Article: How Trade Agreements Affect Access to Affordable AIDS Treatments in Africa

Crosslinked at Future Challenges Organization

(Macrotrends: Pandemics + Globalization)

„Because TRIPS (Agreement on Trade-Related Aspects of Intellectual Property Rights) allowed countries to issue compulsory licences only for domestic use, however, countries without local drug-manufacturing industries, including 37 in Africa, were unable to use compulsory licences to keep medicines affordable.“ („A ‘crisis in waiting’ for AIDS patients:Trade rules will make it harder to get cheap generic medicines)

In the year 2009, an estimated 1.3 million adults and children died as a result of AIDS in sub-Saharan Africa. African women and girls are particularly vulnerable to HIV. As about 76% of all HIV-positive women in the world live in Africa south of the Sahara. Since the beginning of the epidemic, more than 15 million Africans have died from AIDS.

While access to antiretroviral treatment is beginning to mitigate the toll of AIDS, fewer than half of African AIDS patients are receiving the treatment.  In 2009, only 37% of AIDS patients have access to antiretroviral treatments, compared to just 2% in 2002. According to the UNAIDS factsheet, between 2004 and 2009, AIDS-related deaths decreased by 20% in sub-Saharan Africa.

HIV infections and AIDS-related deaths are on the decline among children on the African continent. In southern Africa, between 2004 and 2009, the number of children under 15 who became newly infected with HIV was reduced by 32% (fell from 190 000 in 2004 to 130 000 in 2009). Between 2005 and 2009, the percentage of pregnant women living with HIV in sub-Saharan Africa who received antiretroviral drugs to prevent transmission of HIV to their children increased from 15% to 54%.

In spite of its neighbors‘ (Botswana, Namibia, and Swaziland) progress in reducing maternal mortality and mother-to-child transmission of HIV, South Africa has seen an increase in maternal and child mortality since the 1990s. AIDS is the largest cause of maternal mortality in South Africa and accounts for 35% of deaths in children under 5.  There is hope, because the coverage of antiretroviral for the prevention of mother-to-child transmission of HIV has exceeded 80% as of 2009. This hope hinges heavily upon the economic accessibility of antiretroviral therapies for AIDS patients.

Trade Agreements Will Likely Hinder Access to Cheap Generic Medicines

In November 2001, emerging nations in the WTO Ministerial Conference banded together to adopt the Doha Declaration on the TRIPS Agreement and Public Health in response to the World Trade Organization‘s Trade Related Aspects of Intellectual Property Rights (or TRIPS, for short). The intention was to allow for flexibility regarding pharmaceutical patents in order to allow the fabrication of cheaper alternatives to cost-prohibitive, but essential, medicines.

In the April 2010 edition of Africa Renewal, Michael Fleshman examined the detrimental effects of the World Trade Organization‘s (WTO) 2003 compromise on the importation of inexpensive generic antiretroviral (ARV) drugs into developing countries.   Between 2003 and 2010, only one shipment of ARVs was shipped under the compromise‘s terms. The article, entitled „A ‘crisis in waiting’ for AIDS patients: Trade rules will make it harder to get cheap generic medicines“ states that nearly 3 million Africans depend on ARV therapy because it is readily available at cheap prices ($80 per patient per year). However, this is likely to change because Indian lawmakers have made their laws regarding the replication of (more expensive) pharmaceuticals stricter in compliance to the WTO.

In 2009, around 400,000 children under 15 became infected with HIV, mainly through mother-to-child transmission (MTCT). About 90% (about 360,000) of these MTCT infections occurred on the continent of Africa. The transmission of HIV from HIV positive mothers to their infants often occurs during pregnancy, labor, delivery and breastfeeding.  A study conducted in conducted between June 2005 and August 2008 in five sites in Burkina Faso, Kenya and South Africa indicated that triple antiretroviral drugs during pregnancy and breastfeeding can significantly reduce mother-to-child transmission of HIV.  The results of this study, entitled Kesho Bora (which means „a better life“ in Swahili) were published in the The Lancet Infectious Diseases on January 14, 2011.

What Can Be Done?

One long-term goal can be the establishment of more local drug manufacturing industries in Africa, which entails more investment into the medical and scientific training of African youth in African and European universities. This also requires more investment into the infrastructures of these 37 respective nations in Africa – including the establishment of viable tax infrastructures independent of foreign aid.

Short-term goals can include applying collective political pressure on the Indian government to reverse the law requiring India‘s pharmaceutical industry to comply with the World Trade Organization‘s TRIPS guidelines.  South Africa‘s government can apply pressure as a fellow member of BRICS (Brazil, Russia, India, China, and South Africa).

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