Disease Busters

How do you lower prices when they are controlled by profit-driven pharmaceutical companies?
One of the creative arrangements GAVI brings is that the pharmaceutical industry is represented on the GAVI board. The industry has to know that someone is going to buy the drugs. This guarantee gives the industry incentive to produce and produce massively, thus making the vaccines cheaper and affordable to developing countries … In the past, developed countries were not very sensitive to the priorities of developing countries because those diseases didn't exist [in the West] anymore. But we've seen a shift away from this mentality.

Is it difficult to sustain health programs in countries that are prone to corruption or instability?
First we need to avoid generalization, because Africa is 53 countries. And there have been many countries doing extremely well at fighting corruption … It is true that there are countries in turmoil, and it's not only health that suffers but education, water supply, transportation … Everything becomes disrupted. The good news from Africa is that the number of conflict zones today is lower than before. Just look at countries like Sierra Leone, Liberia, the Democratic Republic of Congo … They're all in peace now, which makes the environment for development much more conducive. A good example is the DRC. Although it emerged from conflict only a short time ago, it has reached high rates of vaccine coverage precisely because peace is giving a chance to immunization.

What is the HIV/AIDS situation in South Africa? In October UNICEF said death and infection rates are outpacing treatment, and it estimates there will be 5 million orphans by 2015.
Research data has shown that, among young people, a behavior change has taken place. But only with young people—we have to be specific. South Africa has been increasing the number of people in treatment, but the challenge is that in certain social groups the infection rate is not dropping. More importantly, South Africa is receiving a lot of refugees. There are 3 million people from Zimbabwe now in South Africa, and it has put a lot of pressure on the system. And when it comes to infectious diseases, you have more chances of increasing infections because of the influx. But I know where you want to go, because it was said that President [Thabo] Mbeki denies [a link between HIV and AIDS], but the government has named the deputy president, Phumzile Mlambo-Ngcuka, to lead the AIDS council, which includes not only government departments but also research institutions and NGOs.

How would you rate Mbeki's handling of the HIV/AIDS crisis?
I don't want to discuss that.

What about the rise in food prices and the production problems for farmers? Are initiatives like the African Green Revolution the answer?
The Green Revolution is just beginning, so it's still too soon to see. What I do know is that there is a renewed commitment by African governments, supported by foundations like the Rockefellers and the Gateses, to improve policy, provide better seeds and fertilizer, which will increase not only food production but also yields. Malawi, for instance, suffered a food shortage one year, but with the change in policy and some good rains, the following year they were exporting food to Zimbabwe. Just with that simple change.

© 2008