By Robert Block

Wall Street Journal 20 April 2001

Moments after attorneys representing 39 pharmaceutical companies dropped a lawsuit to stop South Africa from importing cheap generic AIDS drugs, the country's health minister stood before a crowded conference room and delivered a surprising announcement. South Africa, said Dr. Manto Tshabalala-Msimang, had no immediate plans to use the landmark legal victory to obtain antiretroviral AIDS drugs. "We never said we want to use antiretrovirals," she told the audience, which just moments prior had been singing and clapping. "But we have to place our options on the table to see what we will use."

The moment marked the beginning of the next battle over AIDS treatment in South Africa: the struggle over how, or even whether, the drugs will be distributed and administered. Claiming victory for government's supporters, Kevin Watkins, policy adviser to the British charity Oxfam, warned: "If the government doesn't grasp this opportunity, this struggle would have been wasted." Zackie Achmat, chair of the South African Treatment Action Campaign, announced after the health minister's statement that activists would work to persuade the government to change its position on antiretroviral drugs.

Tshabalala-Msimang said the drugs are still too expensive, too dangerous and too difficult to manage for the government to incorporate them into its AIDS-fighting plans. Instead the government backed nutrition programs and better treatment of infections, she said. "I think we are doing very well," she said. Drug companies agreed that more affordable AIDS drugs are only a small part of the effort to fight AIDS in poor countries. Jean-Pierre Garnier, chief executive of GlaxoSmithKline, noted that one Boehringer Ingelheim AIDS drug has been available for almost a year and many African nations, including South Africa, do not use it. Jeffrey Sturchio, spokesperson for Merck & Co., said the development "underscores... the importance of intellectual- property protection and the need to balance intellectual-property protection with the health needs of South Africans."