10/07/13 - Havana Times - Cuba and the Huge Battle Against AIDS
Isbel Diaz Torres
HAVANA TIMES Efforts to find an AIDS vaccine or functional cure that
will contain the disease have not ceased since the virus was first
identified a little over thirty years ago. Pharmaceutical companies have
been at the epicenter of this battle, while countries like Cuba have
contributed their scant resources to the struggle, from the periphery.
Having infected millions of people around the world, particularly in the
African continent, the HIV epidemic is the greatest sanitary catastrophe
humanity has ever known. According to data from UNAIDS, 3 million new
infections and 1.7 million HIV-related deaths are reported every year.
At the close of 2011, some 34 million people around the world lived with
the HIV virus. Most (69 %) live in Sub-Saharan Africa, where one out of
every 20 adults (4.9 % of the population) has the disease. This region is
followed by the Caribbean, Eastern Europe and Central Asia, where 1 % of
adults lived with HIV in 2011.
HIV Medication in Cuba
The chief aim of all HIV treatments is to prolong the life of the patient
and to afford them the best quality of life possible. To achieve this,
such treatment must not only prevent the appearance of infections and
neoplasias (referred to as opportunistic), but also minimize the
side-effects of the medications themselves, through combinations of
pharmaceuticals which vary from person to person.
Cuban specialists have their work cut out for them in this regard, for the
US blockade makes procuring certain medications and raw materials
According to official estimates, between May of 2012 and April of 2013,
losses in Cubas public health sector caused by the blockade were upwards
of 39 million dollars. These losses stem exclusively from the need to
purchase medications, instruments and other supplies from distant markets
and from the use of intermediaries.
International cooperation efforts are also undermined by Washington, which
persecutes banks, firms and companies that have commercial dealings with
One case in point is Zurich Cantonal Bank, which decided to suspend its
dealings with Cuba. This had a direct impact on Cuban cancer programs,
pediatrics and campaigns aimed at preventing AIDS and other diseases,
which were being operated through MediCuba-Suisse.
We also know that HIV-positives in Cuba currently have no access to
combinations of anti-retrovirals that include Tenofovir (produced by
Gilead) and have also been denied such anti-viral medications as Kaletra,
Nelfinavir, Ritonavir and 80/20 mg Lopi/Rito (for children).
It is perhaps no accident that US Senator Jesse Helms, one of the
promoters of the calamitous Helms-Burton Act (which calls for legal
reprisals against non-US companies that have dealings with Cuba), is an
active detractor of the LGBT community and of its struggle against HIV.
Cubas public health system assumes the costs of standard triple therapies
administered to Cubans residing on the island (around 77 Cuban Convertible
Pesos a year) and provides HIV patients with medication free of charge.
It is worth pointing out, however, that, generally speaking, the islands
public health services are indirectly financed by workers, who receive
infinitesimal salaries, in exchange for a series of basic social services
(free healthcare, most notably).
This does not hold, of course, for supplies made available to Cuba through
donations or international cooperation initiatives, which are free for
both the patients and the State.
In addition, all analyses, examinations and tests that patients are
subjected to in Cuba are also costly in terms of supplies and equipment,
but all Cuban nationals enjoy these services free of charge.
Many a time, Cubans have felt the impact that the shortage of certain
supplies can have, particularly in connection with determining the viral
load, an indispensable prognostic tool needed for therapeutic decisions.
Pharmaceutical Companies and the Origins of the Epidemic
Though many questions surrounding the origin of the HIV virus have yet to
be answered, it is generally accepted that it was first transmitted to
humans from an animal carrier, infected with the Simian Immune Deficiency
According to independent journalist Tom Curtis theory, millions of people
were infected with the SIDV (SV40) though polio vaccines, during a
campaign conducted in the Belgian Congo, Rwanda and Burundy by Dr. Hilary
Koprowski in the second half of the 1950s.
Koprowskis was one of the scientists with most patents in the world,
patents which made him rich and powerful. His work in Africa coincides
with the emergence of AIDS, geographically and historically: the city of
Leopoldville (currently Kinshasa) in 1959.
The United States Food and Drug Agency (FDA) knew the vaccine contained
the virus but refused to take action. Pharmaceutical companies were also
aware of this, but likewise refused to dismantle their many, lucrative
facilities. Monkey kidneys are still being used to produce polio vaccines.
A Killer Business
The benefits secured by pharmaceutical companies, currently one of the
most profitable and influential of business sectors in the world, are
scandalous indeed. Implementing aggressive marketing strategies and
powerful campaigns aimed at steering government policy, these companies
continue to raise product prices and to secure patents that will garner
them even greater benefits.
Independent studies estimate that only 12% of research funds come from the
laboratories themselves. Governments and consumers finance up to 84% of
health-related research, while non-profit organizations contribute with
The Pedro Kouri Tropical Medicine Institute.
With respect to costs, the pharmaceutical industry claims that each new
drug put on the market requires over 800 million dollars in research.
Other sources, however, report that the cost is actually somewhere between
75 and 80 million dollars (the study does not focus exclusively on
pharmaceuticals for HIV treatment). The fact of the matter is that
manufacturing costs have decreased considerably.
According to Wikipedia, the pharmaceutical industry spends most of its
money, not on manufacturing or research, but on the marketing of its
products, a process which entails millions in market and competition
studies, positioning strategies, patents, distribution, promotion,
publicity and sales.
This is coupled with administrative expenses aimed at sustaining
multi-national conglomerates, including the astronomical salaries paid to
their chief executives.
It so happens that the government institutions that are supposed to
regulate these industries are heavily financed by the pharmaceutical
industry itself. The FDA receives 75% of its financing from the industry,
while the European Medicines Agency receives 80%. This is a clear conflict
In the words of Bill Hamilton, the greatest evolutionary biologist after
Darwin, who died in Africa looking for clues as to the emergence of HIV,
the hegemony of the pharmaceutical industry has become the greatest
obstacle in the way of independent medical research.
The US Market: A Case Study
According to the Workgroup on HIV Treatment of Barcelona (gTt), in early
August, the FDA authorized the sale of a new integrase inhibitor:
The wholesale price of this new pharmaceutical (over 14 thousand dollars a
year, per patient) is higher than those of the integrase inhibitors
currently being used, and would be twice as much for patients resistent to
The danger posed by these high costs is that a promising HIV drug which
could well be used as part of a patients primary treatment could end up
being used as a secondary or emergency drug.
The manufacturer has yet to set a price for countries with limited
resources, such as Cuba, where having to spend more than 70 dollars a year
per patient could make the medication inaccessible as a primary course of
Though UNAIDS reports that considerable progress has been made in the
struggle against HIV, thanks to greater access to medications and a
considerable decrease in product costs, dolutegravir demonstrates just how
far we still have to go in this connection.
Twenty years ago, the average cost of HIV treatment was 17 thousand
dollars a year. Today, the average around the world is 150 dollars a year,
a figure which is still too high for countries like Cuba.
The work that the US direct action group Act Up (AIDS Coalition to Unleash
Power) has been doing since 1987 is a clear example of a grassroots
initiative aimed at intervening in such important matters as
anti-retroviral treatment and the production of pharmaceuticals.
In addition to promoting scientific research and broadened medical
attention for AIDS patients, Act Up secured legislation that was favorable
to people living with HIV. To achieve this, they did not hesistate to
approach the pharmaceutical company Burroughs Wellcome Co. and demand that
it lower the price of AZT (then at 10 thousand dollars a year).
Act Up members also protested before the FDA, demanding more medications
and shorter trial periods. They appeared on television to hold a public
debate with officials of this State agency.
Recently, the gTt criticized Spains Decree Law 14/2012 for constituting
an obstacle preventing immigrants with an undefined administrative status
from accessing the countrys public health system.
In this connection, they have called on all people who may be in
possession of HIV medications they no longer need and could still prove
useful to others to contribute whatever way they can, so that immigrants
will not be forced to interrupt their treatment.
Many initiatives can be undertaken to bring pressure to bear on the
pharmaceutical industry, contribute to the battle against AIDS and help
less developed countries secure the sanitary aid they require.
Original Source / Fuente Original:
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