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.
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