Doubts About "Tiered Pricing" Of AIDS Drugs In Africa
July 21, 2000
A plan to have Western pharmaceutical companies offer drugs to combat AIDS at lower prices in Africa could have unintended and disastrous consequences, according to some medical experts. Without adequate health care networks to monitor their distribution, potent new medicines are dangerous, they warn.
Consider what happened when unsupervised patients were exposed to a torrent of anti-tuberculosis drugs in the former Soviet Union.
- In some hospitals, as many as 50 percent of patients strayed from the prescribed regimen.
- Soon upwards of 5 percent of patients in some Russian clinics began to exhibit a strain of tuberculosis completely resistant to all drugs.
- Subsequently, millions of dollars had to be spent to contain the deadly new strain.
HIV also mutates rapidly, quickly becoming resistant to drugs. If anti-HIV drugs are not taken properly, an event similar to the Russian tuberculosis experience could be repeated with HIV.
Even in the U.S., about 10 percent of patients already harbor HIV strains resistant to AZT, the most common anti-HIV drug. If such potent drugs are dumped unsupervised in Africa -- where health-care networks cannot afford to be as vigilant as those in the U.S. -- a virulent, drug-resistant strain of HIV may emerge very quickly and could even boomerang back to the U.S., experts warn.
Source: Siddhartha Mukherjee (Harvard Medical School), "Take Your Medicine," New Republic, July 24, 2000.
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