Viewpoint: What can we learn from the Bush Administration’s effort against AIDS as we battle COVID in developing countries?

A child at Nkosi's Village, an NGO in South Africa, holds his antiretroviral pills. Credit: Siphiwe Sibeko/Reuters
A child at Nkosi's Village, an NGO in South Africa, holds his antiretroviral pills. Credit: Siphiwe Sibeko/Reuters

In 2004 [AIDS] was burning across Africa. Treatments were available but expensive, and everyone wanted to expand Africa’s access to them. Drug-industry critics on Capitol Hill pressed President Bush to solve the problem by breaking Western manufacturers’ patents. He said no and came up with a better plan.

Editor’s note: Scott Gottlieb was commissioner of the Food and Drug Administration from 2017-2019.

At the time, I worked at the Food and Drug Administration. Generic-drug makers, mostly in India, promised cheap versions of AIDS drugs, but there was reason to worry about their quality. My colleagues and I thought that patients in Africa deserved the same first-rate treatments Americans got.

The drug industry worked with the government to develop their AIDS medicines into cheaper combination pills. The FDA put these products through a process for “tentative” FDA approval without the expense of full-blown clinical trials. The U.S. government purchased these pills in bulk and distributed them widely in Africa. 

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President Biden now faces a similar moment of peril and opportunity. America needs to help combat Covid-19 in low- and middle-income countries. The White House is under pressure to suspend patent protections for vaccines so foreign firms can start producing them.

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The U.S. government can put additional resources behind the immediate development of more manufacturing capability, building facilities to make the starting materials and buying more of the specialized mixing machines.

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