by John Iversen

Brazil's exemplary model for fighting AIDS in the developing world is being threatened by pricing practices of three United States pharmaceutical companies: Merck, Abbott and Bay Area-based Gilead.

Brazil is negotiating with the companies to issue voluntary licenses for their versions of Stocrin (Sustiva), Kaletra and Viread respectively. The companies would voluntarily transfer their technology to Brazil's state-run pharmaceutical company and receive fair royalties of about 4 percent. Under pressure from Brazilian AIDS activists, Brazil's House of Representatives took the issue a step further in early June by unanimously voting to declare a public health need and legally break the patents under World Trade Organization guidelines and flexibilities.

One of San Francisco's wealthiest and most prominent couples could choose to have a significant impact on the negotiations. Former Secretary of State George Shultz and his wife, San Francisco Chief of Protocol Charlotte Swig Shultz, own $8,700,000 worth of shares in Gilead. They are Gilead's fourth largest individual shareholders. George Shultz sits on the comparatively small eight-member Board of Directors.

We are asking the public to politely contact the Shultzes and ask them to use their power to have Gilead set an example of corporate responsibility by sharing its lifesaving technology with the world in an arrangement that includes fair royalties for Gilead. We are trying to win their hearts and minds. You can contact George Shultz at the Hoover Institution, 434 Galez Mall, Stanford, CA 94305. His phone is (650) 725-3493 and fax is (650) 723-5441. San Francisco Chief of Protocol Charlotte Swig Shultz works out of the Mayor's Office at City Hall, Room 200, 1 Carleton B. Goodlett Place, San Francisco, CA 94102. Her phone is (415) 554-6143 and fax is (415) 554-6160.

Brazil provides HIV treatment to 170,000 citizens by spending an unprecedented 4 percent of its national budget on AIDS. As a result, people in remote villages of the rain forest receive high-end, triple-combination drug therapy that includes protease inhibitors.

Brazil's aggressive, science-based prevention programs have cut the new infection rates to 0.6 percent, equal to those in the United States and Europe. Adherence rates to treatment regimens are even better than in the United States.

Through a combination of generically produced drugs and negotiated price reductions, Brazil actually has a higher rate of treatment than the United States, where waiting lists and restricted formularies for AIDS patients have become more common under the Bush administration.

The cost of the three drugs made by Gilead, Merck and Abbott eats up a whopping 70 percent of Brazil's total AIDS drug budget, financially threatening its free universal-access program. Brazil's decision to legally produce generic AIDS drugs has a life saving effect on the world.

According to Doctors Without Borders, since Brazil began generic production in 1998, the price of AIDS drugs in the developing world has decreased by 70 percent to 98 percent. The price of raw materials for generic AIDS drugs dropped significantly when economies of scale were achieved, first by Brazil and then by private generic companies in India and state production in Thailand.

Two years ago, Brazil accounted for nearly one half of the 300,000 people receiving AIDS treatment in the developing world. Today, primarily because of generic competition, 1 million are treated. Brazil is also freely sharing its drug-making technology with other former Portuguese colonies in Africa.

Still, 5.5 million people need treatment now and are not receiving it. Despite platitudes from Tony Blair and the G-8 Summit in Scotland, the goal for universal treatment will only be met by generic low-cost treatment combined with a significant infusion of money from G-8 nations for infrastructure like hospitals, nurses and doctors.

Drug companies are the most profitable industry in history; over the past 20 years, they have raked in an annual profit rate of nearly 20 percent, while the Fortune 500 companies averaged about 4 percent. Profits on prescription drugs average nearly 40 percent; over-the-counter drugs' profitability is about 5 percent. The pharmaceutical industry has over 600 lobbyists in Washington, D.C., more than one for every member of Congress.

Much of the basic research done by drug companies is paid for by U.S. taxpayers. Drug companies spend two to three times more on marketing and administration than research. They are huge money making machines. The CEO of Gilead —earned— $18 million last year and owns shares in the company worth $113 million, according to AFL-CIO Executive Pay Watch.

Abbott, Merck and Gilead should set examples of corporate responsibility and issue voluntary licenses to Brazil. Here we have George and Charlotte Swig Shultz, one of San Francisco's wealthiest couples, with shares in the most profitable industry in world history, in the richest country in world history. On the other hand, we have the deadliest epidemic in world history. Everything is inter-related. The Shultzes have the opportunity to shine, share and be global AIDS saints.

Please call, write or fax the Shultzes (see above), asking them to use their power to assure affordable generic AIDS treatment worldwide.

The campaign is endorsed by Priority Africa Network, HealthGAP, Survive AIDS, ACT UP East Bay, Peninsula Peace and Justice Center, WorldCentric, East Bay AIDS Advocacy Foundation, Former Berkeley Vice Mayor Maudelle Shirek, San Francisco Bay View, Middle East Children's Alliance and many others. For information, email priorityafrica@yahoo.com.

John Iversen co-founded ACT UP East Bay and the Berkeley Needle Exchange. He currently volunteers for HealthGAP and Priority Africa Network. Email him at johnnyi@LMi.net.

Endorsed by: Essential Action (Washington DC) Center for Health and Gender Equity (CHANGE), Tacoma Park, MD ACT UP New York ACT UP Cleveland ACT UP Philadelphia Kevin Dowling, Hayward, CA City Council Community HIV/AIDS Mobilization Project, New York City Americans for Safe Access (national) Global Exchange