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Chirac calls for global tax to fight AIDS

Reuters | January 27 2005

DAVOS, Switzerland (Reuters) — French President Jacques Chirac called for a tax to finance the global fight against AIDS on Wednesday, as new figures showed a modest rise in the number of patients receiving life-saving drugs in poor nations.

The experimental tax, which could be raised on international financial transactions, could generate $10 billion a year, Chirac told the World Economic Forum.

His appeal for a radical rethinking of AIDS financing comes at a time when the roll-out of antiretroviral therapy (ARV) in the developing world is finally gathering momentum.

The number of people receiving treatment in poor countries has jumped 75% in the past year, U.N. agencies said. ARVs are getting to 700,000 patients, up from 440,000 six months ago, meeting the World Health Organization's interim target.

But the figure only amounts to 12% of the 5.8 million people who officials estimate will die in developing countries if they do not receive medicine within two years.

More money — $2 billion — is needed in 2005 alone to hit the target of getting medicines to 3 million by the end of the year.

"I propose today moving forward through the creation, in an experimental way, of a levy to finance the fight against AIDS," Chirac told delegates in Davos in a speech delivered by video link.

Chirac said the tax could be imposed on a fraction of all financial transactions without hampering markets, but it could also be raised by taxing fuel for air and sea transport, or by levying $1 on every airline ticket sold in the world.

His ideas are likely to meet strong opposition from the United States and most other rich nations, as well as financial markets and airlines, but will be popular with anti-globalization campaigners and AIDS awareness groups.

Chirac said the money raised would be used not only to make medicines available to far more sufferers but also to finance research into a vaccine and develop prevention campaigns.

Richard Feachem, executive director of the Global Fund to Fight AIDS, TB and Malaria, welcomed his idea which he said could help move the treatment of AIDS in the developing world to a new level after a "strong but modest start".

"It is by far the biggest challenge humankind has ever taken on," he told reporters.

Four years ago, the idea of treating people in the developing world with sophisticated ARVs costing $10,000 a year — which must be taken for life under close medical supervision — was widely viewed as impossible.

Since then, however, the cost has tumbled more than 90%, as Western pharmaceutical companies, responding to intense pressure, have slashed prices, while Indian, Brazilian and Thai generic firms introduced cheap copycats versions.

Peter Piot, head of UNAIDS, the United Nations lead agency on HIV/AIDS, said the global response to AIDS is entering a new era of action rather than talking.

Barriers remain, however. Aside from the extra cash needed, the Progress Report on the U.N. initiative known as "Three by Five" highlighted other key bottlenecks.

These include the high cost of second-line ARV treatment, needed when patients develop drug resistance, and the price of diagnostic tests. There is also a lack of affordable formulations of ARVs for children.

Overall, the price of ARVs averages at least $300 a person a year, according to U.N. agencies, which are seeking a price of $50-$200 by end-2005.

About 38 million people worldwide, including 25 million in sub-Saharan Africa, are living with HIV/AIDS.

Lee Jong-Wook, director-general of the World Health Organization, said the number of people receiving treatment in Africa had doubled in the past six months and Uganda, Botswana and Namibia now have 25% coverage.

The biggest laggards were South Africa, India and Nigeria, he added. The three countries account for 41% of the overall "unmet need" of 5.1 million adults

Patients receive drugs through national programs, aid agencies, the private sector, the Global Fund, the U.S. President's Emergency Plan for AIDS relief, the World Bank and other partners.

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