NGOs will meet June 11 to address profiteering on drugs used in Cambodia to treat
AIDS.
Farah Naureen of Pharmaciens Sans Frontieres said that anti-retroviral drugs (ARVs),
which are used in treating AIDS patients, are being sold at inflated prices in Phnom
Penh's pharmacies and markets.
She gave the example of one ARV which is being produced cheaply by the Thai government.
That country's Government Pharmaceutical Office (GPO) made its generic ARV available
to Thai sufferers for $27 a month, but the same drug costs as much as $200 in Phnom
Penh.
The Post found that several pharmacies near the Olympic Market and at the Juliana
Hotel sell the GPO drug for $60 a month, more than double the Thai rate. Those figures
come in a country that has the worst AIDS rate in Asia, and where per capita GDP
is just one-eighth that of Thailand's.
It is a similar tale with Indian company Cipla's generic ARV. Boxes labeled with
the instruction 'not to be sold for more than 215 rupees [per sheet of ten]', around
$26 a box, cost $90 in city pharmacies.
Naureen said a working group consisting of Médecins Sans Frontieres, the Khmer
HIV/AIDS Alliance, and other local and international NGOs would discuss various options
including importing the drug directly from Thailand.
Minister for Women's Affairs Mu Sochua said that HIV legislation being debated in
the National Assembly could boost the campaign for cheaper ARVs.
"This legislation can streng-then the campaign for anti-retroviral drugs and
awareness. Now the clinics are making a bundle out of it," she said, adding
that the consequences of such high prices were dire.
"I have two relatives who are HIV-positive," Sochua said. "The father
has to pay $150 per month and the daughter $30 per month to a private clinic. Even
I can't maintain this support every month. This is exactly why families get into
debt and sell their land, and their children are sold into prostitution, because
services are not free".
Although the legislation before the Assembly doesn't specifically address the issue
of ARVs, it will legislate for equitable access to health care, said Tia Phalla of
the National Aids Authority (NAA). The clause could be used to force down the market
price.
Phalla warned against seeing ARVs as a panacea when much of the population does not
even have access to clean water, but felt the new legislation would prove an important
step in bringing a "multi-sectorial" approach to the epidemic.
With the passage of the Protection and Management of HIV/AIDS legislation expected
by mid-June, Cambodia will become the second country in the world to have passed
an HIV/AIDS law. Pioneering legislation in the Philippines was used as the model.
The law looks set for a slow passage through the National Assembly, however, as lawmakers
became bogged down in early June in a debate over the role of monks in HIV/AIDS education
programs.
Funcinpec's Princess Norodom Vacheara was worried that if monks became involved in
directly teaching about HIV/AIDS, it would affect the honor of Buddhism and undermine
traditional Cambodian morality.
"I want to keep the monks above social issues," she told the Assembly.
"If the monks are not clean in their minds, we may not be able to respect them."
The CPP's Mom Chimhuy, who is chairman of the Assembly's commission on religion and
education, countered that. He argued that it was only through education that Cambodia
could stop the disastrous spread of HIV/AIDS.
"Our Khmer society gives its highest respect to monks, so the monk has an important
role in educating the whole society," he said.
The law will outlaw discrimination on the basis that a person suffers from the disease
in a range of areas including education, housing, health care and running for public
office. It will also introduce criminal penalties in a bid to halt the epidemic's
spread.
"If you know you are infected with HIV you can be prosecuted if you infect another
person. This means a whole lot for protecting rights," Sochua said.
She acknowledged that dissemination and implementation of the law would prove the
biggest hurdles, and questioned the practicality of enforcing the criminal provision.
"If a man who is infected with HIV infects another person, how can you prove
it and gather evidence for a conviction when the judicial system is so questionable?"
Sochua asked. "How can a woman stand up in front of the judge and prosecutor
and say: 'This is who infected me'?"
Hor Bunleng, deputy director of the National Center for HIV/AIDS, said the legislation
was a welcome development in fighting the epidemic. He particularly welcomed the
law's provisions against advertising 'cures' for AIDS, which will require that advertisements
are first approved by the NAA.
"We want to do something for the people who are exploited. Every day local newspapers
[carry claims from] people who say they can cure AIDS," he said.
The legislation looks set to come into force as money from the UN's Global Fund for
HIV/AIDS is prepared for allocation. Cambodia has received $15 million over three
years from the billion-dollar fund.
Bunleng said the cash would be used in a three component prevention and care package.
The funds would be used to target high risk populations, provide care for people
living with HIV/AIDS, and in community based prevention programs.
