Aids drug price cut for Third World

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The price of the Aids drug, AZT, is to be cut by up to three quarters to help prevent mother-child transmission of the disease in the developing world. Glaxo Wellcome, the multinational drug company, announced the price cut after a trial in Thailand run by the US Centre for Disease Control showed that a short course of the oral drug in the last three to four weeks of pregnancy and during labour reduced the transmission rate by 51 per cent.

A spokesman for the company said the exact price would vary from country to country according to the length of treatment regimen agreed and the support networks available to ensure effective use of the drug, whose brand name is Retrovir. He said the company would still make a profit at the reduced price but part of this would be ploughed back into "programme support", including distribution and patient education.

Nine out of 10 people living with HIV and Aids are in developing countries and women are often unaware that they are infected. Most do not attend ante-natal clinics until late in pregnancy and may only discover they are infected at that stage.

The announcement was warmly received in South Africa. "It is absolutely amazing," said Glenda Gray, director of perinatal HIV research at the Baragwanath Hospital in Soweto yesterday. "For the first time in years we are seeing lights at the end of the tunnel. Glaxo's decision has put AZT within the reach of South African women."

It is two weeks since Dr Gray announced that research at Baragwanath supported the results of the Thai study. But the Baragwanath team's joy was marred by the frank admission that the drug, widely available in the developed world, would be too expensive for of infected women in South Africa.

South Africa has one of the fastest-growing HIV infection rates on a continent blighted by the virus. Roughly 30 per cent of children under five referred to Baragwaneth, just outside Johannesburg, test positive. In KwaZulu-Natal, 25 per cent of all new born babies have the virus. KwaZulu is the hardest-struck province but the rest of the country is only a few years behind. Social factors smoothed the viruses passage.

Migrant-labour practices keep men from their families for months on end and on a continent where women have few if any choices, prostitution is rife and condom use practically non-existent. KwaZulu's predicament is partly blamed on truck routes that pass down the province, bringing the virus from neighbouring countries further north. At truck stops along the way, prostitutes cost less than breakfast.

The virus has crept up on South Africa's first democratic government; and administration which had so many other post-apartheid problems to tackle. That health minister Nkosazana Zuma is desperate for a cut-price solution to the Aids epidemic is evident from the government's continued support for the home-grown drug Virodene.

Though the Virodene researchers broke all the rules in administering the drug to Aids patients before it had been scientifically tested Dr Zuma continues to champion their cause. Her enthusiasm has not been dampened by the banning of the drug which contains industrial solvent.

The government's desperation is matched by patients. Yesterday there were newspaper reports that Virodene, despite the ban, is still in circulation and there is no shortage of Aids sufferers willing to use it.

Some sound a cautious note. Dr James McIntyre, co-director of the research team, is worried by the vagueness of Glaxo's proposal. A Health Department spokesman was rather guarded. Two years ago Dr Zuma met Glaxo executives to discuss purchasing AZT at a reduced price. The health spokesman said the questions the health minister posed then remain unanswered: Just how cheaply does the company intend to sell AZT and for how long will it keep the price at that level?