Subject: Re: AIDS MEDS IN COSTA RICA
From: [email-masked]
Date: Wed, 26 Mar 1997 13:07:50 -0600 (CST)

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: [email-masked]=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

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