Access to Medicines Means Access to Life

by Erika von Kaschke
Special to Global Wire

During US tour, Thai activists explain how a trade agreement could limit access to affordable HIV and AIDS drugs.

Sometimes life can come in the form of a bottle. In the case of the half a million people living in Thailand with HIV or AIDS, those bottles are often filled with anti-retroviral medicine.

But lately that medicine has become harder to come by as pharmaceutical corporations have priced poor people out of the market. Five years after the World Trade Organization’s members unanimously reaffirmed developing countries’ rights to produce, export, and import affordable copies of patented drugs, rich country governments keep breaking their promises.

Countries like the US are forcing developing nations to accept free trade agreements that violate the spirit of the WTO’s decision on medicine patents. The provisions contained in US-negotiated free trade agreements would restrict the availability of generic drugs; people who can’t afford brand-name medicines for infectious diseases like HIV/AIDS or for chronic illnesses like diabetes or heart disease would have to go without.

This fall, Oxfam’s partner, the Educational Network for Global and Grassroots Exchange, brought three Thai HIV/AIDS activists to New York, Washington DC, Pennsylvania, Texas, Illinois, Minnesota and California to speak out against the proposed US-Thailand Free Trade Agreement. The tour was part of Oxfam’s campaign to change trade rules that favor rich countries over poor people and company profits over public health.

“Americans don’t know much about the HIV/AIDS epidemic in Thailand or the negative impact that a US free trade agreement would have on the cheap drugs that the government makes,” said Matthew Coghlan, Oxfam’s Regional Trade Policy Officer in East Asia. “This tour gave the Thai speakers the chance to educate Americans about what’s really at stake.”

Speaking from Experience

Boripat Donmon, or Pii Muu as he’s known, has been living with HIV for 13 years. During that time, he has become an instrumental leader in the fight for greater access to HIV and AIDS medicines in Thailand. His organization, the Thai Network of People Living with HIV/AIDS, gathered 50,000 signatures from the Thai public to lobby the Thai government to revise its national health policies. With pressure from hundreds of other organizations mounting, the Thai government announced last year that it would include treatment for HIV and AIDS in the national health insurance plan, commonly known as the ’30 Baht Scheme’.

Since then, though, people like Pii Muu have been forced to stop treatment. As they become resistant to older drugs that are manufactured by the Thai government, they must take newer drugs still under patent to prolong their lives. But currently patent rules give brand-name companies exclusive rights to market their medicines for 20 years, which allows them to charge more than most sick Thais can afford.

“The situation will only worsen if the US-Thailand FTA is approved,” Pii Muu said during a stop on the tour in New York City. US free trade agreements severely restrict the ability of developing countries to ensure availability of generic versions of patented medicines -- the only proven way to lower prices. “Most Thais make $140 a month -- way below what patented medicines cost” he continued, “I don't know how anyone will be able to afford them with an FTA.”

Sang-Siri Teemanka, also known as Pii Tui, agreed. An organizer with Thailand’s Aids Access Foundation, she has also spent much of her career campaigning to get the Thai national health system to offer affordable anti-retroviral medicines.

“The problem now in Thailand is that the basic treatment manufactured ... at the cheap price will become ineffective for some patients after just three to five years. They will need to change medicines, and the new drugs are patented by the giant foreign pharmaceutical companies,” Pii Tui said. “These drugs are very expensive.”

What Thais Want

Negotiations for a free trade agreement with the US are a contentious issue in Thailand. In January 2006, thousands of people took to the streets in Chiang Mai, Thailand to protest their lack of involvement.

The Thai activists touring the US said they want their government to recognize the people’s rights to shape the trade rules that would have real effects on their daily lives. Specifically, the Thai activists asked that the government educate the people about the US-Thailand FTA, consult with them when negotiating it, and invite them to participate in decision-making.

They also asked that Americans lobby the US government and the WTO to help poorer countries like Thailand assert their right to make available generic versions of the patented drugs.

“We want the US to understand that the FTA is not balanced,” Pii Tui said. “Access to medicine is very important to Thailand. It is not like CDs or computer software. People’s lives are at stake.”

The (IL)Legitimacy of Kwanzaa

Today marks the beginning of Kwanzaa, a week-long African American celebration of Pan African traditions. Kwanzaa consists of seven days of celebration, featuring activities such as candle-lighting and pouring of libations, and culminating in a feast and gift-giving. It was founded by Ron Karenga, and first celebrated in 1966. Karenga calls Kwanzaa the African American branch of "first fruits" celebrations of classical African cultures.

Karenga says that “it was chosen to give a Black alternative to the existing holiday and give Blacks an opportunity to celebrate themselves and history, rather than simply imitate the practice of the dominant society."

According to Wikipedia, it is a celebration that has its roots in the civil rights era of the 1960s, and was established as a means to help African Americans reconnect with what Karenga characterized as their African cultural and historical heritage by uniting in meditation and study around principles that have their putative origins in what Karenga asserts are "African traditions" and "common humanist principles."
There has been criticism of Kwanzaa's authenticity and relevance, and of the motivations of its founder, Karenga.

However the legitimacy of Kwanzaa has come into question…

There has been a despite over how many people celebrated Kwanzaa. It is unclear how many people celebrate the holiday. According to a marketing survey conducted by the National Retail Foundation in 2004, Kwanzaa is celebrated by 1.6% of all Americans (about 13% of all African-Americans), or about 4.7 million. In a 2003 interview Karenga asserted that 28 million people celebrate Kwanzaa. He has always maintained it is celebrated all over the world.

Kwanzaa has also been criticized because it is not a traditional holiday of African people, and because of its recent provenance, having been invented in 1966. The origins of Kwanzaa, however, are not secret, and are openly acknowledged by those promoting the holiday. It was never advanced as an indigenous, African celebration.

Other criticisms center on Karenga's criminal record, including having been convicted and jailed on charges of felonious assault and false imprisonment in a case concerning the torture of two women. The women were themselves African-American, which some critics, among them Les Kinsolving, feel detract from Karenga’s claim that he created Kwanzaa to celebrate and strengthen the unity of black people.

In 1999, syndicated columnist and now White House Press Secretary Tony Snow wrote that "There is no part of Kwanzaa that is not fraudulent.” and other conservative writers have remarked on the Marxist leanings of Karenga and some of the seven principles of Kwanzaa, questioning whether Kwanzaa should be taught in American schools.

Human Rights Day and Conflict Diamonds

Today the international community commemorates Human Rights Day. This is a day to reflect on the different human rights abuses that still occur around the world. With the theatrical release of “Blood Diamond,” a new spotlight has been placed on the ongoing problem of conflict diamonds in Africa. While the film follows the same Hollywood formula of a sappy romance and the elements of a buddy flick, albeit a racialized one, the film does a good job of getting this human rights issue on the table.

From Wikipedia:

In some of the more politically unstable central African and west African countries, revolutionary groups have taken control of diamond mines, using proceeds from diamond sales to finance their operations. Diamonds sold through this process are known as conflict diamonds. In response to public concerns that their diamond purchases were contributing to war and human rights abuses in central Africa and west Africa, the diamond industry and diamond-trading nations introduced the Kimberley Process in 2002, which is aimed at ensuring that conflict diamonds do not become intermixed with the diamonds not controlled by such rebel groups. The Kimberley Process provides documentation and certification of diamond exports from producing countries to ensure that the proceeds of sale are not being used to fund criminal or revolutionary activities. Although the Kimberley Process has been highly successful in limiting the number of conflict diamonds entering the market, conflict diamonds smuggled to market continue to persist to some degree (approx. 1% of diamonds traded today are possible conflict diamonds. According to the 2006 book, The Heartless Stone, two major flaws still hinder the effectiveness of the Kimberley Process: the relative ease of smuggling diamonds across African borders and given phony histories, and the violent nature of diamond mining in nations which are not in a technical state of war and whose diamonds are therefore considered "clean."

Currently, gem production totals nearly 30 million carats (6,000 kg) of cut and polished stones annually, and over 100 million carats (20,000 kg) of mined diamonds are sold for industrial use each year, as are about 100,000 kg of synthesized diamond. In 2003, this constituted total production of nearly US$9 billion in value.

However the film itself has sparked controversies:

The World Diamond Council and the De Beers Group, which controls the vast majority of the diamond trade, have expressed reservations the film will reduce public demand for diamonds. De Beers maintains the trade in conflict diamonds has been reduced from 4% to 1% by the Kimberley Process and it has been suggested the company pushed for the film to contain a disclaimer saying the events are fictional and in the past. De Beers has denied this.

More recently, the New York Post has reported Warner Bros. Pictures promised twenty-seven child and teenage amputee extras for the film prosthetics upon completion of filming. Several month after the completion of filming, the prosthetics had not been supplied, and it was reported the studio told amputees they would wait until the December release of the film to maximize the publicity boost. In the meantime a private charity had to step-in and assist in supplying prosthetics to the amputees. These allegations were countered by an article in L.A. Weekly where it was stated that Warner Bros. did not promise twenty-seven children and teenage amputees prosthetics, but that the cast and crew raised between $200,000 to $400,000 to begin the "Blood Diamond Fund" which was then matched by Warner Bros. and "administered by a Maputo-based international accountancy firm under the supervision of Laws and João Ribeiro, the production managers in Mozambique."

Post Colonial Moment: Native Americans buy The Hard Rock

From the BBC:

British entertainment company Rank Group has agreed to sell its Hard Rock Cafe chain to an American Indian tribe for $965m (£490m).
The business is being bought by the Seminole tribe of Florida, which already runs Hard Rock-branded hotels and casinos in Tampa and Hollywood.

The Hard Rock business made a pre-tax profit of £35m in 2005 and has 132 outlets worldwide.

Rank will now focus on online and phone betting, casinos and bingo clubs.

It has sold off a number of leisure businesses in recent years, including Butlin's, Warner Holidays, Odeon Cinemas, Pinewood Studios and pub chain Tom Cobleigh.

No surrender

Rank said it would pass £350m of the sale proceeds to shareholders via a special dividend.

"Today's announcement sets a clear strategic course for Rank as a focused gaming business," said chief executive Ian Burke.

"We have established clear plans to capitalise on the changes taking place in UK gaming."

The 12,000-strong Seminole tribe has lands in Oklahoma and Florida, and its main business interests are in tobacco, tourism and gambling.

The Florida Seminoles had relied on cattle, citrus fruits and federal loans for economic survival until the late 1970s, when they opened their first bingo hall and tax-free tobacco store.

The tribe now runs two massive Hard Rock hotels and casinos on two of its reservations in Florida and has gaming businesses on three other sites.

It is the only American Indian tribe never to have signed a peace treaty with the United States.

The Verdict from the Iraq Study Group

The Iraq Study Group essentially handed down a harsh verdict on the way the Iraq war is being handled, clearly stating that a conclusion to America's occupation should come immediately.

According to the United States Institute of Peace (USIP), "The Iraq Study Group (ISG) was launched on March 15, 2006 at a meeting on Capitol Hill. It was created at the direction of a bipartisan group of members of the U.S. Congress. Representative Frank Wolf (R-VA) was the leading supporter of the group’s creation. Wolf had been calling for a “fresh eyes” assessment of the situation in Iraq since the summer of 2005. From its inception, the ISG was designed to be bipartisan, and the initiative has attracted broad, bipartisan support among members of the House and Senate."

Below are some excerpts from their report:

INTRODUCTION

The situation in Iraq is grave and deteriorating...

If the situation continues to deteriorate, the consequences could be severe. A slide toward chaos could trigger the collapse of Iraq's government and a humanitarian catastrophe...

Our recommended course has shortcomings, but we firmly believe that it includes the best strategies and tactics to positively influence the outcome in Iraq and the region.

EXTERNAL APPROACH

The United States should immediately launch a new diplomatic offensive to build an international consensus for stability in Iraq and the region... Iraq's neighbours and key states in and outside the region should form a support group to reinforce security and national reconciliation within Iraq...

The United States cannot achieve its goals in the Middle East unless it deals with the Arab-Israeli conflict and regional instability.

There must be a renewed and sustained commitment by the United States to a comprehensive Arab-Israeli peace on all fronts... This commitment must include direct talks with, by, and between Israel, Lebanon and Palestinians (those who accept Israel's right to exist), and Syria...

The United States should provide additional political, economic, and military support for Afghanistan, including resources that might become available as combat forces are moved out of Iraq.

INTERNAL APPROACH

The primary mission of US forces in Iraq should evolve to one of supporting the Iraqi army...

By the first quarter of 2008, subject to unexpected developments in the security situation on the ground, all combat brigades not necessary for force protection could be out of Iraq...

The United States must not make an open-ended commitment to keep large numbers of American troops deployed in Iraq.

LETTER FROM CO-CHAIRS

All options have not been exhausted. We believe it is still possible to pursue different policies that can give Iraq an opportunity for a better future...

Our report makes it clear that the Iraqi government and the Iraqi people also must act to achieve a stable and hopeful future.

What we recommend in this report demands a tremendous amount of political will and co-operation by the executive and legislative branches of the US government...

Success depends on the unity of the American people in a time of political polarisation...

US foreign policy is doomed to failure - as is any course of action in Iraq - if it is not supported by a broad, sustained consensus. The aim of our report is to move our country toward such a consensus.

World AIDS Day 2006

Accountability

Stop AIDS: Keep the Promise.

Today the world commemorates the 19th anniversary of World AIDS Day. Over 40 million people worldwide are living with the disease, while another 25 million have already died from it. While India has the highest prevalence of HIV/AIDS infections in the world, two thirds of all new infections are happening on the continent of Africa. The Western media today will show the annual patronizing pictures of hopeless people dying from AIDS and wrangle about developed countries and pharmaceuticals not giving enough aid to those suffering from HIV/AIDS. Global Wire recently went to South Africa and met with people who are not dying from AIDS, but rather living with pride and dignity. Those who are infected and affected are finding new ways of fighting the disease. Here are their stories:

Treatment Action Campaign

We met with Luyanda Ngonyana, the executive director of the Johannesburg office of Treatment Action Campaign (TAC), which is an AIDS activist organization founded by HIV activist Zackie Achmat in 1998. Achmat is a middle class Indian man who is HIV positive himself. He stopped taking anti-retrovirals because he felt that it was unfair that the vast majority of poor black South Africans don’t have access to these same medications. He will not take anti-retrovirals until everyone has access to them. TAC is unique for combining the issue-specific targeted direct action tactics of American AIDS groups like ACT UP with the culture and organization of the South African trade union and anti-apartheid movements. Over five million people in South Africa are infected with HIV/AIDS. There are over 1,000 new infections every day. TAC advocates for medicine for those living with HIV/AIDS through community mobilization. TAC has a long, bitter history with the South African government. TAC first confronted the South African government for not ensuring that mother-to-child-transmission (MTCT) prevention was available to pregnant mothers. It won this case on the basis of the South African constitutional guarantee of the right to health care, and the government was ordered to provide MTCT programs in public clinics. TAC also assisted the government by defending it in the case brought against the government by the pharmaceutical industry. TAC entered the case as an amicus curiae, submitting a brief in favor of the government's position. Although the withdrawal of the pharmaceutical companies from this case resulted in a government victory, the government showed no interest in providing access to the generic antiretroviral medications that its victory allowed. TAC is against President Thabo Mbeki’s view that HIV didn’t cause AIDS and that AIDS medicines were more toxic than helpful, inviting so-called "AIDS dissidents" to advise his government. TAC is working on the dismissal of Minister of Health Dr. Manto Tshabalala-Msimang, who has failed to address the HIV pandemic correctly. She is known for advocating natural remedies such as garlic and lemons for AIDS treatment instead of antiretrovirals. During the closing ceremonies of the International AIDS conference in Toronto last August, United Nations Special Envoy for HIV/AIDS in Africa Stephen Lewis pointed out the failure of South Africa's response to HIV/AIDS, calling their actions more "worthy of a lunatic fringe than of a concerned and compassionate state." He also announced that earlier in the morning, Zackie Achmat and 44 others had been arrested for occupying provincial offices in Cape Town in protest of government's failure to treat prisoners with anti-retrovirals, and in particular the recent death of one plaintiff in the legal case against the government on this matter.

AIDS Law Project

We met with Cloe, Thabo and Chelsea of the AIDS Law Project (ALP) in Johannesburg. It is an organization that specializes in helping people with HIV/AIDS to deal with legal problems. They also research many of the difficult social, legal and human rights issues around AIDS. They use this research to develop law, policies and "best practice" recommendations on questions such as AIDS and employment, AIDS and pregnancy, AIDS and development, AIDS and women. ALP is the only organization in Africa that works exclusively to promote equal rights and justice for people with HIV. ALP researchers, attorneys and paralegal officers speak at over 250 meetings a year on a range of topics about AIDS, development, employment, human rights and the law. They are currently working on cases relating to prisoners’ rights, AIDS orphans and both male and female rape victims. Most of the cases they see are from people with HIV who are being harassed or torture by family and friends because of their HIV status. ALP has challenged the US government on its ABC (abstinence, be faithful, use condoms) policy, as they feel that it doesn’t take into account the lack of women’s empowerment and the legacy of apartheid that has left a lasting effect on South Africa.

Men As Partners

We met with William Letswalo in Soweto, coordinator for Men As Partners (MAP). MAP is a program of EngenderHealth that tries to get men involved in helping to reduce HIV transmission and gender violence. Around the world, women carry disproportionate responsibility for reproductive health and family size. And while women receive the bulk of reproductive health education, including family planning information, gender dynamics can render women powerless to make decisions. Men often hold decision-making power over matters as basic as sexual relations and when and whether to have a child or even seek health care. But most reproductive health programs focus exclusively on women. Letswalo recognizes the importance of partnership between women and men, as well as the crucial need to reach out to men with services and education that enable them to share in the responsibility for reproductive health and stop domestic violence. Letswalo says that he tries to be an example to other men in the community, by taking turns cooking and cleaning with his wife. Letswalo says that he has gotten a negative response from other men about MAP because many African men feel that their “culture” is being subverted be being equal to women. “Being a real man doesn’t mean you have to beat your wife and children and force your wife to have sex,” Letswalo said. “Being a real man means that you take care of your family.”

Art Addressing Reality

We visited the Credo Mutwa Cultural Village, where we met a sculptor named Philip who did sculptures about women’s empowerment. Many of the sculptures run on themes such as rape, incest, female circumcision and HIV transmission. “We need to change how men view women,” Philip said. “Women need to fight back this disease.”

Grassroots Community Development and Mobilization

We meet with Matilda Vantura (on the right in the white coat), an MP for the Western Cape Provincial Parliament. She showed us around her constituency to see the different development projects she is involved in.

We went to a paralegal office where they provide legal services for low-income community members, many of whom are people living with HIV.

We then went to Tehillah Multipurpose Center. This is a shelter for abused and homeless, young women and their children. Most of the residents are HIV positive and most of the children are products of incest or rape. This shelter tries to provide a second chance for this vulnerable population by having skills-training workshops, such as sewing and silk screening.

We visited Gugu S’Theba, a community development program cosponsored by Microsoft that provides training for those with HIV so they can enter the workforce such as carpentry and pottery design.