In Defense of Al Gore-Just This Once
IN DEFENSE OF AI GORE —JUST THIS ONCE Tthirty-three million human beings across the globe already show the symptoms of AIDS or are infected with the HIV virus. Two thirds of them live in...
...The provision of modern AIDS medications to South Africa is "one of those rare issues—such as child abuse and drunk driving—on which there cannot possibly be two sides" of equal virtue...
...These diseases are more easily diagnosed and treated than AIDS...
...Until this spring...
...Subsequent, objective news analyses of the underlying controversy have been sketchy at best...
...And while all men of good will agree that something must be done, the horrible truth remains that it's difficult responsibly to assert that we know just what that something is...
...And, surprisingly, both have wholeheartedly endorsed the basic activist complaint against Gore...
...But two well-known opinion journalists—John B. Judis, on the left, and Arianna Huffington, on the right—both claim to have investigated the question...
...You must take some before meals, some after...
...In the current fracas, it seems to us, Vice President Gore is attempting to keep all reasonable considerations in balance...
...The suggestion that the vice president has passively condemned impoverished South Africans to hideous death by contagion—in exchange for corporate-backed campaign donations—is not even remotely fair...
...In an essay in the current American Prospect, Jud-is dubs the vice president "K Street Gore," and attributes his "weak and morally repugnant" hesitancy about generic AIDS drugs in South Africa to an "interlocking directorate" of Gore advisers with ties to the U.S...
...All of which—the bilateral intellectual property dispute, narrowly, and the cataclysm of HIV in Africa, more broadly—has failed to win high-profile attention in America...
...And these losses, the companies point out, pose a more than financial risk...
...On the first score, the answer is no...
...On "issues that impinge upon his high-tech network of supporters," Judis concludes, Gore has here proved "willing to do the wrong thing to keep them hap-py—and keep them in his corner" with financial contributions...
...Some medications must be refrigerated, some not...
...We are pleased to say—and we may never say anything like this again—Al Gore is doing the right and honorable thing...
...AIDS is more dramatic, however, and so organized efforts to deal with such "minor" infections go starving for international funding, even where the purchase of relatively simple, non-patent antibiotics is concerned...
...This is a far from stupid argument, and it seems to have fully persuaded certain major players in the Clinton administration...
...If you then infect some other poor soul, his virus may prove resistant—from the onset—to most or all known anti-retrovirus compounds...
...Two thirds of them live in sub-Saharan Africa—more than 25 times the number of cases accounted for by Canada, Mexico, and the United States combined...
...On future AIDS therapies, for example...
...Calm, continued negotiations, the vice president thought, were a better idea...
...Depart from the prescribed regimen even a bit, even for a single day, and a new strain of HIV may quickly spread throughout your body...
...Arianna Huffington offers the exact same judgment, though still more sharply...
...And that the only remaining question is precisely how to do it...
...But it turns out, on close inspection, that the vice president isn't exactly one of them...
...Pharmacologic Al," she writes in her nationally syndicated column, has allowed "powerful special interests to secretly dictate policy—even when the life or death of millions is at stake...
...But we would not...
...And the situation is particularly acute in the emerging democracy of South Africa, where the population-wide incidence of HIV is approaching 10 percent, including 35 percent of all pregnant women and nearly half of all active-duty military personnel...
...In Africa the infection continues to spread, virtually unchecked...
...Here, too, alas, the answer must be no...
...Infectious diseases are killing Africans...
...This is not a theoretical problem...
...South of the Sahara, 4 million new HIV/AIDS diagnoses are made each year, more than 90 times the North American figure...
...It sometimes costs hundreds of millions of dollars to discover, test, and start distributing a desperately needed new medicine...
...In April, the "Consumer Project on Technology," one of the many tentacles of the Ralph Nader octopus, began publicizing a State Department report that "revealed" the participation of Vice President Gore in diplomatic negotiations with South Africa over the Medicines Act amendments...
...for benefit of the network television cameras...
...Gore's staff—which will patiently explain all the trade-law technicalities to anyone who bothers to call—is appropriately cognizant of the value of American pharmaceutical patent rights, and remains intent to ensure that South Africa not totally ignore its treaty obligations to observe those rights...
...Could it be that from this recent media eruption—despite the cruel slanders to which it has subjected the vice president—a previously unrecognized political consensus has emerged that the widespread introduction of anti-retroviral medications is the obvious solution to the African AIDS epidemic...
...It is groundless and grotesque...
...Al Gore, in short, stands falsely accused of obstinately resisting a public health initiative he doesn't necessarily resist at all...
...But for just as long, concerned that the amendments as drafted might expropriate the patent rights of U.S...
...U.S...
...In other words, according to this commentariat odd couple, Al Gore, by preventing South Africa from obtaining the drugs immediately, really is killing Africans...
...David Tell, for the Editors...
...Earlier this year, during intera-gency meetings, he successfully opposed an industry-backed plan to target South Africa with trade reprisals...
...No American is "killing Africans...
...But Gore has otherwise declined to do the pharmaceutical industry's "bidding," as the cartoon criticism of him would have it...
...Someone might say that...
...Which raises two questions...
...And the doubters' warnings cannot be blandly dismissed...
...Because for every prominent physician who favors the distribution of advanced AIDS drugs in Africa, there is another prominent physician who views the idea with something close to horror...
...And two weeks ago, in a letter to the Congressional Black Caucus, Gore explicitly confirmed his willingness, given the health crisis in Sub-Saharan Africa, to consider any well-designed effort "to speed the availability of lower-cost pharmaceuticals in South Africa," including generics...
...And in short order, AIDS activists began disrupting Gore's public appearances, chanting "Gore is Killing Africans...
...He wants to foreclose no potentially effective response to the infectious-diseases crisis in Africa...
...Happy ending, then...
...You must take your pills on a strict schedule...
...By largely ignoring this separate crisis, and insisting instead on a questionable HIV-specific intervention, are the vice president's critics themselves "killing Africans...
...He wants his country to sustain in principle the international patent-protection regime...
...As things currently stand, the vast majority of these people, millions of them, seem doomed to die...
...And in Sub-Saharan Africa, including South Africa, where public health systems competent safely to deliver, administer, and supervise such an inherently risky medical intervention are sadly nonexistent, the standard American AIDS cocktail might thus wind up saving no one, and make the epidemic even less manageable...
...And he declines to endorse the dangerous fantasy that a perfect response has already been identified...
...Throughout the whole of Africa, non-AIDS infectious diseases—pneumonia in infants and children, malaria and tuberculosis in adults—also take huge numbers of lives each year...
...The modern, multi-drug anti-AIDS "cocktail" now so common in the industrialized world is a fiendishly tricky therapy...
...pharmaceutical industry lobby...
...If originating American laboratories are no longer permitted to recover these mammoth investments with profits protected by patents that are respected internationally, then they may well dramatically scale back their research and development efforts...
...It is happening already in the United States...
...pharmaceutical companies stand to lose a fortune on their patented medications if foreign governments start unilaterally authorizing the manufacture or importation (from "gray market" countries like India) of cheap knock-offs—as South Africa has announced it intends to do in this case...
...And, two: Fair or not, does the spectacular bloody-hands charge against Gore at least represent welcome public awareness of a long-underappreciated international humanitarian emergency...
...pharmaceutical companies, the Clinton administration has sought modification or outright repeal of the South African legislation...
...One: Is such a remarkable savaging of the vice president fair...
...So for almost two years now, the government of South Africa has been attempting to implement amendments to its Medicines Act that would make possible the procurement and distribution, in low-cost, generic form, of otherwise prohibitively expensive but potentially life-preserving anti-retrovirus therapies developed in the United States...
...South Africa must have the drugs...
Vol. 4 • July 1999 • No. 41
