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AIDS Fungus Drug Offered to Poor Nations

By:  Barbara Crossette

The New York Times, June 7, 2001

 


UNITED NATIONS, June 6 — The Pfizer pharmaceutical company announced today that it will offer the governments of more than 50 of the world's poorest nations an unlimited free supply of a powerful drug to combat fungal infections associated with AIDS.


The company began providing the drug, which it markets under the brand name Diflucan, to South Africa early this year under a program that company officials said will cost $50 million over two years. At a news conference here today, Henry McKinnell, Pfizer's chairman and chief executive officer, said that the project will now be extended to five other countries in the region — Botswana, Lesotho, Malawi, Namibia and Swaziland.


Pfizer said that it was inviting the governments of all 50 countries that the United Nations considers to be the world's poorest and most affected by AIDS to participate in the project.


"There is no time or dollar limit set on this program," Dr. McKinnell said. "We are ready to begin providing Diflucan immediately." Governments would be expected to sign an agreement assuring Pfizer that the drug would be distributed free.


Dr. McKinnell said that Pfizer would also provide "medical training and patient education." Next week, the company is expected to announce its participation in the establishment of an AIDS medical training center in Uganda.


Pfizer's plan to provide a leading drug free of charge to governments follows a round of price reductions by pharmaceutical companies on antiretroviral treatments that can prolong the lives of people infected with the virus that causes AIDS.

 
Diflucan is used to treat cryptococcal meningitis, an infection of the membranes around the brain and spinal cord that occurs in one of every 10 AIDS patients and kills more than 20 percent of those affected. The drug is also used to treat a condition known as esophageal candidiasis, a fungal infection of the esophagus found in 20 percent to 40 percent of AIDS patients. It can cause chest pain, nausea and vomiting as well as impair the ability to swallow, which leads to weight loss and fatigue.


The announcement by Pfizer was welcomed guardedly by groups for greater generosity from pharmaceutical companies in the fight against AIDS. American drug manufacturers have been widely criticized for pricing products out of the reach of most nations, then opposing efforts by foreign companies to make and sell the same or similar medicines at considerably lower prices. 


Joel B. Pressley, executive director of the New York AIDS Coalition, who shared the platform with Dr. McKinnell at the news conference today, said that he "truly applauds" Pfizer's decision. He added: "Crypto meningitis is but one of the numerous serious issues that have to be addressed in a comprehensive public health approach in dealing with the H.I.V.-AIDS epidemic. Pfizer has made a step in the right direction, a major step. However, it and other pharmaceuticals along with policymakers near and far must make giant strides to find proactive, creative and comprehensive solutions to stem and stop the tide of despair and misery."


Pfizer has been under pressure for several years from the makers of generic copies of Diflucan. The leading competitors are three Thai companies, a Bangladeshi firm and Cipla in India, which admits that under Indian law it can produce knock-offs of all Pfizer drugs.


Pfizer patented Diflucan in 1982 and it remains patented until 2004 in the United States and many other countries. The drug is used in the United States to treat toenail fungus, and several kinds of thrush as well as cryptococcal meningitis.


Dr. McKinnell acknowledged today that the company was intent on keeping its market share even after patents expire. The provision of free supplies of the leading drug in its field can boost the image of the company, critics say.

 
Paul S. Zeitz, a physician and epidemiologist with 12 years of work on AIDS in Africa, described Pfizer's move today as "a strategy to block access to generically manufactured drugs." Dr. Zeitz earlier this year founded the Global AIDS Alliance, based in Philadelphia, to campaign on many fronts for faster and more effective help for poor countries caught in the AIDS crisis.


He said that the agreements Pfizer concludes with poor nations should be scrutinized carefully. "We don't know the details of the written deal," he said. "What kind of influence are they buying with this? Are there unwritten ways that the pharmaceutical companies are influencing the governments? We think there should be open, fair competitive bidding between generics and competitive brands. A free donor program effectively blocks the demand for the generically manufactured drugs."


The Pfizer announcement was welcomed by Peter Piot, the director of Unaids, the joint program of the World Health Organization and other United Nations agencies involved in dealing with the epidemic. He said it would have "a significant impact." 


South Africa's ambassador to the United States, Sheila V.M. Sisulu, also endorsed the project today at the news conference. 


In the United States, Pfizer officials say, Diflucan costs about $10 a daily dose, and must be taken for life in cases of cryptococcal meningitis.