Thai girl has HIV and will die in 2 weeks. There are drugs that could help her. But the multi-billion firm making them has put their price beyond reach. Daily Mirror, 21 February 2001

[we lifted this article from the Daily Mirror Site in Feb 2001, they don't display them for long]

A tiny girl called Inky lies motionless on a simple mattress in the sweltering heat, blankly staring into space. Father Joe Mayer points at his small charge and says: “She’ll be dead in two weeks. And she won’t die in her sleep. These kids die hard.”

Here at the Mercy Centre, an Aids hospice in a Bangkok slum, other children lie on their beds, their breathing ragged and their clothes damp with sweat. Most will live long enough to see four or five of their classmates die. Scooping some of the HIV-positive youngsters into his arms, Father Joe makes a plea for their lives. “I challenge the pharmaceutical companies in the West to look at these children and say they have not profited enough from Aids medicines,” he says.

In London, thousands of miles from Father Joe’s hand-to-mouth mercy mission, the world’s biggest pharmaceutical company, GlaxoSmithKline, is making a killing. Due to unveil record profits today, Glaxo Wellcome and Smith Kline Beecham - which merged in December to become GSK - made an estimated profit of ¬£5.5 billion last year.

More than 10 per cent came from the sale of anti-retrovirals (ARVs), drugs that could prolong the lives of Thailand’s 900,000 HIV and Aids sufferers - if only they could afford them. Every minute - the time it takes for GSK to make ¬£10,000 - 21 people die of treatable diseases in the developing world.

The British charity Oxfam last night accused the global pharmaceutical industry of conducting “an undeclared drugs war against the world’s poorest people”.

New research by the charity reveals that exclusive marketing rights created by patents are driving up prices of drugs which treat major Third World killers - HIV and Aids, respiratory-tract infections and childhood diarrhoea. GSK’s newest anti-retroviral, Combivir, has made a billion dollars for Glaxo. But thanks to a monopoly backed by the World Trade Organisation, it is priced out of the reach of the developing world. In the past, these countries were able to make some drugs themselves at a fraction of the price, but recent legislation backed by the WTO means new drugs cannot be copied for 20 years.

“This is the shadowy side of globalisation,” says Oxfam policy director, Justin Forsyth, launching a new campaign, Cut The Cost. “The drugs industry is using the legislation to cripple cheap, local competition. It is obscene for GSK to make such huge profits when they and other drugs companies are doing so little to help poor people get access to cheap medicines. The industry must take responsibility for its role in saving millions of lives in the developing world, and start putting people before profits.”

Thai Aids campaigner Want Paomang, 30, is in the late stages of the disease. He says: “No one is asking the drugs companies to act like charities. But do they really need to make so much profit from the poor and the sick? Must we wait 20 years for new drugs so they can make more money? It’s as if these drugs are hanging in the sky up above us but we can’t reach out to touch them. We know they are there, but we know we can never have them.”

Campaigners say the US is making an example of Thailand to other developing countries. Local pharmaceutical companies which try to copy Western drugs increasingly find they cannot source the raw materials. Thai government sources have told Oxfam’s Bangkok office they are afraid to argue with the drugs companies as they have the backing of the US Government - which has threatened trade sanctions.

Twenty years is too long to wait for 30-year-old Suk Jai, who caught HIV from her husband. She works in Bangkok during the week, earning 6,000 baht (¬£100) a month, and sends back 4,500 baht to support her two children and elderly mother, leaving 1,500 baht (¬£25) to support herself. Drugs to slow down the onset of Aids would cost between 5,000 and 10,000 baht a month. But the family’s meagre savings are long gone on medical treatment for her husband, who died four years ago. Jai is not “lucky” enough to be one of the 2,000 Thai Aids sufferers who are part of ongoing drug-testing programmes which often stop suddenly. “I would like to take ARVs,” she says, sitting with her two healthy children on the step of her makeshift house in Settakit village. “Because when I am not here, who will look after my kids?”

Her words find their echo at a Buddhist Aids hospice a few miles from Glaxo’s shiny skyscraper offices in Bangkok. This is a pauper’s dying place, where the destitute lie on dirty mattresses under a corrugated iron roof. Lek Khampew, 33, shares a bed with her dying husband and their baby Dodo, a year and 10 months old and miraculously born without the virus. In the next bed lies the body of a 42-year-old man, waiting to be taken for burial. As officials from the temple slowly wrap the dead man in cloth, Lek doles out pills to Anon, her husband of 11 years. She hands him paracetamol and Fluconazole, another billion-dollar drug from the West, which treats cryptococcal meningitis, a common illness in people with Aids.

Fluconazole was recently forced down in price from $15 a day to 30 cents by competition from a locally-produced competitor. But the $9.6million Glaxo spent lobbying the US Government last year means that its ARV Combivir, which would prolong Anon’s life, faces no such competition. “I would like to take them, of course, to stay longer with my wife,” he says. “But we are poor and these drugs are only for people in some other countries.”

GlaxoSmithKline is “disappointed” by the Oxfam campaign. “We regret the announcement offers little or no acknowledgement of GSK’s long-standing commitment to improving access to medicines in the developing world,” said a spokesman. “We are a major researcher into malaria, TB and HIV and we are part of a five-company initiative making products to treat HIV and Aids available at significantly reduced prices.”

He confirmed there were no plans to introduce this scheme to Thailand, however. He added: “The report does not appear to recognise the complexities involved in tackling the problem.” The companies say it takes $500million to bring a drug to market - and that in the case of Combivir, a combination of two drugs, that cost is doubled to $1billion. Oxfam points out that the drugs in Combivir already exist - Lamivudine (3TC) and Zidovudine (AZT). So the cost should be much less. In any case, the charity says drugs under development rarely benefit developing countries. Research is channelled into finding the new Viagra for the West - and not into the diseases that kill millions.

The UN says the total spent globally on researching the main diseases related to poverty in 1999 was around $500million, or the cost of bringing one drug to market. Oxfam adds: “Looking at these figures, it’s not hard to see that not many drugs for poverty-related illnesses are on their way to market.”

Prof Vanita Chitman, whose Pharmaceutical Producers Association represents the interests of the drugs companies in Bangkok, said it was the responsibility of governments and not drugs companies to care for the poor. She claimed that generic, locally-made drugs were often not as effective as the brand-name drugs and were a false economy. But that is disputed by Nobel-winning charity Medecins Sans Frontieres, which is happy to prescribe generics in Thailand where available, and local Aids charities.

Heather Grady, Oxfam’s regional director for East Asia, says: “When it comes to HIV and Aids, lives are just being sacrificed. The question is, how large does a profit have to be?” She also questions the apparent generosity of multinationals in offering “free drugs” to 2,000 people in Thailand as part of trials. “Drug companies evade a lot of requirements by trialling here,” she claims.

At the Mercy Centre, Swat Topang, 32, a friend from another bed, is helping Somkid Jaithong, a 31-year-old patient in the late stages of Aids, to drink water from a metal cup. He says: “The most important thing in here is friendship. I will look after him while I can - and when I am too sick to drink from a cup then someone will help me.”

Back in the children’s ward, some patients have just come from school, piled up with homework, laughing and talking. We ask a little girl called Bew, five, whether she thinks there are medicines which could help her. “Yes,” she says. “But I don’t want to take them. I wish I were dead.” We ask if she understands what death means. “My mother is waiting there,” she replies. Boat, a six-year-old with HIV, feels differently. He has watched his mother die in the Mercy Centre and he knows his father has not much time left. “I would like the medicines for my father,” Boat says. “I don’t feel ill myself yet - although sometimes my skin is very sore and my chest feels bad.”

The children queue to be dusted in powder for skin infections, watched by Father Joe, a priest from Seattle who has spent 30 years in Thailand. “I have one thing to say to the people who run the pharmaceuticals,” he says. “‘Dammit, you owe these kids.’”