From: rastern@sol.racsa.co.cr Date: Wed, 26 Mar 1997 13:07:50 -0600 (CST) Subject: Re: AIDS MEDS IN COSTA RICA San Jos=E9, Costa Rica 23 March, 1997 News From Triangulo Rosa For Immediate Release... FARMACEUTICAL COMPANY REFUSES MEDS FOR COSTA RICAN AIDS PATIENTS. After two meetings and more than five hours of negotiations, officials of the Swiss pharmaceutical company Roche have refused the request of a group of Costa Rican AIDS patients to receive the protease inhibitor Invirase= free. The group first met with Roche officials in February, at which point a promise was made by thecompany to study the matter and return for another meeting. In the secondmeeting, held last Friday, March 21st, the officials again indicated that would be unable to provide free or signicantly discounted medication. The patient group is a coaliton representing about 200 HIV+ persons and PWA=B4s from various clinics and NGO=B4s throughout Costa Rica. The group= has also been meeting with government officials and representatives from other farmaceutical companies for the last six months. Guillermo, one of the Coalition members said, "we feel frustrated because we have spent dozens of hours in "negotiations" with companies and with our own government, but we have yet to receive one pill." Government officials have told the group that they are studying various proposals to provide reimburse for AIDS medications, but that any decisions are still months away. In Costa Rica, the only antiviral medication which is provided is AZT, and that is given only to pregant women. A group spokesperson indicated that "we know the government bureacracy moves slowly and that huge costs are involved. But the pharmaceutical company has plenty of money and could make a humanitarian gesture to save lives until= the government is able to organize itself and make a decision.It seems incredible that we could talk to the people from Roche for over five hours during two months and that they are unwilling to offer anything concretely as far as medications go. We asked for free medications for 50 patients. Dr Max Bucher, Director of Roche in Costa Rica, indicated that he does not have the authority to make a decision authorizing free medication. He told the group that 14 patients in Costa Rica are already receiving Invirase free through their physicians. The Roche product, Invirase, costs about $800 a month here, yet the per capita income in Costas Rica is only $3,000 yearly. Said Guillermo"Nobody here can afford these prices, even less a person who is already ill and unable to work. We have an NGO with a medical Doctor who is willing to administer the medication, if we could just get the pills.We don=B4t understand why the company, which cannot sell the medicationanyway, would rather have it sitting in storage in their offices than potentially saving lives which they could do." Richard Stern, Ph.D, Health Coordinator of the gay/ lesbian group Triangulo Rosa said."We understand that pharmaceutical companies must recuperate the costs of the investigations necessary to develop these medications. But we also feel that the prices that they have set are arbitrary. Why is it necessary to set the same price here in San Jos=E9 as in New York or= London. Here $250 per month is the average salary. Why not set a more reasonable price in poorer countries , recognizing that the primary goal is that medications should be accessible to people who need them. On a worldwide level, these companies must consider the real cost to produce their product at this moment, which is much lower, and try to make these medications available in order to save lives now. We are not talking about television sets here. We aretalking about a tiny pill, that can save thousands of lives,and the actual value of the ingredients in the pill is just a few dollars" Added Stern "There is an irony here. In the US and other countries Health authorities have made decisions to provide these medications based on the fact that it is cheaper to pay for the medications than to pay for hospitalizations. In Costa Rica, the daily cost to the government of a hospital bed including all medications and treatment is only $200 a day, in comparison with three or four times that much in countries in the developed world. But the medication costs the same here as it does there. So Costa Ricans are penalized for a socialized medical system that provides health care at a cheaper cost, based on factors such as local labor costs, etc.=20 Government officials have told the Coalition that it would cost them 3 to 4 times more to provide the medications than it does to have the patient in the hospital. An average AIDS patient in Costa Rica spends 41 days in the hospital from diagnosis to death. This would be a total of $8,000 or roughly the cost of a retroviral cocktail for only 6 to 8 months." "There is a further problem here in that the community of AIDS affected people is not empowered, and only just recently begun to organize itself. Here people with AIDS still have to worry about discrimination at work, in the community, and in hospitals. It is not uncommon for a PWA to be thrown out on the street by their family. When a person dies, the family will say that another illness was responsible due to the stigma. The effect of this is tohelp to keep the epidemic invisible. This hampers prevention, treatment and empowerment. Also very relevant is the fact that gay people still suffer enormous discrimination in this machista, Catholic culture. A gay person with AIDS confronts virtually insurmountable obstacles. 70 percent of AIDS cases in Costa Rica have occurred in the gay community. =20 "The energy and psychological state necessary to fight for one=B4s rights is something that most people with AIDS in Latin countries do not have. This group of patients is the first in Costa Rica that has been able and willing to sit down at a negotiating table and openly say "I have AIDS." The culture that created ACT-UP, and many other groups that are successful in advocating for what they need simply doesn=B4t exist here. The fault is not so much poverty as is popularly believed. The problem is the repressive, vertical, codependent culture which still treats people with AIDS like lepers, maintaining them as helpless victims. We would like to raise the consciousness of people in the developed world, that help is needed, from outside as well, and that outside help could have a significant impact." The Coalition has decided to send a petition to the company headquarters in Switzerland to appeal the decision by Dr. Bucher. The Coalition is asking for support from the international community. Please send a fax to your local branch of Hoffman LaRoche protesting the treatment of Costa Rican AIDS patients by the company. The coalition also asks for the help of groups and individuals who have experience in advocacy actions of this nature, including ACT UP and others to contact us and to pass this message on. The situation about medications in countries such as ours is a desperate one=20 For More Information: Asociacion Triangulo Rosa Apartado 1619-4050 Alajuela, Costa Rica Tel.506-223-1370 or 506-234-2411 (English) Fax 506-223-3964 e-mail: rastern@sol.racsa.co.cr=20 Roche in Costa Rica Dr. Max Bucher Productos Roche S.A. P.O. Box 3438 San Jos=E9 1000 =20 Telephone ++506-220 42 43 Fax ++506-220 42 01 > >................................................................. >. Postings: HIV-Law@Web-Depot.COM . >. Anonymous Postings: Anonymous-HIV-Law@Web-Depot.COM . >. Subscription Requests: HIV-Law-Approval@Web-Depot.COM . >. Questions: Owner-HIV-Law@Web-Depot.COM . >................................................................. > >