1. Pharmaceutical Companies Should do a Better Job Providing AIDS Treatment A Presentation by: Greg Sorrells Julieth Monroy Julieth Monroy and Rachel Kohn and Rachel Kohn

2. What is AIDS/HIV? Acquired Immune Deficiency Syndrome or AIDS, is a virus that attacks the body’s immune system. Acquired Immune Deficiency Syndrome or AIDS, is a virus that attacks the body’s immune system. HIV infects the cells of living organisms and replicates itself within those cells. It attacks the special immune system cell known as CD4 lymphocyte. It uses trickery such as rapid mutations to take over the body’s defenses. HIV infects the cells of living organisms and replicates itself within those cells. It attacks the special immune system cell known as CD4 lymphocyte. It uses trickery such as rapid mutations to take over the body’s defenses. It can be transmitted in three ways: It can be transmitted in three ways: – Sexually – Through blood – Mother to child

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4. Generic vs. Patented Drugs Patented drugs are those that companies such as Merck produce that cannot be reproduced and sold at a lower price. These drugs are legally protected and therefore enable a company with such a drug the ability to monopolize the market. Patented drugs are those that companies such as Merck produce that cannot be reproduced and sold at a lower price. These drugs are legally protected and therefore enable a company with such a drug the ability to monopolize the market. Generic drugs are reproductions of patented drugs that are sold to the people of poorer nations for more affordable prices. Generic drugs are reproductions of patented drugs that are sold to the people of poorer nations for more affordable prices.

5. Generic vs. Patented Drugs contd. Because patents create monopolies, manufacturers can charge high prices. When those monopolies are broken, prices fall. When manufacturers in developing countries began producing generic versions of patented antiretroviral drugs, the annual price of individual AIDS treatment fell from $10,000 to just over $200 in countries where generic versions were available. Because patents create monopolies, manufacturers can charge high prices. When those monopolies are broken, prices fall. When manufacturers in developing countries began producing generic versions of patented antiretroviral drugs, the annual price of individual AIDS treatment fell from $10,000 to just over $200 in countries where generic versions were available. Governments can override patents by issuing compulsory licenses, which grant the right of manufacture to another company on payment of a royalty to the patent holder. But licenses must be predominantly for domestic use. A poor country without the capacity to manufacture drugs cannot issue a compulsory license to a manufacturer in another country and therefore must pay the monopoly price on the patented drug. Governments can override patents by issuing compulsory licenses, which grant the right of manufacture to another company on payment of a royalty to the patent holder. But licenses must be predominantly for domestic use. A poor country without the capacity to manufacture drugs cannot issue a compulsory license to a manufacturer in another country and therefore must pay the monopoly price on the patented drug.

6. Technology: Treatment The main type of treatment for HIV or AIDS does not cure, but can hinder illness for many years. It consists of drugs that must be taken daily for the rest of one’s life; one of the main problems for economically underdeveloped countries. This treatment also slows down replication of HIV in the body. The main type of treatment for HIV or AIDS does not cure, but can hinder illness for many years. It consists of drugs that must be taken daily for the rest of one’s life; one of the main problems for economically underdeveloped countries. This treatment also slows down replication of HIV in the body.

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9. Statistics People living with HIV/AIDS in 2006 People living with HIV/AIDS in 2006 – 39.5 million People newly infected with HIV in 2006 People newly infected with HIV in 2006 – 4.3 million AIDS deaths in 2006 AIDS deaths in 2006 – 2.9 million Sub-Saharan Africa has the largest concentration of people living with AIDS at 24.7 million. Sub-Saharan Africa has the largest concentration of people living with AIDS at 24.7 million. – The next highest is South and South East Asia at 7.8 million. – The lowest is Oceania at 81,000.

10. Ethics/MASA Everybody’s got to make a buck, but is it really all right to put profits before lives? Everybody’s got to make a buck, but is it really all right to put profits before lives? Some countries, such as Botswana, are making an effort to better care for their citizens by creating treatment programs such as MASA. Some countries, such as Botswana, are making an effort to better care for their citizens by creating treatment programs such as MASA. MASA was created in 2002 to provide free AIDS medication to the people of Botswana, Africa. The aim was to provide medication during the coming year to 19,000 of the 110,000 infected people whom it was considered could benefit. As a result of poor resources - laboratory capacity, staff and infrastructure - it was decided to initially target four population groups: pregnant women with AIDS, HIV- positive child in-patients, HIV-positive people with TB, and adult in-patients with AIDS. MASA was created in 2002 to provide free AIDS medication to the people of Botswana, Africa. The aim was to provide medication during the coming year to 19,000 of the 110,000 infected people whom it was considered could benefit. As a result of poor resources - laboratory capacity, staff and infrastructure - it was decided to initially target four population groups: pregnant women with AIDS, HIV- positive child in-patients, HIV-positive people with TB, and adult in-patients with AIDS.

11. Ethics/MASA, contd. It was estimated that it would cost $24.5 million to include 19,000 people in 2002 (around $1,300 per patient), and then an additional 20,000 people would be admitted each year. It was estimated that it would cost $24.5 million to include 19,000 people in 2002 (around $1,300 per patient), and then an additional 20,000 people would be admitted each year. Botswana's national treatment program is now seen as a successful model for other African countries to follow. Though progress was initially slower than expected, the program made rapid progress in 2004 and 2005, and patient responses have been comparable to those seen in Europe and the USA. Botswana's national treatment program is now seen as a successful model for other African countries to follow. Though progress was initially slower than expected, the program made rapid progress in 2004 and 2005, and patient responses have been comparable to those seen in Europe and the USA. MASA has demonstrated that antiretroviral treatment can be provided on a national scale through the public health system of a sub-Saharan African country - not just through localized projects run by foreign aid workers or researchers. In Botswana's case, almost all of the actual cost of treatment has been paid by the Government, while other partners have given support by providing laboratory equipment, staff training or patient monitoring services. MASA has demonstrated that antiretroviral treatment can be provided on a national scale through the public health system of a sub-Saharan African country - not just through localized projects run by foreign aid workers or researchers. In Botswana's case, almost all of the actual cost of treatment has been paid by the Government, while other partners have given support by providing laboratory equipment, staff training or patient monitoring services.

12. Pro’s and Con’s Pro’s Pro’s – Keeps the wallets of drug company CEO’s fatter. – Ensures the proper R&D is being done for each drug. – Ensures the consumer that the drug is safe. Con’s Con’s – Keeps treatment costs high for people in poorer nations. – Doesn’t allow for multiple companies to produce drugs that fight the same cause. – Hinders the opportunity for the advancement of medicine dedicated to fighting this disease.

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14. The AIDS Stigma in Africa The previous clip demonstrates the stigma that AIDS has in Africa. The previous clip demonstrates the stigma that AIDS has in Africa. – Many people refuse even free treatment because of the stigma attached to the AIDS virus. – They believe that people will look down upon them if they admit their problem. – Some Africans simply don’t want to be dealt the bad news so they deny testing. It also reinforces the severity of the situation there by informing the viewer that most people in Africa will consider a person in their mid 40’s to be old rather than what most people in the world today recognize as being old. It also reinforces the severity of the situation there by informing the viewer that most people in Africa will consider a person in their mid 40’s to be old rather than what most people in the world today recognize as being old.

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16. Join(RED).com (RED) was created by Bono and Bobby Shriver, Chairman of DATA to raise awareness and money for The Global Fund by teaming up with the world's most iconic brands to produce (PRODUCT)RED branded products. A percentage of each (PRODUCT)RED product sold is given to The Global Fund. The money helps women and children affected by HIV/AIDS in Africa. (RED) was created by Bono and Bobby Shriver, Chairman of DATA to raise awareness and money for The Global Fund by teaming up with the world's most iconic brands to produce (PRODUCT)RED branded products. A percentage of each (PRODUCT)RED product sold is given to The Global Fund. The money helps women and children affected by HIV/AIDS in Africa. joinred.com joinred.com joinred.com

17. Conclusion We believe pharmaceutical companies have done a great job thus far, but it is not enough. They have to recognize that they can do more. If there are medications available and someone, just one person isn’t able to access them, then we are not doing enough. We cannot look at this from the perspective of percentages or statistics we have to look at it from the perspective of a mother who loses her child to AIDS or a baby who will not have a mother or a father to care for them and love them due to AIDS. Over 25 million people have already died from AIDS all over the world. How many more have to die for us to stop it? We believe pharmaceutical companies have done a great job thus far, but it is not enough. They have to recognize that they can do more. If there are medications available and someone, just one person isn’t able to access them, then we are not doing enough. We cannot look at this from the perspective of percentages or statistics we have to look at it from the perspective of a mother who loses her child to AIDS or a baby who will not have a mother or a father to care for them and love them due to AIDS. Over 25 million people have already died from AIDS all over the world. How many more have to die for us to stop it?

18. Links Generic vs. Patented Generic vs. Patented Generic vs. Patented Generic vs. Patented Merck/Bill and Melinda Gates Foundation Merck/Bill and Melinda Gates Foundation Merck/Bill and Melinda Gates Foundation Merck/Bill and Melinda Gates Foundation Avert Avert Avert (RED) (RED) (RED)