TCS Daily

This is Your WHO on Drugs

By Nick Schulz - November 10, 2004 12:00 AM

Where's the Congressional Black Caucus when you really need it?

The self-described "conscience of Congress" has always taken an interest in issues related to Africa. Well, this week a continuing scandal should get its attention. On the heels of its oil for food debacle, the United Nations is now responsible for more malfeasance. This time, the victims are poor Africans. And American taxpayers are, unwittingly and indirectly, contributing to the problem.

So what has happened? This week an Indian drug maker that specializes in manufacturing knock-off medicines announced it was withdrawing all of its AIDS drugs that have been recommended for use by the World Health Organization (WHO), a UN body. The WHO is the key global health body overseeing efforts to halt the spread of HIV/AIDS in the developing world, particularly in Africa. The company, Ranbaxy of New Dehli, said in a statement that they "found discrepancies in the documentation relating to proof of the products' bioequivalence with originator medicines." In other words, Africans and other poor HIV victims around the globe are taking drugs of unknown efficacy - it looks like they're getting bad drugs.

This withdrawal comes after the removal earlier this year by WHO of other antiretroviral medicines from their list of approved medicines manufactured by Ranbaxy as well as AIDS drugs made by Cipla, another giant Indian drug company specializing in knock offs.

Global health experts have for several months expressed concerns over these drugs, including at the recent world-wide HIV/AIDS conference in Bangkok, Thailand in July. Their concerns were that, in the WHO's zeal to ramp up treatment, HIV victims in impoverished communities were getting drugs that had not been properly tested. Abner Mason of the California-based AIDS Responsibility Project, a health advocacy group, argued in Bangkok that "poor people in the developing world must not be treated with false hope and false medicine but with drugs as safe and effective as those in the developed world."

Despite these common sense concerns -- that AIDS victims in Africa should get the same quality drugs as AIDS victims in New York or London -- several prominent U.S. politicians such as Rep. Henry Waxman (D-Calif.), the powerful ranking minority member of the Committee on Government Reform, pressed the US government to support the use of these knock off medicines. The Bush administration has, sensibly, resisted providing funds for drugs of unknown efficacy; at the same time the administration has provided a generous $15 billion to combat HIV and other illnesses devastating poverty-stricken areas. That money can go to getting proven medicines that work and building the necessary health care infrastructure to deliver them.

Most troubling about the WHO's ham-handedness in handling the global AIDS problem is that the risks involved are not just limited to the current HIV victims taking the questionable medicines. Sub-standard treatment efforts can exacerbate a virus like HIV, encouraging its mutation and making it much harder - and much more expensive - to treat in the future. Antiretrovirals are marvelous, wonderful drugs. But they are complicated medical technologies to develop and administer. And while everyone agrees that as many people should be treated as quickly as possible, the rush to get treatment up in poverty-stricken areas can make a bad situation -- desperate as it already is -- far more difficult and costly to control.

And it's not just HIV/AIDS that WHO is bungling. Earlier this year the agency received a stinging rebuke in the journal The Lancet for botching its "Roll Back Malaria" campaign and giving ineffective medicines to malaria victims.

Given the CBC's interest in policy issues that affect Africa, here's one that should be right up its alley. American taxpayers provide over 20% of the WHO's annual budget. Representatives of those taxpayers, including Black Caucus members, might want to make the WHO know that the American people don't support efforts that leave Africans being treated as second class citizens in the fight against HIV/AIDS.


TCS Daily Archives