AFRO-NETS> Kaiser Daily HIV/AIDS Report - Thu, 13 Sep 2001

[Cecilia Snyder <csnyder@ccmc.org>]

Kaiser Daily HIV/AIDS Report - Thu, 13 Sep 2001 
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*Newsweek Examines South African Makeshift Funeral Industry
  Global Challenges
*Doctors Without Borders and Brazil Sign Letter of Intent to Export 
  Brazil's Anti-AIDS Model, Generic Drugs

Newsweek Examines South African Makeshift Funeral Industry

Rising death rates in South Africa due to HIV/AIDS have led to the 
creation of a makeshift funeral industry, Newsweek reports. Many 
"fly-by-night undertakers", who are unlicensed and operate out of 
storefronts, compete to make funeral arrangements and leave bodies to 
decompose while they search for the cheapest means of disposal, cre-
ating a health hazard and raising costs to the government. The prob-
lem is greatest in Durban, capital of the hard-hit KwaZulu-Natal 
province. Morgues and cemeteries have run out of room and the unli-
censed undertakers are "tempted to cut corners by mishandling bodies" 
-- burying them in mass graves or abandoning them in mortuaries. The 
government has not regulated the new undertakers, who are mainly 
black, because they were "previously disadvantaged," but established 
funeral directors, mostly white and Indian, complain that the new un-
dertakers should be subject to the same regulations. The newcomers 
said they are "simply" subcontractors for licensed morticians -- they 
sell coffins and transport the body for burial while a licensed mor-
tician washes, dresses and stores the body. Sometimes licensed morti-
cians "front" for the newcomers by picking up bodies at morgues for a 
fee, a violation of health regulations.  

Problem Will Get Worse

This corpse "shell game" often results in bodies being moved several 
times or left to decompose. As AIDS deaths rise, the problem will 
only worsen, Newsweek reports. Currently, AIDS-related deaths account 
for nearly a third of the country's 500 daily deaths and 40% of the 
deaths in KwaZulu-Natal, and deaths in South Africa could reach 
16,000 a day by 2005, according to insurance experts. But talk of the 
rising death rate is "all but taboo" among government officials, who 
"taking their cue" from President Thabo Mbeki "barely acknowledge the 
extent" of the HIV/AIDS epidemic or the rising death toll. Because of 
the stigma surrounding HIV/AIDS, many families do not claim bodies, 
leaving the government to dispose of them at a cost of $150 each. The 
government has rejected the idea of cremating the bodies because Af-
rican tradition stipulates that a person cannot enter the spirit 
world if his or her body is not buried intact (Masland, Newsweek, 
9/17).  

Drug Access

Doctors Without Borders and Brazil Sign Letter of Intent to Export 
Brazil's Anti-AIDS Model, Generic Drugs

Doctors Without Borders President Bernard Pecoul and Brazilian Health 
Minister Jose Serra yesterday signed a letter of intent stating that 
the not-for-profit group would work with Brazil to export the coun-
try's successful anti-AIDS model and its state-produced generic anti-
AIDS drugs to other developing countries, Reuters/New York Times re-
ports. Despite having 210,000 AIDS cases, Brazil has limited HIV in-
fection to less than 1% of the population through an "aggressive" 
prevention program, which also provides free AIDS medications to all 
HIV-positive citizens. The government produces eight of 12 patented 
antiretroviral drugs generically at the state-owned factory, Far-
Manguinhos, over the objections of many pharmaceutical companies.  
Doctors Without Borders intends not only to export the prevention 
model and Brazilian-produced generic drugs but also to teach other 
developing nations how to set up their own generic drug factories. 
"One of the aspects is exporting the drugs, but it's also to imple-
ment training, production of generics and help with distribution lo-
gistics," Pecoul said, adding that nations such as Argentina have the 
resources to develop their own programs, while other countries in Af-
rica and Central America may have to "pool resources" to start re-
gional programs. The group will also purchase drugs from Brazil for 
its own programs, but Pecoul "emphasized" that it was not a "commer-
cial operation" (Reuters/New York Times, 9/13).

  Kenyan Government Lacks Money for Antiretrovirals Even After Passage 
of Drug Importation Bill

The Kenyan government announced yesterday that it does not have 
enough money to purchase antiretroviral drugs, even though the Kenyan 
Parliament recently passed legislation allowing the nation to import 
and manufacture cheaper generic drugs, East African Standard/BBC 
Monitoring reports (East African Standard/BBC Monitoring, 9/13). The 
Kenyan Parliament in June passed the Industrial Properties Bill 2001, 
which allows Kenya to "suspend drug patent rights" in a national 
health emergency to import into or produce within the country less 
expensive generic medicines. The bill stipulates that Kenya give drug 
makers six months' notice before licensing other companies to import 
or produce generic versions of patented drugs (Kaiser Daily HIV/AIDS 
Report, 6/13). Dr. Richard Muga, director of the Kenyan Department of 
Medical Services, said that the government hopes to receive money for 
AIDS drugs from the U.N. Global AIDS and Health Fund. The East Afri-
can Standard/BBC Monitoring reports that the government's statements 
yesterday "dealt a big blow to people living with AIDS who had hoped 
that the passing of the bill would make drugs more accessible" (East 
African Standard/BBC Monitoring, 9/13).

The Kaiser Daily HIV/AIDS Report is published for kaisernetwork.org,
a free service of The Henry J. Kaiser Family Foundation, by National
Journal Group Inc. , 2001 by National Journal Group Inc. and Kaiser
Family Foundation. All rights reserved. 

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