer groups see
black-and-white duplicity in Roth's effort. Roth is chair of the Senate
Finance Committee, which oversees trade law. Activists say his proposal
would invalidate Clinton's proclamation at the World Trade Organization
meeting in Seattle in December, and also would kill a similar policy spelled
out in an amendment on a pending U.S.-Africa trade bill. Both aim to remove
barriers to cheaper drugs for Africa.

Activists who disrupted appearances by Vice President Al Gore last year are
now targeting Roth. Members of Act-Up Philadelphia, an anti-AIDS group, say
they will show up at a planned fundraiser for Roth in Dover, Del., on April
28.

``Roth is pushing a proposal that will mean more AIDS for Africa and less
medicine for poor African countries,'' said Paul Davis, the group's
information officer on trade issues.

``This is highly protectionist and harmful to Africa, and (to) the efforts
to get more affordable medicine to the people who need it,'' said James
Love, who heads Ralph Nader's Consumer Project on Technology.

Roth is in the hospital recovering from back surgery, but his press
secretary, Virginia Flynn, said the influential senator ``is trying to work
out a compromise, and he's pretty much doing it against a lot of
opposition.''

Roth's proposal would permit patent protections to be suspended, but only if
a number of conditions are met. Countries would have to show they are making
``significant progress'' toward developing proper distribution networks for
the medicines and training the medical personnel necessary to administer
them. They also would have to demonstrate ``meaningful efforts'' to prevent
the spread of HIV/AIDS.

Love says those conditions are rigged so that most African countries would
flunk, because they have notoriously poor distribution networks and, given
the huge number of victims, are obviously not doing well at preventing the
spread of the disease.

Love and other activists contend that Roth is too close to the
pharmaceutical industry. Among 100 senators, he ranks 12th in campaign
contributions from drug-company political action committees and executives,
according to the Center for Responsive Politics, a Washington-based
campaign-finance watchdog group.

Roth has received $35,250 in contributions from individuals and PACs
connected to drug companies to defend his Senate seat against a challenge
this year by Delaware's Democratic Gov. Tom Carper.

Calls for the United States to relax its stance on patented drugs have grown
in urgency as AIDS has developed into the most serious health crisis on the
African continent. Of 34 million people worldwide infected with HIV/AIDS,
two-thirds of them -- some 23 million people -- live in sub-Saharan Africa.

The anti-AIDS movement says fighting to protect U.S. patents on expensive
drugs is grossly unfair when applied to treating AIDS. The drugs cost
$10,000 to $15,000 a year, which is far beyond the reach of most people
infected with the disease in Africa.

In Seattle, Clinton said that while patent protection is important, future
trade policy would be made ``in a manner that ensures people in the poorest
countries won't have to go without medicine they so desperately need.''

Only weeks before, Sens. Dianne Feinstein, D-Calif., and Russ Feingold,
D-Wis., had added an amendment to a pending trade bill; it said the U.S.
government would stop pressuring African countries to comply with patent law
as they deal with AIDS.

Now the Feinstein-Feingold amendment is meeting fierce opposition in the
House-Senate conference committee on the trade bill. Opponents include Rep.
Bill Archer, R-Texas., chair of the House Ways and Means Committee, which is
in charge of trade law in that chamber.

Conservatives side with the pharmaceutical industry and other pro-business
groups in opposing relaxation of intellectual-property rights held by U.S.
businesses around the globe. They argue that waiving patent rights for AIDS
drugs for Africa would do very little good, because few countries in the
region are equipped to get the medicine to people who need it, or to ensure
that complex AIDS drug ``cocktails'' are administered properly.

With the possible exception of South Africa, the most developed of
sub-Saharan countries, no government or business entity in the region has
the ability to set up a production facility and a distribution network for
the 15 drugs used for treating AIDS, say those who oppose tinkering with
patent protections.

``The No. 1 barrier to public health in Africa is poverty,'' said Shannon
Herzfeld, senior vice president for international issues at a
Washington-based trade group, the Pharmaceutical Research and Manufacturers
of America, which represents 100 U.S. companies. ``Grabbing onto the notion
of relaxation of intellectual-property rights as a fix is the wrong
solution.''

Distribution networks are so poor, she said, that even in South Africa, half
of all medicines purchased by the government for its people are lost on the
black market.

Alex Ross, the AIDS coordinator for the Africa bureau of the U.S. Agency for
International Development, said, ``The problem is, none of these things is
going to solve the problem in and of themselves. ``

Lowering the cost of the drugs by dropping trade barriers can help
``incrementally,'' Ross said, but solving distribution problems and training
an army of medical professionals to administer the drugs safely are also
essential.