Dr Jeffery Sachs, Professor of International Development at Harvard University, considered by the New York Times to be the most important economist in the world, launched a wide ranging attack on the World Bank and developed world governments for their handling of the African AIDS crisis in the opening session of the Eighth Annual Retroviruses Conference tonight in Chicago.
He also called for greater clarity about the costs involved in providing antiretroviral therapy to Africa and the numbers who will need treatment over the next few years.
“The United States made more than $9 trillion of capital gains during the1990s yet our government has been incapable of giving more than pennies” he told the conference.
“We are talking about 5 million individuals if we only treat symptomatic individuals. We might potentially be able to scale up to treat 1 million AIDS sufferers in Africa within two years, and two to three million in five years. How much would this cost? Two million might cost $1 billion a year, plus another billion in order to improve the public health capacity.”
“We are debating in this country whether we should have $2 trillion worth of tax cuts. $2 billion for the rich world is a levy of $2 per person per year. We could bear this cost. “
“Last year President Clinton announced a ten million dollar grant for AIDS prevention during a trip to Nigeria. $10 million was about a quarter of the cost of Clinton’s trip to Nigeria. I recommend that he should have stayed at home and sent $35 million instead.”
“The World Bank has made three loans to Africa during the whole of the 1990s to fight AIDS. In the second half of the 1990s the World Bank has talked about massive programmes for AIDS prevention and care without mentioning antiretroviral treatment until the past two months, and still doesn’t envisage that $500 million [allocated] for MAP [Multicountry AIDS Programme] should be used for treatment at all”.
He also criticised a legal action due to be heard in South Africa next month, in which 40 pharmaceutical companies are suing the South African government for its failure to respect patent rights. Southern African health ministers are currently discussing whether they should buy generic versions of anti-HIV drugs or start manufacturing their own in response to the public health emergency.
“This legal action is a shockingly misguided action. How could this hundreds of billions of dollars capitalised industry not recognise what this will do their public image?”.
Dr Sachs proposed five measures to address the crisis in Africa:
- The United States and other wealthy nations should acknowledge that if HAART is a realistic proposition for mass treatment programmes in Africa, they will pay for it.
- Pharmaceutical companies should maintain their promise to supply drugs at cost price, and in return should be allowed to maintain their profit margins in wealthy nations
- The medical profession should test the proposition that HAART can be implemented effectively in developing countries in large, well controlled studies
- The World Bank should support these “scale up” studies to the tune of $250-500 million from its Multicountry AIDS Programme
- Another $150-200 million should be given to international NGOs to run smaller demonstration studies which look at the community-based implementation of HAART, perinatal prevention programmes and HIV testing.
He also argued strongly that pharmaceutical companies are not to blame for the current impasse in providing treatments.
“The products are not moving because Uganda cannot afford treatment despite [the pharma companies] reducing the price [to cost price]. They can only afford it if the rich countries pay for it, and the pharmaceutical companies realise that they cannot make it happen without the rich countries [being involved].