I hadn’t read the other story associated with the piece which follows a family with my surname (no relation) who were unscrupulously given home loans by a company in which the Gates Foundation has invested. While the selective use of these heartwrenching anecdotes may not say much about the broader patterns of Gates investments, the second article notes that the only companies the Gates’ folks don’t invest in are tobacco companies. Given the scale of their holdings, it may make sense for them to at least think about a broader screen or at least more active use of their proxy votes in company board meetings. That said, I’m still on board with what I said in my last post, the articles have a pretty anti-business feel and seem to have an agenda to go after the Gates Foundation.
(hat tip: the folks at THD).

Ruth Levine of the Center for Global Development, which just received $10mn in funding from the Gates Foundation, asked this rhetorical question in support of more social screening on the part of the Gates Foundation:

Is it too much to expect that foundations, which exist to promote public well-being, would think as carefully about the impact of their investments as they do about their gifts?

I think that’s probably fair, particularly since the Gates Foundation’s footprint and influence in the broader philanthropic sector is so large, but I stand by take on the actual reporting. I also wonder what the LA TIMES writers expect the Gates Foundation to do. Yank all their offending investments, no matter how tenuous a firm’s ties are to some egregious act by one of its factories, subsidiaries or investments. Some of those few companies investing in Africa may be doing a lot of net good. As one of the poster’s on the CGD blog said:

It is not clear to me that the Gates Foundation would be creating the most social good by screening their investments and removing all companies that produce social harm (i.e. polluters). In fact, there may be a better role for them as leaders in proxy voting and/or proposing shareholder resolutions to effect change in company behavior. History has strongly suggested that even relatively small minority support for shareholder resolutions (2%-10% of all voting shares) can greatly impact a company’s behavior.

Fifthly, corruption – much spoken about, very difficult. If you’re in the business of fighting AIDS, TB and malaria, you’re in a high risk business because you are financing work in some of the most systemically corrupt countries in the world. I think the Global Fund has set up systems to detect misuse of funds which are good and which are working and I think the Global Fund also is fortunate to have a very, a very strong ability to act quickly and strongly on any evidence of corruption and this comes from our legal status. We are not part of the United Nations therefore we’re not owned by member states. We are not a bilateral organization subject to the political relationships between Country A and Country B which can sometimes override tough decisions about corruption. We are a Swiss foundation.

I like to tell the story when we terminated to – we suspended to Ukraine just before the Ukrainian elections a few years ago on corruption grounds and the then-president of Ukraine called Kofi Annan and said “You’ve got to stop **** from doing this. He’s embarrassing me terribly. You’ve got to talk to him,” and Kofi Annan said, “You talk to him. He doesn’t work for me.”

He also talked about the importance of renewing PEPFAR when it expires in 2008.

The PEPFAR and the Global Fund together will have probably 2.4 million people on anti- retroviral therapy by the end of 2007. That is anti-retroviral therapy until death. That is the kind of promise between the wealthy nations and the poorer nations that we’ve never entered into before. If the money stops the drugs stop and people are dead within weeks. If the money fluctuates the drugs fluctuate and resistance is greatly fueled by the virus to the drugs, in the virus to the drugs.

Clearly, 3 by 5 was more of a “political declaration and an act of faith than a systematic programme of work” (60) and as such, it was “ambitious, weakly conceived … with insufficient structure against which results could be measured.” This made performance monitoring and resource planning difficult (60) but 3 by 5 also incorporated significant risks which would be borne by those it purported to help.

This is likely to be a very important set of reports that will get more play. Fortunately, it appears that neither PEPFAR nor the Global Fund were really interested in supporting the WHO on this effort and wisely stayed away. It is sort of sad, given that the WHO has 8,000 staff who are supposed to be the experts on health. Yet, given what happened with the WHO’s AIDS efforts in the 1990s and the way its program was systematically gutted (all documented in Greg Behrman’s book), it’s not surprising that it botched the effort when it tried to get back in the game in the past few years. The WHO comes out smelling really bad out of all this, but Bate and Mooney also in their conclusions go after the UN since the WHO is a specialized agency of the UN. I wonder if they just have an axe to grind with the UN.

I think this thread of the story should be something to watch. Margaret Chan, the new head of the WHO, is likely to have her hands full, and this may be the tip of the iceberg for the glow to come off of AIDS initiatives in the coming years. Now, we’re in the business of success and failure where the stakes are high. Bate and Mooney talk about the issue of drug resistance, and this could be a very serious problem if the 3 by 5 is ultimately implicated in less than stellar ARV treatment programs.

MUMBAI, Nov. 30 — The cost of treating children infected with H.I.V. and AIDS is poised to plummet next year, under a deal announced today between two Indian drugmakers and former President Bill Clinton’s foundation.

Cipla and Ranbaxy Laboratories agreed to make 19 different anti-retroviral drugs designed for children available to 62 developing countries at an average price of $60 a year, which is less than half of the lowest current price, the Clinton Foundation said in a statement. Because not everyone has access to the lowest current price, the plan will actually translate into a four- to six-fold cost reduction for many children, said Stephen Lewis, the United Nations special envoy for H.I.V. and AIDS in Africa.

A $35 million grant from Unitaid, a drug-buying consortium formed in September by France, Brazil, Chile, Norway and the United Kingdom, will be combined with $15 million from the Clinton Foundation to assure the Indian drugmakers a volume of sales high enough to justify the lower prices.

However, there is a worry that the ability for generic firms to make these kinds of contributions may slow as India firms up its intellectual property rights laws:

Indian drug companies were able to produce the special pediatric drugs because they mixed together a customized combination of chemicals invented by Western companies but never patented under India’s once-lax intellectual-property protections. Yet India has recently changed its patent rules, under its World Trade Organization commitments, so as to protect Western innovations.

Thailand, however, has announced it is breaking a patent on an expensive second-line ARV drug (Efavirenz apparently isn’t a second-line drug but a first line drug that replaces nevirapine because of its side effects) because it is encountering drug resistance. Stay tuned. The Center for Global Development has also posted on this, suggesting the Thai government’s action may embolden others.

Health officials in Thailand announced on Wednesday that they would break a patent on the AIDS drug Efavirenz and make generic copies.

Efavirenz is a second-line AIDS treatment, made for those immune to the first generation of AIDS drugs, and it is substantially more expensive than first-line drugs.

]]> http://blogs.law.harvard.edu/politicshiv/2006/11/30/clinton-foundation-brokers-deal-to-lower-drug-prices-for-tots/feed/ 0 http://creativecommons.org/licenses/by-sa/3.0/ http://blogs.law.harvard.edu/politicshiv/2006/01/19/aids-as-a-focus-of-diplomacy/ http://blogs.law.harvard.edu/politicshiv/2006/01/19/aids-as-a-focus-of-diplomacy/#comments Thu, 19 Jan 2006 16:31:18 +0000 Nate http://blogs.law.harvard.edu/politicshiv/2006/01/19/aids-as-a-focus-of-diplomacy/

Secretary Rice unveiled significant changes in int’l HIV policy personnel today:

Separately, today Rice plans to unveil a restructuring of U.S. foreign assistance, including announcing the nomination of Randall L. Tobias as the new administrator of the U.S. Agency for International Development. Officials said Rice plans to elevate the USAID post, giving Tobias — a former Eli Lilly chief executive who now heads the administration’s global AIDS relief program — an office and a planning staff in the State Department. Rice will designate Tobias as having a rank equivalent of deputy secretary of state.

Although the move stops short of merging USAID with State, it is intended to draw the agency closer into the department’s fold, the officials said. Additionally, the new director will be given broader authority over a range of foreign assistance accounts now managed by separate entities. “Effectively, this will allow a single person to have visibility into these various accounts,” a State official said.

Seems to me that this indicates a further shift of international policy toward HIV efforts. Say what you want about the Bush administration (and there’s plenty to say), but it’s still doing more than any previous administration with regard to HIV. It could stand to do much more, but the tendency does seem to generally be toward more rather than fewer resources.

]]> http://blogs.law.harvard.edu/politicshiv/2006/01/19/aids-as-a-focus-of-diplomacy/feed/ 0 http://creativecommons.org/licenses/by-sa/3.0/ http://blogs.law.harvard.edu/politicshiv/2006/01/05/christian-activists-for-aids/ http://blogs.law.harvard.edu/politicshiv/2006/01/05/christian-activists-for-aids/#comments Thu, 05 Jan 2006 23:29:45 +0000 Ben http://blogs.law.harvard.edu/politicshiv/2006/01/05/christian-activists-for-aids/ Campus activism is being redefined. As discussed in Burkhalter’s 2004 Foreign Affairs piece, “The Politics of AIDS: Engaging Conservative Activists“, a conservative response to the global pandemic is rapidly taking shape. Students wearing orange t-shirts emblazoned with white O-R-P-H-A-N across the front are becoming more frequent sights on campuses better known for their religious instruction of the young faithful. Worldvision coordinates Acting on AIDS (AoA) as a student mobilization at often small religious American colleges and universities. The work appears loosely coordinated with the ONE Campaign. Young participants may take part in prayer vigils, AIDS awareness rallies, film screenings and t-shirt design contests. What it all means for the orphans of deceased AIDS patients remains to be seen.

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