Why curing baldness is more lucrative than saving African lives

The world's pharmaceutical companies would rather develop a drug against baldness than invest in a drug against the scourge of sleeping sickness, according to market research company IMS Health of Westport> Connecticut.

In a report released on the eve of President Thabo Mbeki's first official

visit to the United States, the company highlighted the lack of interest among major pharmaceutical manufacturers in producing drugs specifically for African diseases. With the controversy over AIDS already dogging the South African President's visit, the report sounded a warning over the looming disaster caused by the lack of drugs against malaria, tuberculosis and trypanosomias (sleeping sickness).

Western drug manufacturers counter accusations of insensitivity to Africa's requirements by pointing out that it's all a question of economics, citing low financial incentives producing drugs exclusively for the African market.

This cavalier attitude is under fire from African-American health activists at a time when the scourge of AIDS is a US presidential election issue. Even the World Trade Organization has joined in. Condemning the manufacturers, they call on world governments to exert pressure on pharmaceutical producers to turn their attention to Africa's desperate medical needs. President Clinton himself brought the subject up as a matter of urgency with western leaders in Lisbon as part of his European tour.

Sub-Saharan Africa accounts for I% of the world's drug sales, while North America, Japan and Western Europe account for over 80%. As such, the continent is facing a diminishing supply of drugs for treating malaria, tuberculosis, leishmaniasis and the various burrowing worms that kill or cripple millions of Africans yearly. Criticised that his company would rather find a cure for a bald American than a dying African, Francois Gros, a spokesman for the Franco-German Aventis pharmaceutical company, agrees.

"Unfortunately we have a financial commitment to our shareholders," he laments, confirming that his company is phasing out manufacture of three of the four drugs effective against sleeping sickness. "Therefore we have to focus on the $l.5bn blockbuster drugs for the cardiovascular, metabolic and anti-infection market in the more developed countries."

Dr James Orbinski, president of Doctors Without Borders/Medecins Sans Frontieres the world agency that won the Nobel Peace Prize for its humanitarian work in third world war zones - is angered by this heartless attitude.

"The poor countries have no consumer power, so the market has failed them," he complains, adding that he is tired of the logic that says, "He who can't pay, dies."

Tsetse fly menace reemerging

Sleeping sickness is a disease particular to Africa, spread through the bite of the tsetse fly, the scissors-winged fly species found from Senegal to Somalia to South Africa. The tsetse fly is re-emerging as sprayer eradication programmes are curtailed by governments struggling with negative economic growth. When injected with the protozoan carried in the fly's saliva, the parasites enter the patient's brain, causing hallucination, lethergy and totally irrational behaviour. Affected patients have been known to attack family members and pillage other villagers' plots to feed ravenous appetites before finally lapsing into lassitude and coma before death.

Treatment against the disease is through the use of Melarsoprol, a drug consisting of melarsen oxide dissolved in propylene glycol, literally arsenic in antifreeze. The only truly effective medicine against the debilitating disease, its manufacturer ceased production in July with one last batch, enough for 1,000 patients, hardly sufficient for the 300,000 newly infected patients yearly.

SA versus drug giants

Recent reports in the United States indicate that an economic confrontation between the South African government and the pharmaceutical lobby supporting Vice-President Gore in his presidential bid is gathering momentum. Triggered by amendments to South Africa's Medicine Act which authorised the government to import or manufacture inexpensive generic drugs, the Pharmaceutical Research Manufacturers of America (PhRMA) denounced the move as threatening its $3436n global industry.

Frank Chikane, director general of Mbeki's office at the time waded in. "You sell medicines to us here, the same product, labelled by the same company, but it's two times more expensive here than in neighbouring Botswana," said, "Why should we not go in and pluck up the cheapest medicines we can?"

In a May 2000, in an effort to defuse the issue prior to President Mbeki's first visit to America, President Clinton signed an executive order broadening and formalizing the Trade Act agreement with South Africa. By including the clause "the US withdraws objections to the Medicine Act in any country in sub-Saharan Africa that attempts to regulate AIDS drugs as long as it meets the minimum requirements of the World Trade Organisation" the executive order formalises a settlement deal in which South Africa "reaffirms" its commitment to international patent laws.