The patents and priorities of the western drugs industry are stacked against the sick of the developing world. But philanthropy, the impact of Aids, and new faces in global institutions have reinvigorated the battle against poor people's diseases.by Shereen El Feki / November 20, 2000 / Leave a comment
In the oasis villages around Ouarzazate, beneath Morocco’s Atlas mountains, globalisation is bearing strange fruit. The kasbahs bristle with satellite dishes; caf?s offer mint tea and “il internet”; and the call to prayer is accompanied by the ringing of mobile phones.
But some western exports remain out of reach. Azithromycin is a powerful antibiotic which stamps out all sorts of bacteria, including the one which causes blinding trachoma. This is a problem for 1.5m Moroccans living in the region, where the disease is often carried by flies which flit about infected eyes. While good hygiene and surgery go some way to mitigating the disease, drugs are crucial to tackling it.
The country’s health ministry has tried mass treatment with an old-fashioned medicine called tetracycline, which requires six weeks of twice-daily dosing, a regimen which few patients will follow. By contrast, a single dose of the newer drug azithromycin keeps patients clear of the bacteria for a year. But azithromycin is expensive, and the government cannot afford to treat more than a small fraction of patients. Last year, however, the drug’s biggest manufacturer and patent-holder, the US pharmaceutical firm Pfizer, donated $18m worth of azithromycin to Morocco through a new foundation, the International Trachoma Initiative (ITI). Now, 600,000 people have been treated, and the Moroccan government is bullish about eliminating the disease in a few years.
ITI has launched similar donation programmes in Vietnam, Mali, and Tanzania, and plans to expand into Sudan. There is no shortage of takers: 150m people in the world are developing trachoma, five times more than the number infected with HIV. But this largesse is not universally admired. The aid agency M?decins Sans Fronti?res (MSF), questions the sustainability of these gifts. MSF reckons that companies are more interested in publicity than philanthropy, and impose such conditions on donations as to severely limit their scope. MSF would much rather see drugs such as azithromycin bought from cheaper manufacturers-if only international patent law and national healthcare budgets allowed.
The drug gap
It takes only a glance at the empty shelves of a rural dispensary in, say, Kenya or Vietnam to appreciate the extent of the international drug divide. The World Health Organisation (WHO) reckons that there are over 300 essential drugs which should be made available in all countries. One third of the world’s population has no access to them. Powerful drugs for malaria and other infectious…