of the world's leading HIV/AIDS authorities says an African drugs agency may be
created within a year. UNAIDS executive director Michel Sidibe says the
organization will manufacture, regulate, store and distribute cheaper
medicines. Most of the 33 million people infected with HIV worldwide live in sub-Saharan
Africa. Many die because they don't have access to life-prolonging
anti-retroviral treatment. But Sidibe has vowed to change this.
"This agency is vital," says
the UNAIDS chief, who's originally from Mali and acknowledges a "special
interest" in the welfare of Africans, 22 million of whom are HIV-positive. More
than three million of the world's four million people on HIV treatment live in
Africa, with another six million Africans urgently needing urgent but not yet
Most of the Africans
receiving medication are on first-line treatment. This is the most effective
and affordable combination drug course available. But scientists say it's
normal for people to develop resistance to these medicines after using them for
a prolonged period.
"[In] time, we could have
rate of deaths (in Africa) increasing because the drugs aren't working. And we
have to move to (get those people on) second and third-line treatment. That is
very costly. It's unsustainable," Sidibe says.
It costs about $90 a year
to keep someone on first-line HIV medication. But Sidibe says this amount rises
to US$ 1,000 a year when more effective second-line treatment is required.
That's why he emphasizes the "urgent" need for an agency to make cheaper drugs
Agency to 'resolve a series of problems'
Sidibe has spent a lot of
time in South Africa, where almost six million people are HIV-infected and
1,500 new infections occur every day. Seven hundred thousand South Africans are
receiving HIV treatment. The country's president, Jacob Zuma, has pledged to
boost this to 1-point-4 million people within the next two years.
But Sidibe asks, "How will we
sustain that, if 50 percent of those people become resistant (to the drugs)? I
am saying it's time for Africa to have a
single authority to deal with pharmaceutical issues. It will help us to resolve
a series of problems."
One of the problems the
agency will eliminate, says Sidibe, is the growing influx of poor quality,
ineffective HIV medication into Africa.
"When you have those
sub-standard drugs coming in, it's coming into competition with proper drugs,
so there's no incentive to produce (HIV medicine) in our continent. And it's
timely now to really think about a continental vision which can help us to
produce those (safe) drugs."
Sidibe says he aims to
continually appeal for African "vision," especially among the continent's
political leaders. "We need to not forget that our people will be on treatment
for years to come…. We have 300,000 babies born every year with HIV. So those
babies will be there for us (to treat) for years to come. If we don't have a
mechanism to produce low-cost treatment for those people, it will be a
tragedy," he says.
Sidibe's also hopeful that an
African drug agency will "integrate, progressively, Africa
into the global market. And it will…create an environment which is attractive
for a foreigner to invest in the production of drugs in this continent."
One of the agency's aims, he says, will be to
"unite" Africa in efforts to bolster the
continent's response to HIV/AIDS.
"This single authority can bring people from Lesotho
to Mali to Burkina Faso to work together, trying to begin a restructure, but
also helping us to put in place those sub-regional observatories of the price
(of HIV drugs), so we don't have someone from Swaziland paying more than
someone in Burkina Faso or Benin. I think those are the strategic changes which
could bring some kind of hope in this continent."
'Move fast…. Many lives in danger'
Sidibe recently met with
African Union (AU) and New Partnership for African Development (NEPAD) leaders,
Ethiopian prime minister Meles Zenawi, South African deputy president Kgalema
Motlanthe and the nation's health minister, Aaron Motsoaledi.
"They're all keen to see how
this continental vision (for an African drug agency) can be reality. Now it's
important to move from the concept to…a business plan which can help the
leaders and also the NEPAD to integrate that in their strategy to move
forward," Sidibe says, before urging African authorities to "move fast,"
because many lives are at risk.
"If tomorrow we have 50
percent of our people (drug) resistant, it will be terrible – not just for this
continent, but for (the) world. The movement of people (is) going on. Migration
is real," he says.
Sidibe expects funds for the new agency to come from
international donors, and also from "some" African countries. He's hopeful that
despite a global financial crisis, leaders will do "whatever they can" to make
the organization a reality "because their people are dying."
Sidibe agrees that skeptics will have concerns about
the proper, efficient management of such an agency in Africa.
"It's true that Africa
needs to reform itself. It's true that we need to take a decision which could
make (this agency) more accountable to our people, that transparency is needed,
that we need to foster public accountability," he says.
Sidibe, though, is adamant that these concerns
"should not stop us moving" and he's called for a "mindset shift" regarding
health among African political leaders.
"Health is considered (by them) as a cost. (But) for
me, (investment in) health is producing money. It's producing resources. It
should not be seen by our leaders as just expenditure. It is an investment."
Sidibe maintains that Africa has the scientific and
business knowledge, both on the continent and in the Diaspora, required to
competently staff the agency. "I'm seeing a huge (number) of young African
scientists outside of this continent," he says. "And they are coming from the
best schools of the world. Maybe such a single authority could attract them to
come back to Africa, to contribute to the
transformation of this continent."
to also fight TB
Asked when he expected the agency to be set up,
Sidibe responded, "I think it's a political decision. What AIDS has taught us
is that politics matters. Let us not be lying to each other about this. If we
are really serious about it, we must have the opportunity to work on it with
developed countries. You have a single authority in Europe; you have one in the
So we can learn from those, and transfer the competencies and technologies
quickly to do it in Africa. So for me, within
one year it can be done."
Sidibe says "global walls" pertaining to
international health crises "must fall."
"We cannot close the door anymore. We have (the) H1
N1 (swine flu virus) going everywhere. Suppose tomorrow we have an explosion of
this virus in Africa. What will happen? It
will be very serious. (Africa has) no research base, no real technology, no
capacity tomorrow to produce (a) vaccine," he says.
Sidibe's clear that an Africa-wide drugs agency
"shouldn't be seen as only about AIDS. AIDS should be the entry point. It's
time to take AIDS out of isolation. AIDS should be a force to transform. We
have civil society; we have movement that has been created around AIDS which
helps us to mobilize 14 billion dollars a year. We should leverage those
resources to produce a broader health and development outcome."
He says 500,000 people, most living in southern
Africa, are dying every year from HIV and tuberculosis (TB) co-infection.
"We should stop that. And we can, by producing the
drugs to fight TB. This would be a good start for this new agency," Sidibe