Get Involved: Sending Affordable HIV/AIDS Medicines to Ghana
              (by Melanie deWit and Christian Charron)

Stephen Lewis maintains that "there is absolutely no precedent for what is happening there." Perhaps never before have the eyes and minds of the world been focused so keenly on Africa. The G8 recently announced a much-heralded agreement to provide debt relief to Africa's poorest nations. More significantly (at least for the hordes of twenty-somethings who will be flocking to concert venues around the world this summer), the Live 8 concerts have also generated a tremendous amount of media publicity concerning the world's poorest inhabited continent. Maybe Africa is beginning to get the attention it needs and deserves with regards to its development priorities.

But this attention must be put into perspective. Live 8 is commemorating a cause which is now more urgent than ever before. Although there is no single cause or solution to Africa's development woes, there is no truer embodiment of these woes than the HIV/AIDS pandemic. As Live Aid was taking place 20 years ago, the world was just beginning to appreciate the significance of the pandemic. Today, it has sadly grown into a full-blown disaster which threatens to virtually annihilate the adult populations of several African nations.

During the past year, more than 3.1 million adults and children became infected with HIV in Sub-Saharan Africa and 2.3 million people died from the disease. This summer, we will all see footage of the hundreds of thousands attending the Live 8 concerts. The crowds will form literal seas of people spreading out as far as the eye can see. Collectively, these crowds will not amount to even half of the total number of AIDS deaths in Africa during 2004. There are presently an estimated 25.4 million Africans living with HIV/AIDS, and there exist over 12 million African children who have been orphaned by the disease. When added together, these numbers dwarf the entire population of Canada. The infection rates and total deaths increase year after year at alarming rates. As the pandemic impacts disproportionately on the 15- to 49-year-old demographic, it is single-handedly wiping out the most productive sector of the workforce of entire nations. The HIV/AIDS pandemic is creating a downward spiral which is crippling economies and stalling development.

Perhaps what is most disturbing is that none of this needs to happen. There exist medicines which turn AIDS into a chronic condition as opposed to a death sentence. However, these drugs are extremely costly. Large pharmaceutical companies able to produce these medicines are using their significant resources to ensure that prices and profit margins remain high. Clearly, these medicines can have a significant impact in terms of stalling the spread of AIDS on the African continent. But if the medicines remain unaffordable for the vast majority of the African population, is there really any hope at all?

A possible answer to this question comes in the form of Canada's Bill C-9. Dubbed the "Jean Chrétien Pledge to Africa", the legislation incorporates patent law flexibilities adopted by the WTO in the August 30, 2003 Doha Declaration. Bill C-9's compulsory licensing scheme allows generic drug manufacturers to produce the lifesaving medicines that Africa needs at a fraction of the cost of what brand name pharmaceutical corporations are willing or able to offer.

Bill C-9 undoubtedly packs a powerful punch in the fight against AIDS, and it is currently unique in the world as being the only piece of legislation that takes advantage of the Doha flexibilities. Despite these facts, the bill has remained idle since coming into effect on May 13, 2005. To date, there have been no applications put forward to access the legislation. If it is to have any effect for the millions dying needlessly in Africa, C-9 must be accessed as quickly as possible.

To this end, the Access to Drugs Initiative, a broad coalition of academic and non-academic organizations, aims to provide a uniquely Canadian contribution. The Access to Drugs Initiative (ADI) is based in Toronto and is spearheaded by Noah Novogrodsky, Director of the International Human Rights Program at the University of Toronto's (U of T) Faculty of Law. Also a key figure in the Initiative is noted Canadian Stephen Lewis, the United Nations Special Envoy for HIV/AIDS in Africa. To a large extent, ADI's operations depend on several tireless U of T law students. Other ADI partners include the University of Toronto Faculty of Pharmacy, Gilbert's LLP, MDLinx, Inc., and Médecins sans Frontières.

The objective of ADI is to ensure access to more affordable generically manufactured pharmaceuticals by developing countries. Currently the most effective treatment for HIV/AIDS is Fixed-Dose Combination Antiretroviral (ARV) Therapy. Through ADI, discussions have taken place with Canadian generic drug manufacturer Apotex Inc. in the hopes that the company will produce some of these essential medicines at prices drastically below what brand-name pharmaceutical companies are willing to offer.

ADI's immediate goal is to implement a project in Ghana whereby Bill C-9 would be accessed for the first time in order to help expand the Ghanaian ARV treatment program. Ghana is a country with relatively low HIV/AIDS prevalence with only 350 000 adults and children affected. However, only 2 000 of these individuals are currently being treated with ARV therapies. The ADI project in Ghana would increase this number to 7 000 in total. While this goal in Ghana is a modest one, it would provide the country with an opportunity to meet the treatment target set for it in the WHO's "3 by 5" initiative. This would make Ghana one of only a handful of developing nations to reach this target. Since Ghana is a country which exhibits the good governance necessary to implement an effective AIDS strategy, it represents an ideal test case for the C-9 legislation. This summer, U of T law students will travel to Ghana in an effort to harmonize Ghanaian patent law with the requirements of Bill C-9. It is hoped that this initial test of the legislation will proceed expeditiously in order to make an impact for the thousands of Ghanaians suffering needlessly.

While the ADI project in Ghana is definitely a cause for excitement, it cannot be denied that the HIV/AIDS pandemic spreads far beyond Ghana's borders. It is anticipated that the initial test case in Ghana will serve as a model for treatment plans covering the whole of the African continent. With infection rates in some nations upwards of 40%, Africa needs help quickly and urgently. For ADI to succeed, the initiative will require funding from both governmental and non-governmental sources, as well as a sustained commitment from all involved. There is no doubt that the U of T law students are in it for the long haul, but the commitment to Africa on the whole must be more consistent. Members of parliament must be held to account so that the potential of Bill C-9 is not wasted. More importantly, Africa cannot afford to wait at twenty year intervals for the world to take notice of its problems. The Access to Drugs Initiative is taking action today so that should there be another Live 8, the tune being sung about Africa will be entirely different.

Additional information about ADI can be viewed at http://www.law.utoronto.ca/accesstodrugs.

Sources

"2004, c.23 (Bill C-9)". Canadian Legal Information Institute. 2005. 24 Jun. 2005. <http://www.canlii.org/ca/as/2004/c23/>.

"Coming Into Force of the Jean Chrétien Pledge to Africa". Industry Canada. 16 May 2005. 24 Jun. 2005. <http://www.ic.gc.ca/cmb/welcomeic.nsf/0/85256a5d006b972085257000006c78bf
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deWit, Melanie. "The Access to Drugs Initiative Strategy Plan." Access to Drugs Initiative. 31 May 2005. 24 Jun. 2005. <http://www.law.utoronto.ca/accesstodrugs/index.htm>.

"HIV & AIDS in Africa". Avert.org. 24 Jun. 2005. 24 Jun. 2005. <http://www.avert.org/aafrica.htm>.

Lewis, Stephen. "AIDS, Africa and the Rule of Law." University of Toronto. Toronto. University of Toronto Law and Development Bridge Week. Toronto, 9 Feb. 2005.

"Regulations Amending the Food and Drug Regulations (1402 — Drugs for Developing Countries)". Government of Canada. 1 Jun. 2005. 24 Jun. 2005. <http://canadagazette.gc.ca/partII/2005/20050601/html/sor141-e.html>.

"Sub-Saharan Africa". UNAIdS. 2005. 24 Jun. 2005. <http://www.unaids.org/EN/Geographical+Area/By+Region/sub-saharan+africa.asp>.

"What We Do". Canadian International Development Agency. 16 Mar. 2005. 24 Jun. 2005. <http://www.acdi-cida.gc.ca/whatwedo.htm>.

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