By Sara Speicher
International AIDS Conferences (IAC) are marked by loud and creative protests – from building a “slum” outside the Media Centre that highlights housing needs for people living with HIV to wrapping up a pharmaceutical company’s exhibit to protest the closing of a drug manufacturing plant.
But advocacy doesn’t always take the form of loud demonstrations. A team of faith-based representatives also engaged four pharmaceutical companies – Boehringer Ingelheim, Gilead, ViiV Healthcare (joint venture for HIV drugs by GlaxoSmithKline and Pfizer), and Merck – in four quiet but pointed dialogue meetings at AIDS 2010.
This is the third IAC where meetings with the companies have been held, and Pat Zerega, Director for Corporate Social Responsibility, Evangelical Lutheran Church in America, has noticed a change in the quality of dialogue.
“Many of the pharmaceutical companies are eager to meet us”, said Zerega, who also convenes the Pharma Working Group for the Ecumenical Advocacy Alliance (EAA). “Several companies have told us they learn as much from us as we learn from them.”
One of those learning points was connecting HIV treatment with food security.
“When we would introduce our food and HIV focus, we were met with a blank stare,” said Zerega. But the faith representatives talked about how effective HIV treatment depends on having sufficient and nutritious food – which in many impoverished areas is sorely lacking.
David Deakin, who works in the HIV unit for Tearfund, recalled being in Mozambique in March where they had had a very bad harvest. “We saw over 50 patients in their home and there was little food, and I saw people vomiting up their ARVs,” he said. “This is what we see and this is the voice we can bring to the pharma companies. Often their knowledge of Sub-Saharan Africa is through clinical trials which are very controlled. We know the uncontrolled situation on the ground.”
As faith representatives shared the vital linkages between HIV treatment and food security, some of the company representatives ended up wanting to meet with their nutritionists to discuss nutritional guidelines for HIV-related drugs and asking what they could do to address food security so that the medicines are effective, said Zerega.
The faith representatives also raised companies’ participation in the “patent pool”, an initiative of UNITAID to make protected drug formulations more available for generic manufacture in low- and middle-income countries. Pharmaceutical companies will soon be asked to sign up to the pool once the legal host entity is set up by UNITAID in the coming weeks. In an initial meeting with UNITAID at AIDS 2010, the faith representatives were able to hear what UNITAID is asking pharmaceutical companies and could frame their questions on patents, licensing and registration within the current framework.
Zerega said that the companies gave an honest assessment of where they see the holes and the questions that still have to be answered – particularly about how it will be implemented.
Kola Akinola, senior policy officer, HIV and AIDS for Tearfund, said it was a good opportunity to talk with the pharma companies about the patent pool and “why we think it was important for them to join.” Having heard their concerns, he noted, the faith representatives can share with UNITAID the major issues in the patent pool framework that will need to be addressed.
Deakin observed that the patent pool is at a “crucial stage.” “It could go either way,” he said, noting that three of the four companies have significant concerns. “One of the companies said that if they don’t sign up to the pool, we have the right to ask them what they think is a better alternative. The reality is the real work has to be done between UNITAID and each company”, he stated.
Faith representatives also raised issues around access to medicines and services, particularly to prevent vertical (mother-to-child) transmission and the development of child-friendly HIV-related medicines and diagnostic services.
And definite gaps remain in approach. For instance, Zerega notes, the companies have reiterated their understanding of the needs within the least-developed countries, yet questions remain about the response for middle-income countries where huge access gaps exist between rich and poor.
Deakin, who worked in the pharmaceutical industry himself for 20 years, felt the meetings were open, good discussions, and that the input from the faith community was valued. “We’re a stakeholder for them; we represent people on the ground,” he stated.
Akinola added that the past advocacy of the faith community has also made a difference to the discussions. “We come with numbers and we come with a constituency, and they know it is a very large constituency,” he said.
The companies, Zerega observed, “appreciate that we’re interested in sustainability of treatment, not philanthropy.”
Ongoing dialogue with the pharmaceutical companies goes back now to the EAA’s Pharma Working Group and the North American-based Interfaith Center for Corporate Responsibility’s shareholders meetings. There are also some specific actions to take to follow up on HIV and food security and the patent pool. Already, though, one can anticipate meetings in July 2012, at the 19th International AIDS Conference in Washington, D.C.
“Pharma is very aware of the presence and role of the faith community in delivery and advocacy,” said Zerega. “They know we are watching, and we will keep raising our concerns and we will hold them to their promises.”
