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                               MEMORANDUM TO PARLIAMENT
President Thabo Mbeki (MP) and Deputy President Jacob Zuma (MP)
Minister of Finance: Mr. Trevor Manuel (MP); Minister of Foreign Affairs: Dr. Nkosazana Dhlamini-
Zuma (MP) Minister of Health: Dr. Manto Tshabalala-Msimang (MP); Minister of Social
Development: Dr. Zola Skweyiya (MP) Minister of Trade and Industry: Mr. Alec Erwin (MP);
Chairpersons of Portfolio Committees on Finance; Foreign Affairs; Health; Social Development;
and Trade and Industry –c/o Dr. Abe Nkomo. Leader of Opposition: Mr. Tony Leon (MP) – All
Members of Parliament.

                                                                                                          12th February 2001

On World AIDS Day, 1st December 2000, our Minister of Health, Dr. Manto Tshabalala-Msimang
outlined government policy on the treatment of people with HIV/AIDS. Once again, we wish to
bring it to the attention of every legislator and person in our country.
              Access to affordable drugs is a matter of life and death in our region, as access to these drugs
              determines who lives and who dies. The lack of equitable access to affordable drugs exposes the
              pitfalls of the world's trading systems, and this a sore point between the major drug manufacturers,
              based largely in developed countries, and the disproportionately affected and resource constrained
              developing countries.

              South Africa has been at the forefront of negotiations with major pharmaceutical companies and UN
              Agencies to accelerate access to affordable drugs, including drugs for AIDS-related care and
              treatment. …This meeting [with the European Union] recognised the need for SADC countries to
              negotiate as a Region in order to gain access to affordable medicines. To assist Member States
              during the discussions with pharmaceutical companies, the SADC Health Sector has developed
              Principles to Guide Negotiations with Pharmaceutical Companies on Provision of Treatment for HIV
              and AIDS.

               SADC Council of Ministers approved these Principles in August 2000. The guidelines do not focus
              only on the provision of antiretroviral drugs, but address the issue of HIV-related interventions in a

              These include aspects such as laboratory support, treatment of opportunistic infections, infrastructure,
              capacity building, enhancing local manufacturing capacities, and monitoring of the use and impact of
              antiretroviral drugs.

              Accordingly, we are in consultation with the SADC Ministers of Industry and Trade, and Finance and
             Investment, in order to ensure that the multilateral trade agreements such as some provisions of the
             TRIPS Agreement, can be used effectively to improve accessibility of affordable drugs.

             Therefore, the decision not to implement a large-scale antiretroviral programme in the public health
             sector is not an ideological stance. It is based on the fact that these drugs, at current prices, still
             remain unaffordable. …

              So you can see that unless the cost of these drugs is reduced to affordable levels, or provided free of
             charge, it would be almost impossible to provide them in the public health sector. Hence our keenness
             to enter into dialogue with the pharmaceutical companies on the reduction of drug prices. And,
             therefore, as a principle, we support generic substitution, compulsory licensing, parallel importing,
             strengthening of local production capacity, because these strategies are critical in achieving the goal
             of access to affordable drugs.

The Treatment Action Campaign (TAC) and all of civil society can unite behind this policy. In this
legislative year, our challenge as legislators and civil society will be to change this policy into a
sustainable plan and to implement this plan. Today, the Treatment Action Campaign is here to
support government against the drug companies and to ensure that Parliament plays proactive role
in the development of a treatment plan for people with HIV/AIDS.

Over four million people in South Africa live with HIV/AIDS. At the moment, most of our people are
condemned to die. They do not have access to life-saving medicines that allow most people with
HIV/AIDS in North America, Europe and Brazil to live longer, healthier lives. The main reasons for
this lack of access are the high prices of patented medicines, poor health-care infrastructure and
lack of political will to fight the HIV/AIDS epidemic.

TAC Supports the Medicines and Related Substances Control Amendment Act 90 of 1997
In the first democratic parliament, former President Mandela and former Health Minister Dr.
Nkosazana Zuma created a legal framework to make health-care and medicines more accessible.
The Medicines and Related Substances Control Amendment Act, No. 90 of 1997 is one such law.
Since then, the law has been rendered ineffective through litigation while more than 400 000
people with HIV/AIDS in South Africa have died, the majority because they could not afford access
to anti-retroviral treatment.

We condemn the Pharmaceutical Manufacturers Association and the pharmaceutical
companies who, through litigation, have delayed the implementation of this law. Each day that
this law is delayed, they protect their exorbitant profits at the expense of the lives of people with
HIV/AIDS. The Treatment Action Campaign and its civil society partners will organise mass action
against these companies.

The PMA counterparts in Brazil, Thailand and the Phillipines have also pressurised these
governments not to make medicines accessible. In the last few weeks, the US government has laid
a complaint against Brazil at the World Trade Organisation. Brazil has implemented a programme
of free anti-retrovirals for all people with HIV/AIDS based on generic state production and
licensing. The country has cut its HIV/AIDS mortality by half and substantially reduced cases of TB
related to HIV/AIDS. Brazil deserves the support of every thinking person.

The Minister of Health’s World AIDS Day speech calls for substantial reductions in drug prices as a
minimum condition for the provision of anti-retrovirals on a sustainable basis. TAC and its allies in
South Africa and globally have won a tremendous victory by forcing drug companies to lower
prices. Moreover, generic companies have indicated that they can provide combination anti-
retroviral therapy at less than R400.00 per person per month.

However, TAC believes that the government must encourage local generic production in
partnership with Brazil, Thailand and India, as well as the local generic industry. This is the only
way to ensure sustainability of an HIV/AIDS treatment programme. This requires courage and
vision that only co-operation between the Ministry of Health, Finance and Trade and Industry can
produce. The government must develop a financing plan together with a licencing plan to produce
generic anti-retrovirals and to develop all health care infrastructure.

   TAC calls on Minister Manto Tshabalala-Msimang to accept the necessity and responsibility to
    implement a treatment plan based on generic anti-retrovirals. TAC calls on the MoH to develop
    such a plan before 16 June 2001. In the interim, the MoH must ensure that every health care
    facility in the country implements the Standard Treatment Guidelines for the Treatment of
    Opportunistic infections and that the prevention of mother-to-child-transmission programmes
    are implemented at every ante-natal clinic across the country.

   TAC calls on Minister Alec Erwin to use his powers in the Patents Act to licence all the
    necessary anti-retrovirals and diagnostics essential for an HIV/AIDS treatment plan. Where
    necessary, Minister Erwin must issue compulsory licences against the drug companies for
    generic anti-retroviral production;

   TAC calls on Minister Trevor Manuel to call a finance conference of the G8 countries and the
    international institutions to raise grants for the implementation of a treatment plan for HIV/AIDS,
    the eradication of TB, malaria and other neglected diseases in South Africa and throughout
    Africa, Asia and Latin America;

   TAC calls on the South African cabinet and parliament to reduce military expenditure and
    apartheid debt repayments and to redirect this expenditure into the development of health care
    infrastructure and the creation of a basic income grant;

   TAC calls on the Minister Nkosazana Zuma to introduce a motion in Parliament in solidarity with
    people with HIV/AIDS in Brazil and to support the government of Brazil against the US. TAC
    asks Parliament to request that the WTO Dispute Settlement Board drop the complaint against
    that country.

   Access to treatment is an issue of life and death for all Africa’s people. TAC calls on Tony Leon,
    the Democratic Alliance and all the opposition parties to support the government in the litigation
    instigated by the Pharmaceutical companies, as well as the policy outlined by the Minister of
    Health on World AIDS Day.

We urge Parliament and all MPs to attend the TAC Treatment Congress on 18-21 March 2001 and
the Ministries to whom this Memorandum is addressed to respond on or before this date to the
recommmendations contained in it. We wish you a productive legislative year.

Siphokazi Mthati                          Zackie Achmat               Sindiswa Godwana