Globalization, Pharmaceutical Pricing, and South African Health Policy: Managing Confrontation with U.S. Firms and Politicians

Abstract

Brewing since the advent of South African democracy in 1994 and promises of health sector transformation, an extraordinary drug war between President Nelson Mandela's African National Congress government and U.S. pharmaceutical manufacturers took on global proportions in 1998-1999. Within months of the passage of South African legislation aimed at lowering drug prices, the U.S. government quickly applied powerful pressure points to repeal a clause allowing potential importation of generic substitutes and imposition of compulsory licensing. At stake were not only local interpretations of patent law and World Trade Organization rules on Trade in Intellectual Property, but international power relations between developing countries and the pharmaceutical industry. In reviewing the ongoing debate, this article considers post-apartheid public health policy, U.S. government pressure to change the law, and pharmaceutical industry interests and links to the U.S. government, and evaluates various kinds of resistance to U.S. corporate and government behavior. The case thus raises--not for the first time--concerns about contemporary imperialism ("globalization"), the role of the profit motive as an incentive in vital pharmaceutical products, and indeed the depth of "democracy" in a country where high-bidding international drug firms have sufficient clout to embarrass Vice President Al Gore by pitting him against the life-and-death interests of millions of consumers of essential drugs in South Africa and other developing countries.

Compulsory License in Biodiversity Based Patent: Public Health Concern and Benefit Sharing for Developing Countries

“…The provision of compulsory license is a crucial element in public health-related patent law, but the use of such license has been generally opposed by the research-based pharmaceutical industry (Bond, 1999) on the ground that they discourage investment, research and development.(Scherer,F.M. (1998).…”

Southern Africa's response(s) to international HIV/AIDS norms: the politics of assimilation

“…In addition, the above mentioned "Donor Matrix" does not provide a reliable guide to donor spending in the country given that it is based on donor commitments over many years instead of the actual allocation and disimbursement of money.184 This lack of control allows that international donors explore loopholes in the system and directly reach local governments and NGOs without any interference from the central government. patented drugs (Bond, 1999 (Bond, 1999). Furthermore, during Apartheid, some views within ANC political ranks implied a direct link between biological weapons research programmes in the United States and its NATO allies and the spread of HIV/AIDS (Mzala, 1988).…”

Campaigning for life: building a new transnational solidarity in the face of HIV/AIDS and TRIPS

“…South Africa's attempt to improve access to essential medicines by creating a more competitive market by considering parallel importation and even compulsory licensing soon attracted the attention of the international pharmaceutical industry and the US government in particular (see Bond 1999). In fact, the US government was active in the debate from very early on, with the United States Trade Representative (USTR) writing a letter to South Africa's United Nations representative in April 1997 querying South Africa's implementation of TRIPS and raising questions about compulsory licensing.…”