Despite months of activism and a landmark court case, the status and price of Ziagen – an AIDS drugs partly developed at the University – will remain unchanged for the foreseeable future.

In late April, the South African government and 39 pharmaceutical companies, including Ziagen patent holder GlaxoSmithKline, settled a four-year-old lawsuit on patent rights when South Africa changed a disputed act to conform to international intellectual property laws. Activist groups hailed the decision as a landmark step.

Since then, however, the South African government has announced it will not purchase any AIDS drugs, generic or otherwise. Instead, it plans to buy drugs to treat HIV-related infections and concentrate on improving its health infrastructure.

South Africa has been at the center of the AIDS storm because of the lawsuit and its high incidence of AIDS infections. One in nine South Africans have HIV/AIDS, the highest rate in the world.

The government’s announcement supports what pharmaceutical companies have said for years: High prices are not the only issue in bringing treatment to those infected with HIV. Glaxo spokespersons cite a lack of political will and poor health systems as other significant barriers.

However, many groups still feel these companies are making excessive profits on drugs and are at least partly responsible for keeping them out of the hands of those who need treatment.

Of the 36 million people infected with HIV, more than two-thirds live in sub-Saharan Africa. For a variety of reasons, sales of Ziagen do not mirror this fact: Last year, worldwide sales of Ziagen topped $220 million, of which $206 million came from the United States and Europe.

The money the University earns from Ziagen sales is reinvested in a variety of programs, including research into new drugs.

Students running the University- based Minnesota AIDS Action Coalition expressed disappointment at the decision of the South African government but said they were not surprised.

Coalition member Amanda Swarr said this is only a temporary state.

Swarr has spent time in South Africa volunteering for AIDS organizations and feels the government will eventually realize it must purchase HIV/AIDS medications for its citizens.

The South Africa-based Treatment Action Campaign has given the government until June 15 to change this decision, or it will launch an international campaign targeting political officials.

Similarly, the AIDS Action Coalition has requested that by fall the University and Glaxo alter their current license agreement and grant sub-licenses to companies producing generic versions of Ziagen.

Coalition members say all they are asking for is capitalism. They say increased competition will lower prices and make drugs more affordable for both citizens and governments.

But both University and Glaxo officials have no plans to grant sub-licenses.

Pharmaceutical companies are reluctant to grant sub-licenses,
partly due to the possibility of generic drugs being smuggled into the United States and Europe. Companies say they must recover the cost of developing drugs in those places or the world might face a shortage of new drugs.

On Ziagen specifically, Glaxo spokeswoman Nancy Pekarek said the company is still monitoring the possibly deadly allergic reactions some people have to Ziagen and hesitates to bring it into developing countries where it feels doctors do not have adequate training.

She added that there have been no requests to make generic copies of Ziagen.

University General Counsel Mark Rotenberg said the University is addressing AIDS in Africa within the context of its mission as a teaching and research institution dedicated to the public good. And although he said the University is working to make changes outside those boundaries – such as lobbying Congress – he acknowledged it will probably have a limited impact.

The AIDS Action Coalition is looking to extend the issue beyond Ziagen. It said it wants the University to address the question, “What responsibility does the University have for a drug once it is on the market?”

The coalition has met with University officials to address what it sees as a gap in current policy and will continue activism in its place.

Sam Kean welcomes comments at [email protected]