BANGKOK, Thailand (AP) – The World Health Organization said Tuesday the world has “failed miserably” in getting lifesaving drugs to millions afflicted with HIV, and France accused the United States of bullying poor countries into ceding rights to make affordable generic medicine.

A U.S. official denied the French allegation at the International AIDS Conference as “nonsense,” while delegates lamented that only about 7 percent of the 6 million people in poor countries who need antiretroviral treatment are getting it.

U.N. Secretary-General Kofi Annan urged Washington to show the same leadership in fighting AIDS as it has in fighting terrorism.

“We hear a lot about weapons of mass destruction, we hear a lot about terrorism. And we are worried about weapons of mass destruction because of the potential to kill thousands. Here we have an epidemic that is killing millions. What is the response?” Annan said in an interview with the British Broadcasting Corp. in Bangkok.

“We really do need a leadership. America has a natural leadership capacity because of its resources, because of its size,” Annan said.

Since the last AIDS conference in Barcelona in 2002, the number of people being treated for the disease has doubled in the developing world to 440,000. At the same time, 6 million people died from the virus and 10 million people became infected, WHO figures show.

“By these measures of human life, the ones that really matter, we have failed. And we have failed miserably to do enough in the precious time that has passed since Barcelona,” said Jim Kim, WHO’s AIDS director.

Cost is a key issue. European and U.S. pharmaceutical giants make most of the drugs, which are protected by patents and cost as much as $5,000 per person a year.

Developing countries such as Thailand, Brazil and India are making cheap generic drugs – WHO put its seal of approval on four new generic Indian products Tuesday – but they not enough to reach everybody.

An estimated 38 million people are infected with HIV, mostly in poor countries: 25 million in sub-Saharan Africa and 7.2 million in Asia.

The Bush administration’s five-year, $15 billion plan for worldwide HIV/AIDS prevention and treatment is modeled after a program in Uganda, which stresses abstinence, monogamy and condom use.

It recommends that 55 percent of direct aid go to treatment programs, 20 percent to prevention, 15 percent to palliative care and 10 percent to children orphaned by the disease.

The funding package allows money to be spent on generic antiretroviral medicine primarily in 14 African and Caribbean countries only if it is approved by the U.S. Food and Drug Administration, which so far has only approved branded versions of the drugs.

However, the FDA said in May it would fast-track its reviews of any applications for generic drugs so that U.S. funds could be used to purchase the cheaper versions.

The Bush plan includes $5 billion over five years to bilateral programs in more than 100 countries and increases the U.S. pledge to the Global Fund to Fight AIDS, Tuberculosis and Malaria by $1 billion over five years.

While the FDA plan does ensure faster evaluation, with fewer data requirements, than the agency usually mandates, AIDS advocacy groups and members of Congress still blast it as an extra layer of bureaucracy that will cause delays if not discourage generics in favor of more expensive patented medicines. Critics say it undermines the WHO, which has set its own standards for the drugs.

State Department spokesman Richard Boucher rejected criticism by Annan of the U.S. AIDS effort, saying the money proposed by President Bush to combat AIDS is an “enormous amount” and a significant increase over what’s been spent before.

China, which had long denied having an AIDS problem, appealed for outside help in its fight against HIV. Wang Longde, Beijing’s vice minister of health, told a session of the International AIDS Conference that his country lacks the resources to properly deal with its emerging epidemic.

China says it currently has 840,000 people infected with HIV – 80,000 of whom have full-blown AIDS. But the United Nations’ AIDS agency has warned that China could see 10 million HIV cases by 2010 if it doesn’t act quickly.

In a statement read out at the conference, Chirac said forcing certain countries “to drop these measures in the framework of bilateral trade negotiations would be tantamount to blackmail.”

“We should implement the (WTO) generic drug agreement to consolidate price reductions … what is the point of starting treatment without any guarantee of having quality and affordable drugs in the long term?” Chirac said.

World Trade Organization rules give developing countries the flexibility to ignore foreign patents and produce copies of expensive drugs in times of health crises. All WTO members including the United States have signed an agreement to respect that clause.

But there is nothing to prevent a country from imposing patent restrictions in a bilateral trade agreement, such as one Washington is negotiating with Thailand.

France’s global ambassador on AIDS, Mireille Guigaz, said Chirac was not trying to create tension with Washington.

“The United States wants to put pressure on developing countries who try to stand up for their own industries,” Guigaz said. “This is a problem.”

A U.S. official who declined to be named called the French allegations “nonsense,” and insisted the trade agreements will conform to WTO rules allowing poor countries to make generic drugs. “There really is no issue,” he said.

About 100 AIDS activists, carrying mock body bags, interrupted a speech by the head of Pfizer, accusing multinational drug firms such of denying lifesaving medicine to HIV sufferers through inflated prices.

“Break the patents, treat the people,” they shouted.

Pfizer CEO Hank McKinnell resumed after a few minutes, saying the protection of patents drives innovation by ensuring companies will earn profits on important inventions.

Without intellectual property rights, “you would have exactly the same number of drugs that has been discovered in the Soviet Union in the past 50 years, which I think is about one,” he said.

WHO on Tuesday approved four new Indian-made generic drugs against HIV: 150 mg lamivudine, made by Strides, and antifungal fluconazole in three strengths – 50 mg, 150 mg, 200 mg – made by Cipla.

The head of UNICEF, Carol Bellamy, told delegates on the third day of the conference that more than 3 million children in the world lost one or both parents to AIDS from 2001 to 2003 but governments have largely overlooked their plight.

“The orphan crisis is arguably the cruelest legacy of the AIDS pandemic,” Bellamy said, adding that the children are left vulnerable to discrimination, violence and exploitation.

The conference, which draws a mix of science and activism, was in its third day and has featured appearances such celebrities as Richard Gere and Ashley Judd. Senior African statesman Nelson Mandela also was expected.

At the heart of the AIDS debate is how to control the spread of the virus.

Many delegates dismissed Bush’s policy of abstinence as a setback in global efforts to control the pandemic. They say using condoms and giving clean syringes to drug users is the best way to prevent HIV.

AP-ES-07-13-04 1434EDT



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