‘A,’ ‘I,’ D’ and ‘S’ are merely letters of the alphabet but put them together and it transforms into one of the most intimidating word in the history of mankind. 27 years ago, when the name AIDS came about, this disease was elusive. No scientist, doctor or health care professional could understand the nature of this virus, let alone how it was transmitted. But we powered on, as epidemiologists, scientists and healthcare workers worked hand in hand to not only identify the retrovirus but also to find a possible treatment, one which would improve the quality of life of an AIDS patient by leaps and bounds.
A retrovirus manipulates our immune cells and incorporates itself as part of our body’s defence system. It tricks us and makes us believe that it is one to be trusted. The sheer manipulation of this virus is astonishing as it not only “camouflages” as one of us, but kills our all mighty T cells without which we are defenseless against all infections. Finding a treatment that inhibits a retrovirus is a sheer stroke of genius.
Don’t mind me, as I go on to quote the apt words of Suzanne Collins, author of the Hunger Games, “the only thing stronger than fear is hope”. When the results of clinical trials came out, everyone who were riddled with AIDS or who had their loved ones battling with HIV had hope once again. But that would not last for long.
Little did they know that successful trials in the laboratories in France and the United States of America did not necessarily translate into curing AIDS patients in rural Tanzania.
The gaping loop holes of medical provision in the lower and middle income countries started to become evident. While HIV medication was available in the Western world, people were still dying in Africa of a disease that could potentially be “cured”. In south Africa, for example, with an estimated 4.2 million HIV positive people, 1700 infections per day and 68000 HIV positive newborn babies each year (MSF 2001), the stakes were high.
In 2000, the biennial AIDS conference was conducted in Durban, South Africa. Peter Mugeyni , a leading researcher in HIV and AIDS, famously proclaimed, “Where are the drugs? The drugs are where the disease is not. The disease is where the drugs are not”.
Unfortunately this was the case. While the patients in high income countries were receiving treatments that improved their quality of life several folds, people in Subsaharan Africa and South Asia were still dying. So why this inequality in access to medicine? One word should suffice; Patents.
Patents are rights purchased by pharmaceutical companies on medications, like the antiretrovirals (ARVS). They prevent any other companies from producing generics, an identical copy of a patented or branded drug. With patents, pharmaceutical companies have monopoly over medications. Big Pharma apply the most fundamental economic demand and supply principal to their advantage and ARVs were priced at $50000 a year at the time of its arrival in 2000. Needless to say, low income countries could not afford such expensive prices. The death toll continued to spike in Subsaharan Africa and South Asia but the pharmaceutical companies held on to ARVs with iron chains. In 2001, an Indian pharmaceutical company, Cipla, offered ARVs for under $1 a day. With much protests from international organizations such as MSF and national activists groups like UAEM (Universities allied for Essential Medicines), the prices on ARV started to slowly reduce.
A report released by UN in 2012 stated that 9.7 million people are receiving ARVs. Recent studies have shown that eradication of HIV is in sight with educational programmes and treatment for prevention campaigns. HIV is now a disease that does not instil fear in us anymore. But what the HIV epidemic did reveal to us is the inequality in the medical MDG 6: HIV and the lesson it taught: Access to Medicine provision across the world. Like the retroviral properties of HIV, the inequality in access to medicine is deceiving and destructive.
On the surface it may seem that one is making progress on the medical front. But what is progress if lifesaving treatment does not reach the people who need them the most?
This article is part of the UNYANET Millennium Development Goals blog series.