US embassy cable - 04VATICAN1389

UNCLAS  VATICAN 001389 
 
SIPDIS 
 
 
SENSITIVE 
 
DEPT. FOR EUR/WE: LEVIN; EB/TPP/MTA/IPC:WILSON; 
S/GAC:BLACK, DYBUL 
 
E.O. 12958 N/A 
TAGS: PREL, SOCI, TBIO, VT 
SUBJECT: HIV/AIDS: COUNTERING VATICAN MISCONCEPTIONS ON 
MEDICINES AND U.S. EFFORTS 
 
 
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SUMMARY 
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1.(SBU) Ambassador and several U.S. pharmaceutical 
executives met April 2 with the heads of three Holy See 
departments to set the record straight on U.S. policy on 
HIV/AIDS and the actions of U.S. drug companies  to 
facilitate the accessibility of HIV/AIDS medicines.  The 
Embassy developed this initiative in response to statements 
of Vatican and other Catholic officials accusing American 
drug companies of excessive profit-making in the developing 
world, and charging the USG with seeking to protect the 
industry at the expense of HIV/AIDS sufferers in Africa. 
The Ambassador outlined the President's Emergency Plan for 
HIV/AIDS Relief, and emphasized the administration's 
efforts to provide pharmaceuticals that are safe, 
effective, and affordable to those in need of them.  The 
industry reps noted that their companies sold medicines at 
no profit to sub-Saharan African nations and had no desire 
or intention of blocking generic production of drugs under 
their patents in these least developed nations.  They said 
their companies' price of production of anti-retroviral 
medicines had already been reduced to about a dollar per 
day per person.  Generic producers, they added, had yet to 
prove that they could beat these production costs, but they 
hoped they could; i.e., the U.S. companies have no profit 
goals in Africa.  End Summary. 
 
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SETTING THE RECORD STRAIGHT 
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2.(SBU) Recent public criticism by Vatican and other 
Catholic officials of excessive profit taking and 
"genocide" by the U.S. pharmaceutical industry led the 
Ambassador to arrange a face-to-face meeting between senior 
representatives of the U.S. pharmaceutical industry and 
three Holy See departments.  The meeting also offered the 
opportunity for Post to focus the Vatican on the 
President's Emergency Action Plan for HIV/AIDS.  The April 
2 meeting brought together Cardinal Alfonso Lopez-Trujillo 
of the Pontifical Council for the Family, Cardinal Javier 
Lozano-Barragan of the Council for Health Care Issues, and 
Archbishop Paul Cordes, President of the Pontifical Council 
"Cor Unum," the Vatican's development agency.  Several 
staff also attended from each of the departments, all of 
which deal with HIV/AIDS in some way as part of the 
Catholic Church's extensive efforts to deal with the global 
impact of the disease.  U.S. pharmaceutical reps included 
Dick Thompson, Mark Speaker and Lamberto Andreotti from 
Bristol-Myers Squibb (BMS), and Brian Healy and Susan 
Crowley from Merck and Co., all top executives in the 
industry. 
 
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President's Emergency Plan 
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3.(SBU) The Ambassador began the session by emphasizing 
the scope of the President's $15 billion Emergency Plan for 
HIV/AIDS Relief.  He noted that in just over two months 
since Congress appropriated funds for the initiative, the 
Emergency Plan had delivered more than $350 million to 
implementing partners who are fighting HIV/AIDS.  He also 
pointed out to the Holy See officials that U.S. 
contributions to HIV/AIDS relief in 2004 would be 
approximately twice those of all other donor governments 
combined. 
 
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USG Committed to Safe, Effective, Affordable Drugs 
--------------------------------------------- ----- 
 
4.  (SBU) On the question of generics, the Embassy and 
industry representatives sought to counter the recent 
misleading reports in the Catholic and secular press that 
the U.S. was seeking to block the production of affordable 
generic medicines to protect its drug industry.  The 
Ambassador said the USG was committed to providing 
pharmaceuticals that are safe, effective, and affordable to 
those in need of them.  We noted that the USG had moved 
ahead at the March Gabarone meeting to develop principles 
for evaluating the quality, safety, and efficacy of generic 
fixed-dose-combination drugs. 
 
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U.S. Companies Focused on Help for Africa 
----------------------------------------- 
 
 
5.  (SBU) The pharmaceutical industry representatives 
stressed that they were already offering anti-retroviral 
drugs to sub-Saharan African nations at no profit, meeting 
only the cost of production.  With the substantial costs 
associated with developing new medicines, this was no small 
gesture, they noted.  The reps insisted, contrary to Holy 
See assertions, that U.S. companies were not seeking profit 
in Africa; in fact, they said, it would be easier for them 
to ignore the developing world altogether and focus on the 
West where there was a normal profit margin.  Instead, by 
offering drugs at the cost of production and with the 
introduction of several charitable programs, the companies 
had made Africa a priority. 
 
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Prices and Generics 
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6. (SBU) The Merck and BMS representatives further 
explained that they were not seeking to protect what few 
patents existed in the least developed nations.  If 
producers of generic medicine wanted to manufacture 
HIV/AIDS medicines under patent by these companies for sub- 
Saharan Africa, the U.S. reps said they would not stand in 
the way.  But, they said, even the generic companies have 
yet to prove that they can produce these drugs below the 
production cost of around a dollar per day per person  a 
cost that does not account for the substantial costs the 
U.S. companies invest in developing new drugs.   Cardinal 
Barragan noted that even the cost of $365 per year for 
these drugs was unaffordable for most sufferers in the 
least developed countries.  Merck's Healy agreed and said 
that was why the Global Fund and the President's Emergency 
Action Plan played such a crucial role in purchasing and 
delivering the medicines to those who need them. 
 
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COMMENT 
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7. (SBU) Comments from Vatican officials often make 
headlines worldwide and can affect public perceptions in 
many countries.  The Catholic Church and affiliated 
agencies provide care for 27 percent of HIV/AIDS sufferers 
worldwide, so comments from the Holy See on the subject 
carry significant weight.  Given this involvement, Embassy 
believed it essential to set the record straight on U.S. 
efforts - public and private - to meet this humanitarian 
challenge.  Of course, conspiracy theories and suspicions 
of profit motives die hard; for this reason the Ambassador 
is sending a follow-up letter to Vatican participants 
reemphasizing the key points conveyed (text to be faxed to 
EUR/WE).  The industry reps and Holy See officials 
s 
discussed possible follow-on collaboration in the 
distribution of medicines, perhaps using the infrastructure 
available in some African countries through churches and 
bishops' conferences.  Though not all of the naysayers will 
ever be convinced of the U.S.'s efficacy and altruism, the 
ongoing dialogue arising from this meeting should 
contribute to a more balanced understanding of the issue 
and a greater appreciation for U.S. leadership in 
addressing the HIV/AIDS challenge. 
 
NICHOLSON 
 
 
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 2004VATICA01389 - Classification: UNCLASSIFIED