International health

AIDS: trade agreement could mean more Guatemalan deaths

A trade pact between the United States and Central America could have devastating effects on efforts to reduce the growing number of HIV-AIDS cases in Guatemala.

That’s the opinion of UdeM researcher Mira Johri, who has been spending time in Guatemala, helping to set up a pilot program that aims to bring down the number of HIV-positive women passing on the virus to their newborn babies, known scientifically as vertical transmission.

The humanitarian group Medecins sans frontières (MSF), one of the loudest critics of the trade agreement, says the March 9th passing in Guatemala of the US-Central American Free Trade Agreement (DR-CAFTA) will have a negative effect on the number of anti-retroviral (ARV) drugs available in the future. Up until now, a quarter of its citizens who live with the disease have had access to ARV drugs. But the medication has come mostly in the form of the so-called generics, the lower-priced drugs that are not patent-protected. This availability is now put into question because the agreement has strict rules protecting pharmaceutical companies.

MSF says the trade pact goes against a global agreement signed in Doha in 2001, which had been designed to correct some World Trade Agreement rules that were particularly onerous for the developing world. The group provides almost half of all the ARV drugs to the country’s AIDS patients, treating 1,600 people in hospitals and clinics in Guatemala. According to the World Health Organization and UNAIDS, as many as 13,500 Guatemalans living with HIV/AIDS are in urgent clinical need of ARV treatment, while only 3,600 receive it.

The difference between the price of the generic and the brand name medication is staggering. Generic drugs that combine the ‘triple cocktail’ of ARV drugs into one pill, and are administered by MSF, cost the group US$216 per person per year, while Guatemala’s social security system pays US$4,818 for the same combination from drug-maker GlaxoSmithKline. Guatemala has put out a declaration to reduce mortality due to AIDS by a goal of 50 per cent by 2008. Critics say paying higher prices for the medication will be a hard pill for the country to swallow if they want to make significant reductions.

Mira Johri’s project, which is a collaborative study involving Guatemalan doctors, scientists and policymakers, will implement and evaluate a program to bring down mother-child transmission rates, now at a national rate of 30 percent or greater. The group is aiming for a less-than-one-per-cent result for their subjects. “The reason Guatemala does not yet have a national programme to prevent vertical transmission of HIV relates to the high cost of such a program,” says the researcher in the Department of Public Health She adds that the higher prices for generics that DR-CAFTA agreement calls for, may compromise future plans to develop such a program.