[e-drug] generic ARV drugs in Malawi

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E-DRUG: generic ARV drugs in Malawi
-------------------------------------
[copied as fair use; WB]

HEADLINE: AIDS overwhelms Africa ; GREAT DECISIONS; AIDS overwhelms Africa,
tests U.S. national morality


March 17, 2002

Blantyre, Malawi -- The sight was shocking. Peering into the medical ward
of
Queen Elizabeth Hospital was like peering into a corner of hell. AIDS has
overtaken the hospital.

Seventy percent of the medical-ward admissions are AIDS-related, but the
hospital lacks the proper medications to treat the sick. So the patients
come to die in ever increasing numbers, far beyond any capacity to manage.
Two to a bed; sometimes three to a bed. When the beds overflow, the next
wave of the dying huddle on the floor under the beds, to stay out of the
way
of families, nurses, and doctors passing through the wards. The constant
low-level moans and fixed gazes of emaciated faces fill the ward.

 These patients are dying of poverty as much as they are dying of AIDS.

 In the next corridor is an outpatient service that offers AIDS drugs. Four
hundred or so patients are successfully being treated with antiretrovirals.
They are the tiny fraction who can afford to pay approximately $1 per day
out of pocket for the medicines.

The treatment has been successful. CIPLA, the Indian generics producer,
supplies the drugs; the patients take them twice a day and they get better.
No great complexity, no unusual complications of toxicity, no struggles to
achieve patient adherence to the drug regimen. Just a doctor prescribing
medicines, and his patients responding.

A few miles away, one sees the implications of the dying fields that Africa
has become. A village in Malawi is like a giant orphanage, in which a few
elderly and wizened grandmothers look after the children of their dead and
dying sons and daughters.

Enter a village and suddenly one is surrounded by dozens of children, a
handful of elderly, and almost nobody of working age. On the day of our
visit, it turns out, the few remaining men are off to a funeral. The
grandmothers talk softly of their lost children as their orphaned
grandchildren squat quietly nearby.

One grandmother shows us the rotting, bug-infested millet that she will use
to make the gruel that keeps her and her wards barely alive. A beautiful
young girl proudly tells us that she is in the second grade. She walks
barefoot three kilometers early each morning to get to school. She wants to
go to college, says her grandma. To make it, she will have to beat
forbidding odds.

The rich world is an accomplice to the mass deaths in Africa. Why aren't
U.S. leaders visiting the hospitals, villages and health ministries in
Africa to ensure that the United States is doing all it can do to stop the
deaths? Why aren't U.S. leaders talking to African doctors?

We are spending tens of billions of dollars to fight a war on terrorism
that
tragically claimed a few thousand American lives. Yet we are spending
perhaps 1/100 of that in a war against AIDS that kills more than 5,000
Africans each day.

A report of the Commission on Macroeconomics and Health of the World Health
Organization shows that a tiny share of rich-country income -- one penny of
every $10 of GNP -- would translate into 8 million lives saved each year in
the poor countries.

 The rich world is running out of excuses. Every misconception we've heard
about treating AIDS patients -- that the drugs don't work in Africa, the
patients wouldn't adhere to "complex" regimens, that the doctors aren't
qualified or can't be trained -- has been matched by similarly lazy
misconceptions about foreign assistance.

We've been told that any aid would be wasted, that debt relief would be
squandered by corruption. We've been told that it's not "cost effective" to
spend a tiny fraction of our own income to save millions each year, as if
it's cost effective to let a generation die, to allow the collapse of
Africa's tottering health care system, and to stand by as tens of millions
of children are orphaned.

Debt-relief foes in Congress have warned that the benefits of debt
cancellation would never reach the poor. We found the opposite. In each
country that we visited on this trip -- Malawi, Uganda, Ghana -- the
government is pursuing a meticulous and transparent process to ensure that
budgetary savings from debt relief are actually channeled into urgent
social
sectors. The problem is not waste or corruption, the problem is that the
extent of help from the U.S. and Europe is so meager in the face of the
enormous crisis.

In a small room in Uganda, the intermingling of beauty and unnecessary
suffering touched us more deeply than we could have imagined. A singing
troupe of HIV-infected individuals, all likely to die in the next few years
for lack of access to life-saving meds, sang to us with great power, charm
and bravery of their struggles.

Rock star Bono, traveling with our group, reached for his guitar. With
haunting beauty, he responded with his magnificent ballad, "I Still Haven't
Found What I'm Looking For." The Ugandans swayed rhythmically to his pure
and gripping tones. The tears flowed freely.

The U.S. complicity in Africa's mass suffering, unless reversed, will stain
our country. Africa is the place where we will confront our own humanity,
our morality, our purposes as individuals and as a country.

Copyright 2002 Journal Sentinel Inc. Milwaukee Journal Sentinel



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