Confronting HIV/AIDS.

Two years ago, Parliament passed the Pledge to Africa Act, one of Prime Minister Jean Chretien's more noble moves upon leaving office. The Act was expected to make anti-retroviral drugs (ARVs) available at a modest cost to African and other HIV-ravaged countries. It was widely hailed as a courageous and pioneering measure.

Shortly thereafter, a generic drug company made an agreement with Medecins Sans Frontieres to supply drugs at cost, about 45 cents a pill. So far so good, but since that time not a single pill, capsule or teaspoonful has left Canada for the beleaguered countries. What happened?

The plan had to run a massive blockade beginning with Canada's drug patent laws and the bureaucratic procedures required to gain approval. Along with this were the labyrinthine procedures of the World Trade Organization, which protects the large drug manufacturers. These hurdles were surmounted with time but still nothing happened.

The whole scheme is now stuck on the provision in the Pledge to Africa Act that requires a generic manufacturer to negotiate with the major pharmaceutical companies, who are the patent holders, and arrive at a reasonable royalty payment. No negotiations are presently taking place. They can't even arrange a meeting. Until they meet, nothing happens. Unless the government threatens to intervene, nothing will happen.

The world picture is not much different. Price of ARV drugs has come down in recent years. This is the impact of the constantly unfavorable comments that the major drug companies are subject to. Perhaps, the comments arising at the international AIDS conference in Toronto will bring the prices down some more.

These major drug companies are moved by occasional threats from large countries such as Brazil and India, to manufacture their own generic versions. The drug companies lowered the price but it is still too high for the poorer countries. Brazil, which provides free ARV drugs, spends almost 40% of its health budget on three ARVs. Most poor countries cannot afford the bargains offered to Brazil.

Meanwhile, more than 8,000 people a day die of HIV-AIDS, 95% of them in the developing countries. But development in these countries is grinding to a halt as the infection kills off a large part of the young adult population on whom the economy depends. These deaths leave thousands of orphaned children in the care of impoverished grandmothers, orphanages, or fending for themselves on the streets.

The epidemic cannot be viewed apart from the broad social and economic problems of the developing nations. Gerry Barr, President-CEO of the Canadian Council of International Co-operation, points out that, "Poverty fuels the AIDS pandemic and AIDS is devastating communities and local economies, relegating millions to live and die in poverty." He adds, "Women and children are bearing the brunt of this pandemic--this vicious circle can and must be stopped." The government of Canada should set an example for the G8 countries by bringing its international development contributions up to the long recommended standard of 0.7% of gross national income. (Canada now spends less than half this amount and no country has yet reached the goal.)

This assistance should include funds to expand public health services providing preventive and treatment programs for HIV/AIDS and other infectious diseases. Education and social services should be made available to the orphaned population.

Some months back, we commented on the practice by the affluent countries of aggressively recruiting health-care professionals in the developing nations an unethical, though legal activity. Few health care organizations in Europe or North America will admit to such shameful practices. However, third party agents are busy doing the dirty deed for them. Canada has a long and dishonorable history of poaching skilled personnel trained at someone else's cost.

The HIV-AIDS pandemic requires that we stop this practice now! Rather, Canada should be helping these countries to develop resources that will give doctors and nurses reasonable facilities, proper working conditions, and assure that this personnel is regularly and adequately paid by the standards of their communities.

HIV-AIDS challenges Canada to think about its role as a positive force in the world.