TAC E-Newsletter - 21 October 2002 To subscribe: news-subscribe@tac.org.za To unsubscribe: news-unsubscribe@tac.org.za Leave the subject line and message body blank. Contents -------- * Statement by the Treatment Action Campaign on Coca-Cola * Response by three TAC members (Bongiwe Mkhutyukelwa, Thembinkosi Mtonjeni and Vuyani Jacobs) to an article by David Patient critical of TAC published on AF-AIDS. This response has not appeared on AF-AIDS, even though it was posted to it. * Letter by Zackie Achmat published in the Mail & Guardian newspaper, responding to an article that he was nominated to for the ANC National Executive Committee * Advert for a new TAC position - International Office Co-ordinator We call on all organisations to give full support to the Nedlac negotiations for an HIV/AIDS treatment plan. There have been promising signs in the last few weeks that Government is making progress towards adopting a treatment plan, including antiretroviral programmes. This is a welcome shift. To ensure that the process does not falter we appeal to all our supporters to step up the public pressure for a treatment plan. In the next few weeks, we will be distributing a discussion document to all supporters discussing the way forward to a treatment plan. NOTE ON THE COMPETITION COMMISSION COMPLAINT AND BOEHRINGER INGELHEIM'S DEAL WITH ASPEN We call on all our supporters to put pressure on Boehringer Ingelheim and GlaxoSmithKline to issue unrestricted non-exclusive, open, licenses (with a maximum 5% royalty fee) for the manufacture of generic antiretrovirals in the public and private sectors. In the last week Boehringer Ingelheim indicated that they have agreed to give a voluntary license to Aspen Pharmacare for Nevirapine. While we believe this deal has arisen due to pressure from activist groups and the complaint at the Competition Commission, it has two serious shortcomings: (1) it excludes the private sector and (2) it has been negotiated with a single company - voluntary licenses for antiretrovirals must be made available on transparent, publicly available, objective terms so that any generic manufacturer that meets the criteria can get a license. By excluding the private sector, the license fails to account for their being very few patients who are supplied their medicines through the public sector. Even when this changes, as many patients should be able to use the private sector as possible in order to reduce the burden on the public sector. The exclusivity of the deal with Aspen (irrespective of whether or not it has an exclusivity clause in it; it is wit! h one company) means that the market will still not be competitive enough for the lowest sustainable prices to be reached. GSK made a similar deal with Aspen a while ago with similar shortcomings. A question and answer fact sheet (PDF format) on the Competition Commission is available on the TAC website: http://www.tac.org.za/Documents/DrugCompaniesCC/QuestionsAndAnswers.pdf See page 5 of today's Business Day. We have placed an advert calling for support for legal action against GlaxoSmithKline and Boehringer Ingelheim. --------------------------------------------------------------------------- *************************************************************************** --------------------------------------------------------------------------- Coca-Cola and Ghanaian Police Harass HIV/AIDS Activists in Ghana On 16 October, the Ghana AIDS Treatment Action Group (GATAG), a member of the newly established Pan African Treatment Access Movement (PATAM), was finalizing its last minute preparations for a demonstration against Coca-Cola when police raided their offices and arrested their General secretary, Stephen Sowah. He was then interrogated and threatened by the police and later released. Subsequently it has come to our attention that there were further attempts to breakup the protests planned for 17 October against Coca-Cola in Ghana. Without treatment, millions of people living with HIV/AIDS on the African continent will die avoidable deaths over the next decade. An essential part of the response to dealing with the HIV epidemic is that people with HIV/AIDS are able to organise themselves and participate in civil actions such as marches and pickets. Therefore the TAC is deeply concerned by the harassment of one of our fellow PATAM organisations in Ghana. The demonstration being organised in Ghana was part of activities organized for a Global day of action on 17 October to pressurise Coca-Cola to provide antiretroviral treatment, where required, to the employees and families of its bottlers. We are informed that the Coca-Cola bottler in Ghana is partially owned by the Ghanaian Government. According to GATAG, the harassment took place after Robert Lindsay, Vice President of Coca-Cola Africa Public Affairs & Communication, called to confront GATAG activists for "demonstrating against their own government and a company that does so much for the community". Following activist pressure, in particular the announcement for a day of action on 17 October, Coca-Cola announced on 29 September that it would treat its direct workers with HIV and that it would assist its bottlers with subsidies so that they could do the same. This was a progressive step. However, a number of activist organisations are concerned that some aspects of the deal lacked clarity. These concerns include: * Too few of the bottlers have signed on to the deal. * Workers will have to cover 10% of their treatment costs. The TAC viewpoint is that this is only acceptable if workers in very low-wage paying countries are exempt from this clause and workers have access to the most affordable treatment that makes use of low-priced generic medicines. However Coca-Cola has apparently negotiated a deal with GlaxoSmithKline, meaning that employees will not have access to lowest-priced, proven generics. * It is not clear to what extent family members are included in the deal. The TAC wrote to Coca-Cola requesting a meeting to clarify these issues. We have made it clear to Coca-Cola that they will need to negotiate formally with all organisations involved in this campaign and we offered to facilitate setting up such a meeting. Although Coca-Cola replied in a private email to us, we have made it clear that a formal response is necessary, addressed to all the relevant organisations. This is as far the negotiations have proceeded. Following the events of the last few days, the TAC demands the following from Coca-Cola and the Ghanaian Government: * Both Coca-Cola and the Ghanaian Government must immediately stop harassing activists in Ghana and stop infringing basic civil liberties. * Coca-Cola must issue a public statement clarifying the questions they have been asked regarding their announced treatment programme. The company must formally meet with PATAM and other organisations involved in this campaign. The TAC will formally ask Amnesty International and Human Rights Watch to investigate the events of the last few days in Ghana. We call on all concerned people to send faxes to Coca-Cola and the Ghana Government expressing dissatisfaction at events in Ghana. Please address faxes for Coca-Cola to Robert Lindsay. Please address faxes for the Ghana Government to the ambassador of the Ghanaian embassy nearest you. The Coca-Cola fax number in South Africa is 021 936 5899. The Ghana Consulate fax number in South Africa is 012 342 5863. [ENDS] ********************************* David Patient posted a message to AF-AIDS which made some outrageous comments about treatment and Africans. Three TAC members wrote a response to David. They tried to post their response to AF-AIDS, but it has not appeared on the AF-AIDS email list. Here it is. Please distribute widely. David Patient Knows Nothing About Africans Living in Poverty Bongiwe Mkhutyukelwa, Thembinkosi Mtonjeni, Vuyani Jacobs David's understanding of how people in Africa (Africans) live and what it means to take antiretrovirals is misinformed. David talks about Africans in the same patronising way that we have heard some farmers talk about their workers. Many people who watch television and who hear him speaking in the media think he is an expert on HIV/AIDS, but actually he uses his power to misinform people. The fact that people do not have a concept of time is wrong. Even before the arrival of watches people knew the time, because they had their own measurements. In Khayelitsha, hundreds of HIV positive people use antiretroviral therapy with excellent results in the Medecins Sans Frontieres pilot project. Khayelitsha is extremely poor with many people living in shacks and a lack of proper sanitation. Yet many people have benefited from the antiretroviral therapy programme. It has saved their lives. There are similar reports from Somerset and Tygerberg Hospitals in Cape Town and Chris Hani Bar! agwanath in Soweto. David says that poor people will not take their medicines properly, causing resistance. He uses TB as an example. Actually 65% of people take their TB medications to completion. All the clinical shortcomings including the TB model are well researched and well dealt with by using the Direct Observed treatment Short-course (DOTS). 65% is not good enough, but it means that more than half benefit. Doctors say that one of the main reasons for the high dropout rate is that clinics are underfunded and understaffed, not because the patients are poor. TAC's campaign is aimed at improving these things. Somerset Hospital have done research that shows that South Africans adhere to antiretrovirals as well as any developed country. The reality of the matter is that people need antiretroviral treatment for the Opportunistic Infections, including Diarrhoea, TB and pneumonia. David's description of the typical African life is wrong. One of us, Vuyani, has personal experience of regaining a shattered life through antiretroviral treatment. We will also tell you the story of Nontsikelelo, our friend, who takes antiretrovirals and benefited greatly from them. Vuyani is poor and Nontsikelelo lives in extreme poverty. Vuyani's Experience (told by Vuyani directly) 'David has argued that Africans cannot stick to time. David said Africans need a village clock. Antiretrovirals saved my life. I have had thrush and skin problems. Worst of all I started losing my memory because of meningitis. Numbers were disappearing out of my mind and I was in panic. My weight was extremely low and my CD4 count was 117. I had plenty of diahorrea. But I had support from friends and determination to be healthy again. I started antiretroviral therapy and was determined to stick to my medication depite side effects like dizziness and feeling sleepy three days in a row. But I have to say my support group at MSF prepared me. One can see without any rocket science my viral load became undetectable. That's not all though; I have started regaining my memory and even started writing poetry after years. David is attempting to be an old missionary, trying to describe a life in a day of an African. The programme in Khayelitsha was made possible for poor people in a ! poorly resourced settlement. Nevertheless we were counselled on adherence, keeping track of our daily activities and life styles. The counselors lectured us on side effects and what to do with them. I'm on TB treatment, taking pyrazinamide, ethambutol, rifampicin, isoniazid drugs. If I can have those why not HIV/AIDS drugs? 'I have 3 sick cousins with HIV; their older brother died of AIDS 3 weeks ago. The smallest of them is on TB medication and is improving. She phones me from Aberdeen in the Karoo and says, ''Vuyani I need drugs like yours, I want to go back to my boss who said the job is still waiting for me if I'm feeling better I should come.'' ''You can't have mine because this medication needs monitoring and knowledge about them, more over doctors need to prescribe it'', I replied. 'She is frustrated and can't understand why Aberdeen in Karoo can't have this medication. Even if she comes to Cape Town she won't have them because here only people staying in Khayelitsha can go on the MSF programme. I'm one of them. 'Yet people like David Patient describes an imaginative village and its people sound very primitive.' Nontsikelelo's Experience Nontsikelelo Zwedala who is on a clinical trial lives in Phillipi in exteremely poor conditions. She lives in a shack and does not have a toilet in the shack. She said, 'I was on the last stage of the disease and when I started my medication my CD4 count was only 14 and I had a viral load of 3 million. I am taking Nevirapine, D4T and 3TC. I was very scared of the side effects but I don't experience any serious side effects anymore. Anyway I would rather live with the side effects than die of AIDS. The minor side effects I had were always monitored by my doctor and he changed the treatment if necessary. I had a problem of forgetting to take my pills during the first month, but I got used to them and committed myself to adhering since I knew that without them I would certainly die. I take them twice daily and my health is improving.' Nontsikelelo weighed about 45kg before treatment and had thrush all over her body. None of us thought she would live very long. Now she is over 6! 0kg and looks very healthy. People should be given the choice to take life-saving medicines. It is enshrined in the constitution that people have a right to life and the right to health care. David is denying them that by exaggerating and scaring off people from taking antiretrovirals. The exaggerated sense of poverty described by David in South Africa is not insurmountable. The government can deal with that, but it will need courage and much more spending on health-care. Many people are hungry, but TAC is not suggesting that antiretroviral treatment be implemented in one day. The TAC has also organised large marches for the Basic Income Grant (BIG) so that every poor South African person will be able to get basic nutrition. Has David supported this or does his commitment end with encouraging dying people to eat garlic on his TV advertisements (of course garlic might be useful for people with HIV, but it is not a treatment). South Africa needs a comprehensive plan to fight the epidemic. If David were talking about the current government policy on HIV/AIDS being an obstacle to antiretroviral treatment being implemented properly, he would be right. TAC's proposed National Treatment Plan proposes that the HIV crisis can be improved by voluntary counselling and testing, post-exposure prophylaxis for rape survivors and health-care workers, mother to child transmission prevention and highly active antiretroviral therapy. This would supplement, nor replace, current government HIV policy. HIV does not have to be a death sentence for poor people, because by using antiretrovirals properly, the disease can be treated. [ENDS] ********************************* Letter by Zackie Achmat published in the Mail & Guardian newspaper, responding to an article that he was nominated to for the ANC National Executive Committee [BEGIN] The Mail & Guardian (October 11) announced that I have been nominated for the national executive committee of the African National Congress as part of the left's campaign for "the soul of the ANC." For the record, I have no intention of standing for any position in the local, provincial or national structures. I am a member of the ANC and the South African Communist Party. I have been an activist for social justice for 26 years. All my energies are directed towards the development and implementation of a pro-poor HIV/AIDS policy that includes antiretroviral treatment for people living with HIV/AIDS. This work is non-partisan and in this struggle I am one of thousands of activists across our country. I believe that a rational pro-poor HIV/AIDS policy and plan -- which the ANC government must implement -- is a non-party political issue. Everyone has a duty to ensure that serious HIV prevention programmes, a national HIV/AIDS treatment plan, affordable medicines and quality health care through sustained public investment become a material reality. The M&G article "constructed" a "left struggling for the soul" of the ANC. Regrettably, this is a figment of the writer's imagination rather than a reality. I believe the ANC would benefit from a thoughtful and strong internal left current. Many mass parties who claim to defend the interests of the poor, from the Brazilian social democrats and Workers' Party to the Indian Congress Party and French socialists have seen strong left-wing tendencies. This is good for internal democracy and in any party, useful for ideas and critical to ensure mobilisation for delivery to working and poor people. Fear of the left, anti-communist hysteria and other red herrings should have been buried with National Party rule. Zackie Achmat [ENDS] ****************************** TAC Position Available for International Office Co-ordinator ------------------------------------------------------------ The TAC is establishing an international office. The purpose of this office will be to manage the organisation's growing international demands. The requirements of the co-ordinator will be as follows: * Liaise, plan, organise and work together with the member organisations of the Pan African Treatment Access Movement (PATAM). * Co-ordinate or conduct research efforts into HIV-related issues in a number of African countries. * Liaise with oversees organisations who assist the TAC or require our assistance. The successful applicant is likely to have the following characteristics: * Experience in organising with activist groups, especially work related to HIV/AIDS. * Knowledge of science and politics of HIV/AIDS and knowledge of African political and cultural dynamics. * Negotiating skills. * Experience conducting research or co-ordinating research efforts. * Ability to speak French, Portuguese or Swahili would be advantageous. The co-ordinator will be required to work in the TAC national office in Cape Town. Relocation costs and salary are negotiable. Candidates living openly with HIV are also encouraged to apply. CVs will be accepted by post or fax only. No email CVs will be considered. Only shortlisted candidates will be contacted. Please post applications to: PO Box 74 Nonkqubela 7793 Please fax applications to: 021 788 3673 Closing Date for applications: November 20, 2002 [ENDS] ****************************************************** [END OF NEWSLETTER]