Kofi Annan, former UN Secretary General has underscored the role of pharmaceuticals in increasing access to AIDS medications worldwide. The Former world top diplomat shared his views in a missive entitled “A War Chest: Ten-year fight for world health”, that was recently published in Le Monde diplomatique. Kofi Annan writes;
Ten years ago very few people in the developing world were receiving AIDS treatment. They knew that, while AIDS had ceased to be a death sentence in rich countries, they themselves had little reason to hope, because the drugs were just too expensive for the developing world. I recall a visit to a hospital in Maputo, where a dying woman looked me straight in the eye and asked if I could help her. She knew that medication could save her but, as she was poor, for her the disease was a death sentence. I will never forget that look, which was much more powerful than her words.
In 2000 the global outlook was bleak: HIV had infected a tragic proportion of the population in southern Africa in just over a decade and we feared the spread would continue at that pace — not only in Africa, but also in Asia and the former Soviet states.
“In 2000 the global outlook was bleak: HIV had infected a tragic proportion of the population in southern Africa in just over a decade and we feared the spread would continue at that pace…”
In the absence of a cure and with life-sustaining medicines costing $10,000 per patient per year, many of us feared that AIDS would greatly affect economic and social development and cause political instability as country after country succumbed to the pandemic.
At the pivotal international AIDS conference in Durban in July 2000, Nelson Mandela made an unforgettable appeal in his closing address: “In the face of the grave threat posed by HIV/AIDS, we have to rise above our differences and combine our efforts to save our people. History will judge us harshly if we fail to do so now, and right now.”
The rapid spread of tuberculosis and malaria added to this burden and to a strong feeling of powerlessness: would these diseases of poverty really destroy our tremendous common efforts to achieve development and progress?
When I called for the creation of a global fund — a “war chest” to fight the diseases of poverty — in Abuja in 2001, I did not dare believe that the turnaround would be so quick and dramatic. The plan of action I built with the help of WHO Director-General Gro Harlem Brundtland, UNAIDS Executive Director Peter Piot, UNICEF Executive Director Carol Bellamy and others had five goals: prevention of the spread of the disease, especially by getting young people involved; stopping the transmission of the virus from mothers to their children; giving people access to care and treatment; quickening the pace of scientific research; and protecting the most vulnerable.
The plan was ambitious. I said clearly at the time that leaders in all countries needed the foresight and courage to firmly commit to the fight against AIDS and to make it a priority in their national budgets. The creation of the Global Fund to Fight AIDS, Tuberculosis and Malaria was a big part of the response. It drew on expertise in the United Nations system, government bodies and nongovernmental organisations — especially with associations of people living with HIV/AIDS and the other diseases — and the private sector.
“It would not have happened unless prices of drugs were made affordable. The large pharmaceutical firms were therefore crucial to realising this dream.”
It would not have happened unless prices of drugs were made affordable. The large pharmaceutical firms were therefore crucial to realising this dream. I met with them often during this time, together with Gro Harlem Brundtland and Peter Piot.
In April 2001 these companies performed a spectacular volte face when they dropped legal action that they had begun against South Africa’s efforts to lower the price of AIDS-related and other drugs. Increasingly driven by competition from generic drug companies using the safeguards in World Trade Organisation treaties the price of one AIDS drug after another plummeted. Today, a year’s treatment for AIDS cost less than $100 per patient.
I also encouraged many leaders to talk openly about AIDS, asking them to break a code of silence and dispel the prejudice and discrimination that surrounded the disease. Keeping quiet about AIDS costs lives. Unfortunately this message sometimes fell on deaf ears, especially when it came to the subject of condom use.
As we look back on this revolutionary decade in the fight against AIDS, we can celebrate equally remarkable gains in the fight against TB and malaria. The annual number of new TB cases has fallen every year for the last five years, and we are on track to achieve the global target of halving TB mortality by 2015. In country after malaria-endemic country, we see remarkable falls in child mortality thanks to the widespread availability of bed nets and effective treatment.
While all of us can be proud of what has been accomplished in this decade, we know there is more to be done. Today it is time to dream anew — of the end of AIDS, TB and malaria once and for all, a dream that can become real if only we keep up the fight.