- The Washington Times - Thursday, August 9, 2001

NEW YORK — Nigeria plans to launch the largest AIDS treatment program in Africa using cheap generic drugs on Sept. 1, a U.N. special envoy said.
The 10,000 adults and 5,000 children who will receive a drug cocktail are just a tiny fraction of the more than 2.6 million Nigerians infected with the HIV virus that causes AIDS.
But the Nigerian government's commitment demonstrates that within Africa efforts are under way to tackle the epidemic that has infected about 26.5 million people across the continent, said Stephen Lewis, special envoy of U.N. Secretary-General Kofi Annan for HIV/AIDS in Africa.
"It's a quite extraordinary intervention, a measure of the president's determination that they maintain the level of the pandemic where it is and try to turn it back," Mr. Lewis said at a press conference in late July. "They recognize that if Nigeria fails, then much of Africa will fail."
Nigeria, which is an unlikely country, was patched together by British colonialists. The most populous nation in Africa with 123 million people, Nigeria combines hundreds of ethnicities and languages in West Africa.
Botswana in southern Africa, which has a population of only 1.6 million, has the world's highest rate of AIDS infections. It will launch a treatment program using anti-retroviral drugs in early 2002, he said.
At the first U.N. conference on AIDS last month, Nigerian President Olusegun Obasanjo warned that "the prospect of extinction of the entire population of a continent looms larger and larger." He called for cancellation of Africa's debts and international help. But he also took action himself.
Mr. Obasanjo sent his health minister to India a few weeks ago to negotiate with the pharmaceutical company Cipla Ltd., which makes generic AIDS drugs.
In February, Cipla offered to sell a three-drug AIDS cocktail to nonprofit agencies for $350 a year per African patient — provided the patients weren't charged. The company said at the time that African governments could purchase the same drugs for $600 per patient.
But the Nigerian health minister was able to negotiate a $350 a year per patient deal with Cipla, Mr. Lewis said.
The Nigerian government will subsidize about 80 percent of the cost, but patients who receive treatment will have to pay between $7 and $8 a month, Mr. Lewis said.
Nigeria intends to use a six-drug regimen for 60 percent of the patients and a two-drug regimen for the other 40 percent, he said.
The drugs are expected to have similar results, but the government will monitor and evaluate how patients cope with the different programs that will be administered by Nigeria's teaching hospitals, he said.
"It is the government's intention on Sept. 1 to begin a process of anti-retroviral treatment in Nigeria which will be at least initially larger than anywhere else on the continent," he said.
Mr. Lewis, who just returned from visits to Zambia, Kenya, Rwanda and Nigeria, said governments are anxiously awaiting help from the global AIDS fund that Mr. Annan proposed. It has received $1.4 billion, but the secretary-general says it needs $7 billion to $9 billion annually.
Despite financial and other obstacles, Mr. Lewis said he was "even more confident" that Africa could turn the tide on AIDS than he was before the trip. He cited "the extraordinary" degree of public awareness of the disease and "the quite profound determination" of political leaders to tackle it.
In Kenya, parliament unanimously passed a law last month allowing the government to suspend patent rights in times of emergency, which clears the way for cheaper, generic AIDS drugs.
The East African nation, which has 2 million adults living with the HIV virus, is expected to start importing or manufacturing anti-retroviral drugs shortly, Mr. Lewis said.
In Rwanda, only 500 people are receiving AIDS drugs because the $140 per month cost is half the average income for an entire year, Mr. Lewis said.
But the Rwandan government through testing, counseling and provision of some drugs to HIV-infected mothers appears to have significantly cut transmission of the virus.
The U.N. Children's Program tested 33 children born to mothers who took part in the program and only two were HIV positive, which is just 6 percent, "much, much lower than the anticipated rate," he said.

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