China
Now Set to Make Copies of AIDS Drugs
By
ELISABETH ROSENTHAL
 EIJING,
Sept. 6 — China took significant steps today to face up to its
growing H.I.V.-AIDS epidemic, raising its estimate of the number
infected to one million and saying it would manufacture a full
complement of AIDS drugs if Western patent holders did not lower
prices within the next few months.
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It was a striking reversal by Chinese health officials, who
previously insisted that as a new member of the World Trade
Organization, China had to be especially vigilant about respecting
patents and would not permit the use of generic AIDS drugs.
But even as the government was articulating its new sense of
urgency and commitment to action, the wife of one of the country's
most outspoken advocate for AIDS patients, Dr. Wan Yanhai, who
disappeared in Beijing two weeks ago, said State Security Bureau
officials had acknowledged that he was in custody.
In their announcements today, health officials for the first time
publicly asked for international help with the country's AIDS
problem, which they had insisted they could handle on their own.
"We need international organizations to help us in this battle to
control AIDS," said Qi Xiaoqiu, director general of the Department
of Disease Control at China's Health Ministry. "We need more capital
support and expertise."
It is unclear exactly why the government decided to take the
plunge and talk more candidly, but China is in the process of
submitting a $90 million grant application to the Global Fund for
AIDS, Tuberculosis and Malaria, so it desperately needs to show some
good-faith efforts on AIDS to help its application. That money is in
part earmarked for dealing with AIDS in rural China, including
"cocktail" therapy for AIDS sufferers, said someone who has seen an
early draft of the proposal.
China's first application to the fund, seeking money for AIDS
prevention and treatment among drug addicts, was rejected earlier
this year partly because of the government's closed attitude about
the problem, leading to unreliable statistics and other
shortcomings.
Mr. Qi said that "drugs and other medicine are especially needed
in places where there is a large concentration" of AIDS patients. He
was referring to poor villages in Henan Province in central China,
where many farmers contracted H.I.V., the virus that causes AIDS,
through unsanitary practices by blood-buying operations.
Last week, China licensed its first domestically produced
anti-AIDS medication, a version of the drug AZT. Mr. Qi said a
shipment had already gone off to Henan, where it was being used by
patients, although he did not say how many had access to the drug.
To advocates for AIDS patients here, poor access to medicines has
been particularly galling, since China has a strong pharmaceutical
manufacturing industry — one that is known, in fact, for its
expertise in Western medicine.
One company in Shanghai, Desano, already legally makes the raw
ingredients for many of the pills in the so-called AIDS cocktail,
which it ships overseas to be transformed into generic pills. Aside
from AZT, generic AIDS drugs are not available in China.
Dr. Wan, the AIDS activist who has been detained by security
officials, posted a classified document prepared by the Henan Health
Bureau on the Internet in late August, showing that officials there
were well aware of a serious H.I.V. problem as early at 1995.
Selling blood was officially banned in that year, although the
practice continued for several years in a number of villages, people
from Henan say.
Dr. Wan, who was followed and harassed by security officials all
summer, disappeared from a Beijing street on Aug. 24. He founded the
AIDS Action Project, a small organization that ran a Web site and
conducted AIDS advocacy work in China and was to receive a
prestigious Canadian human rights award this month. On Thursday,
officials of the State Security Bureau indicated to one of his
colleagues that he was being held for disclosing the secret report,
his wife reported.
"Finally someone admits that Wan is in their hand," his wife, Su
Zhaosheng, who is studying in Los Angeles, wrote in an e-mail
message.
The main focus of today's news conference was on the AIDS crisis
among farmers in central China and on the need to provide patients
with affordable drugs, two hard-to-solve problems that health
officials had previously largely avoided addressing.
At the news conference, Mr. Qi emphasized that China was taking
the epidemic seriously, calling the situation "very dangerous." He
said the Communist Party's Central Committee had commissioned a
special study of the epidemic, the first time it has lavished that
kind of attention on a disease.
He added that the government had already earmarked 80 million
yuan, about $10 million, to be directed toward Henan to combat AIDS.
But perhaps the biggest breakthrough was Mr. Qi's indication that
China would consider bypassing patents to produce its own cheaper
versions of AIDS drugs if the major Western pharmaceutical
manufacturers did not reduce prices by the end of the year.
Until now China vehemently rejected that route, trying instead to
get cheaper drugs by negotiating discounts from foreign
manufacturers.
China maintained that position even as many other developing
countries — including Thailand, India and Brazil — have started to
produce or buy generic versions of the drugs. That has made
effective treatment affordable for patients in those countries and
has lengthened countless lives.
Earlier this year, the World Trade Organization basically granted
countries the right to bypass drug patents if the medicines were
declared essential to combating a national health emergency and were
otherwise unaffordable.
To date, China's negotiations with drug companies have yielded
only piecemeal results, bringing the price of the cocktail of
expensive Western medicines used to treat AIDS from an exorbitant
$8,000 a year in China to a merely unaffordable $3,000 to $4,000 —
not including the testing that taking such drugs involves. The same
medicines, in generic form, cost about $300 in Thailand.
As a result, Mr. Qi acknowledged, only about 100 patients in
China are now on the AIDS cocktail, and most of those patients'
drugs have been donated by foreign groups.
China's previous estimate of the number of people in the nation
with H.I.V. was 850,000, but many experts say that even today's
estimate of one million is very low.
"We are ready to negotiate with the pharmaceutical companies,"
Mr. Qi said, "but if affordable prices cannot be reached," they
would take the other route." Asked how much longer the Chinese were
willing to negotiate, he said, "Until the end of this year."
Anger over the lack of drugs to treat the epidemic has been
generally mounting among China's experts.
"We need a group of drugs to treat patients now," Dr. Shao Yiming,
one of China's leading AIDS specialists, said recently on China
Central Television. "It's a dead end to wait for patents to expire.
It's up to our government, under the appropriate circumstances, to
invoke the W.T.O. clauses."
If Chinese manufacturers start producing generic medicines, it
still remains unclear how much benefit patients will reap, since all
of the manufacturers hope to profit from such a venture.
A spokesman for the Shenyang Dongbei Pharmaceutical Company,
which is newly licensed to make AZT, refused to say how much the
newly marketed generic version is selling for, calling that a
"commercial secret."
At the news conference today, Mr. Qi also discussed in greater
detail than ever before the rural AIDS epidemic that comes from
practices used for buying blood.
Based on government statistics, he estimated that in one severely
affected part of Henan, Shangcai County, about 10,000 people had
contracted AIDS and 1,000 had died.
Poor farmers in central China sold their blood for about $5 a
bag. The government-affiliated blood stations often harvested the
fraction of blood used to make medicines and then pooled the rest of
the blood and reinjected it into the sellers. This practice resulted
in widespread H.I.V. infection among those who sold their blood.
But as before, the details provided are at best sketchy, and
government estimates still seemed well below those suggested by the
few independent experts who have quietly worked in the area. Those
experts say that a majority of adults in some villages now carry
H.I.V. and that more than a million people in the province may well
be infected.
National Briefing | South: Alabama: Ban On Packaged Shrimp
(July 2, 2002)
Suddenly, AIDS Makes the News in China (December 5, 2001)
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AIDS Patients in China Lack Effective Treatment (November 12,
2001)
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World Trade Organization Admits China, Amid Doubts (November
11, 2001)
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