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CYRUS BROACHA: Okay, welcome back. It’s still called “Staying-Alive,” our show today in this little room, but our idea here is to stay alive. Well, we have commitment and we’re trying to find out some serious hard answers. Before we do that, 20 years AIDS has been around, the virus has been around, and we still don’t really have a cure, but we do have drugs that can retard the progress and push that AIDS virus back and give you a chance to have a healthy life. And the problem is, these drug aren’t always affordable. Sometimes you and me from under-developed countries, from countries that don’t have too much money, don’t get access to these drugs. Is that fair? Is that okay and how do we stop that? How do we change that?

We’ll found out all this and more in this section, but first let’s meet new panel members who have just walked in. We’ve got Dr. Paula Achera (Misspelled?) from Brazil. I hope I pronounced that correctly, the Ministry of Health in Brazil. He’s given me two points for pronunciation and nothing for effort. And of course, we’ve got Vickie Erich (Misspelled?) of Glaxo Smith & Kline. I buy my calcium tablets from you, and you’ve got a lot of answering to do, Vickie, and I can’t help you because some of these guys are really tough. Also, we’ve got a very important story from Ozzi, but before we hear from him, we’re going to take a look at this. Let’s find out about these drugs.

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UNIDENTIFIED WOMAN: Anti HIV drugs are the main treatment for HIV. They are not a cure, but can stop people becoming ill for many years. They fight HIV in the body and help prevent damage to the immune system. Anti HIV drugs have been shown to add years to the life expectancy of many people living with HIV, but they are expensive costing up to $9,500 U.S. dollars a year to treat one person. Less than one percent of the global HIV positive population can afford anti-HIV drugs.

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CYRUS BROACHA: All right, so it’s a question of can we afford to live, literally. Let’s find out if that’s the right approach or not. You’ve got a personal story, Ozzi. You come from Trinidad, cricket country, tell us about it.

OZZI: Thank you. I have a friend, a very good friend of mine. Her name was Alana (Misspelled?). She was 19 years old, but Alana was one of those real fun persons. She was very flamboyant, very ambitious, she made us laugh a lot, she had a positive, you know, look at life. Alana, unfortunately, died two months ago. All of that was lost and she was robbed of an opportunity to live and see her dreams. And the reason being is Alana could not have afforded the drugs that was available and we tried to help as much as could, but I mean, there’s only so much we could have done as her friends. And today, when I think back about it, I’m thinking that she was only 19. She could have done so much. She was so articulate. She was bright. She was doing well and it really affected me a lot. And I would, therefore, want to ask Vickie, why does the cost have to be so much for young people, in particular young people like Alana who want to get a chance, a chance to live life and a chance to see their dreams?

CYRUS BROACHA: All right, Vickie, of course, Glaxo Smith & Kline makes drugs, as do some other companies. Tell us, how do we answer this young man?

VICKIE: We are very, very aware of the issues around prices, the pharmaceutical industry, and I think we are really committed to trying to do something about it, particularly in developing countries. And what we really are doing is committing ourselves to actually reduce the prices to developing countries and we, our company, and other companies have actually brought the prices down to a level, which is now one-tenth of what it is in the Western world, the price that you saw mentioned earlier. But however low the price has become, somebody has to actually pay for those drugs, and so, what it means is that your countries have to make a commitment to the science who provide those drugs, and some way they have to find the funds. So we see those as the two issues as to why, perhaps, you are not currently able to access those products at those prices.

CYRUS BROACHA: Ozzi, any response?

OZZI: I think that--that maybe somewhat true, but I believe at the end of the day, pharmaceutical companies, they make a lot of profit and they benefit a lot from consumerism, which is consumed by human beings and, indeed, I believe that these pharmaceutical companies have a sort of moral obligation to give back to society. And it’s not only just about developing countries, it’s about young people. It’s about specifically young people who still cannot afford one-tenth of the drugs because they don’t work anywhere. They are unemployed. Most of them, families that have rejected them, they don’t get support from communities. This is the target group I’m talking about.

CYRUS BROACHA: Okay, it’s an emotional appeal, Vickie. Very quickly, what about the moral situation here? Do you have a moral situation here?

VICKIE: Absolutely, we are very, very committed to this whole issue, and from the point of view of the young people, we as a company put a lot into social responsibility. We are very committed in the HIV/AIDS area to supporting communities who are affected by HIV and AIDS, because that is one thing that we can do and a number of our programs actually benefit people in developing countries.

CYRUS BROACHA: Okay, I think Kpabu has something to say as well. Kpabu?

KPABU: Yeah, if you’re so committed and it’s so good to talk about commitment. I come from South Africa where South African people had to drag you through a very costly, lengthy court case. That--I think it was unnecessary. If you’re so committed, why did you have to go through such a process, which is very costly, that eventually you lost?

CYRUS BROACHA: Vickie?

VICKIE: Thank you. The court case was unfortunately directly related in the media to HIV and AIDS access to medicines, but as you may see now in South Africa even though the court case has actually been settled, you still do not have access to antiretroviral medicines. So, it brings you back to my previous point that it’s up to the South African government to make the decision as to whether they are actually going to provide those antiretroviral medicines. We cannot make that decision for them. All we can do is make our offers available at the pricing and, as I said, it’s their decision, but we do realize that the funding is a major issue.

CYRUS BROACHA: Vickie’s put the ball in the government’s court. Adam, do you have something different?

ADAM: I do. Our generation’s lives are on the brink and I would really question the pharmaceuticals’ commitment in terms of this. I understand that you as a corporation have to make profit, but so often that profit is at the expense of human life, and many times you pay very expensive lobbyists to protect your own interests. And because of activism a lot of the prices that you talk about have come down, but you are still blocking access to generic medicines, medicines that countries like Brazil are producing in their country. And I want to ask, when will you stop behind the scenes pressuring governments to not produce their own drugs, which to me is a more sustainable solution than the price reductions you’re talking about.

CYRUS BROACHA: We’ll come back to Brazil in general later, but Vickie, quickly.

VICKIE: Let me just talk about the points of countries producing their own drugs. The thinking behind bringing down the cost of producing drugs, is to make large volumes of drugs, huge volumes, and individual countries making their own drugs are not necessarily going to achieve that objective. That’s the one issue. Also, I think what everybody probably here believes, is that every single drug is covered by a patent, for example, in Africa, and that is totally not true. Only two opportunities to cover a drug with a patent in Africa have actually been taken up. So, it means that nearly every country in Africa, your country actually has access to generic medicines, if they felt the multinational drugs were not appropriate or the prices were not appropriate. So, the opportunity is there for the governments to have a choice. We’re out of the stage.

CYRUS BROACHA: Leaving economics out of it for a second, Vickie, so basically what we’re looking at is the drugs are available. People cannot die if they’re given the drugs, but for some reason they don’t reach the people in all this economic speak that we have. And again, we’re not disrespecting you. We understand where you’re coming from. I think, Naina, you want to say something?

NAINA: I think it’s interesting that you pass the blame on to the government. We all really know, though, that pharmaceuticals--pharmaceutical companies care more about profits than people’s lives. My father was a Senior Pharmaceutical Marketing Executive for 15 years in the most profitable pharmaceutical company, and I know that marketing matters more and you spend almost three times as much on marketing than research and development and I think that’s ridiculous.

CYRUS BROACHA: Vickie, you’re on your own.

VICKIE: Absolutely. From the profits point of view, we are not ashamed to be making profits. That makes--puts us into a position--our profits are transparent. They are published. They are in the public domain. That puts us in the position, as you mentioned, to do the research and development and, I think you’ve seen today that, in fact, there is not a cure for AIDS. What we believe we should be doing is searching for that cure and we are the one company that is searching for a cure and prevention for HIV and AIDS, malaria and TB. As far as your points on the marketing cost is concerned, is we as a company have a responsibility to see that our drugs are used correctly and to make them known out in the marketplace. Yes, most certainly some of our marketing costs are driving our brands, but a lot of it is to make the doctors understand how to use the products and use them correctly.

CYRUS BROACHA: The bottom line is, they are still not reaching the people who need them. Once again, we’ll try and find out--we’ll come back to that whole set of questions, but coming back to Brazil, a success story in a sense. This is the only country where actually drugs are available freely and it’s a good blueprint for the rest to follow?

PAULA ACHERA: Yes, in Brazil, we adopted the policy of universal and free access to all the ARV drugs available on the market, and it was necessary to adopt some strategies. And one has been accepted to produce the generics, to produce as generics some drugs that were not still under patent. And the other hand was to negotiate with companies in other basis. And so, I think that it’s important to say, the market--the drugs market is very profitable and we have to change this. This is--we have no choice. It’s a new era and we have to reduce profits. It’s one. We understand that we have to pay the investment, etc., but it’s not so much that we paying today. In the negotiation with the companies in Brazil, we start to develop ourselves the process of production and establish what is the correct price and we proposed this to the company. If they accept, okay, if not, we start to produce, and this is a decision. But just to be brief, I agree with one point, we are not talking about contingent on the premise of drug companies, we need governments to be committed with the question and we don’t have enough commitment until now in development in poor countries.

CYRUS BROACHA: All right, so just to put you on the spot once again. Do you think that the drug companies are doing the right thing, that the policy is right?

APOLLO ACHERA: No-no, it’s not that. They are producers. They are private companies. They need money to research and they have to recuperate their investments. What I am saying is that they integrate in their recuperation, they establish exaggerated prices and that is not fair in the era--in the era of AIDS. This is the question. (applause)

CYRUS BROACHA: Vickie, Paula has stressed about changing price policy amongst your company, companies like yours. How do you respond to that?

VICKIE: If I understand your question correctly, I think, it was mentioned about the cost space.

CYRUS BROACHA: Right.

VICKIE: And as I understand it, I think Brazil actually owns the manufacturer, themselves. From our point of view, we’re a commercial organization, so it’s difficult to compare that, but the one comment I would like to make, that our commitment is that we will make our products available in developing countries at no profit. So, while yes, we are making profit in the ways, we are able, therefore, to deliver products at no profit in developing countries as long as the governments are able to take up those offers.

CYRUS BROACHA: I have a very important question I want to squeeze into this section. I think it comes from this young lady.

ANTIGENE: Dr. Piot, I want to ask you, I come from the United States and I can access medications, but I have friends who are dying in developing countries. How are you going to make sure that the United States is accountable to the rest of the world and to make sure that they put in the right amount of money that they really should be towards fighting this?

PETER PIOT: We’ve estimated in UNAIDS how much it costs to provide treatment for everybody also in the poor nations; treatments for people with HIV. And also I should say, that we have reached now, finally, the stage 20 years into the epidemic and about 10 years after treatment became available, that it’s accepted that treatment is as important as prevention. And it’s about $10 billion per year that are necessary, roughly half for prevention and half for treatment. And a lot of that money can--will come from the developing countries, themselves. Brazil, you pay for this yourself from the government budget and then, the rich countries, there is no other way. That the rich countries will have contribute; the United States, the countries from the European Union, Japan, their contributions will be necessary. So, where are we with that? We are at the moment at about one-third of the $10 billion. In other words, $3 billion, so the cap of $7 billion will have to be filled by the rich nations, by the governments in the developing countries. And I agree fully that leadership is absolutely important and other channels.

CYRUS BROACHA: Okay, this is the end of Part 2. We’ll come back and talk some more. Are the governments to blame? Who is accountable in that government? Let’s see if we can find someone who can talk for the government as well. Our thanks, once again, to our wonderful panel, we’ll be back. Stay with us -- Staying-Alive.

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