Sunday, August 28, 2016

HIV, counterfeit medicines and the Clinton Foundation

did the Clinton's highly praised program to fund HIV treatment by using counterfeit medicine which was cheaper?

The counterfeit/inferior drug problem, mainly from China and India, probably kills more people than heroin.

I just listened to a C2C program (I listen to it via internet radio in the afternoon but it is here on youtube)

 where the Clinton Foundation was accused of using inferior and cheaper generic medicines for HIV patients in Africa that didn't work. The source of the medicine was from India.

Right wing site WND has the story. read the whole story for the links if you don't believe their reporting

Ira Magaziner, the chief executive officer and vice chairman of the Clinton Health Aids Initiative, known as CHAI, approached the Indian company, Ranbaxy, in 2002 to negotiate a deal. It allowed CHAI to assume a controlling position to administer the airline-ticket levy program through UNITAID, a program of the U.N.’s World Health Organization in Geneva. CHAI proposed to Ranbaxy that “they could put the developing countries together to form a sort of ‘buying club’ that could “ramp up economies of scale and lower cost,” according to Professors Ethan B. Kapstein of Arizona State University and Joshua W. Busby of the University of Texas at Austin in their Cambridge University Press 2013 book “AIDS Drugs for All.” ....
 A Kaiser Health News “Morning Briefing” dated Nov. 21, 2003, reported former President Bill Clinton “visited Indian generic drug Ranbaxy Laboratories’ pharmaceutical plant in Gurgaon, India, to show support for Indian companies that have agreed to manufacture low-cost generic antiretroviral drugs for nationwide HIV/AIDS treatment plans in four African and more than 12 Caribbean countries.” 

So getting cheaper generics so you can buy more medicine and treat more people. What could go wrong?

BMJ article on the problem of substandard medicines lists a lot of things that can go wrong.

Uh, just ask anyone who lives outside the elite bubble in third world countries: A lot of the cheap stuff (not just medicine) is shoddy, poorly made, or doesn't work very well.

Ironically, a couple years ago, the "Green" type anti big pharm types were blasting major drug companies for overpricing these drugs, insisting that the HIV programs should buy cheaper generics, either made locally or generics, as was done here.

The Clinton founation website brags:

When the Clinton Health Access Initiative (CHAI) was founded in 2002, only 200,000 people were receiving treatment for HIV/AIDS in low and middle income countries, with medicines that cost over $10,000 per person per year. Over a decade later, more than eight million people are receiving treatment and CHAI has helped reduce the cost of medicines to around $100 to $200 per person per year in many countries. Countries have repeatedly proven that it is possible to rapidly scale up treatment services. For the first time, there is real promise that we can turn the tide against HIV/AIDS.

The Atlantic pushes this meme saying they "made a deal" with the companies and the high price was the middle men making lots of profit.

2006 The NYTimes article said Clinton was playing catch up on the issue of HIV in Africa and again is full of praise

But: Uh Oh: US Justice dept report: the Indian company Ranbaxy got a 350 million dollar fine for their fraud. 2013

They were faking a lot of their data in quality control.

The conservative think tank AEI report on the problem here. A lot of it is about Ranbaxy being licensed to sell the cholesterol lowering medicine Lipetor, in the US. But the report includes this snippet:

It was surprising that the FDA was prepared to overlook Ranbaxy’s drug quality problems. In 2005, whistleblowers from Ranbaxy alerted the FDA that members of Ranbaxy’s staff were deliberately cutting corners in producing HIV medication to be bought with US taxpayer funds. The FDA and US Department of Justice identified two questionable Ranbaxy plants and 30 suspect medications, yet only restricted their US-bound sales in 2010. 

Fortune magazine on the Great Valentine's day raid on the company and an expose on the company. 2013

in Gurgaon, as Thakur’s project managers gathered data and interviewed company scientists and executives, he says, they stumbled onto Ranbaxy’s open secret: The company manipulated almost every aspect of its manufacturing process to quickly produce impressive-looking data that would bolster its bottom line.
“This was not something that was concealed,” Thakur says. It was “common knowledge among senior managers of the company, heads of research and development, people responsible for formulation to the clinical people.”

India Times story on how their companies make drugs cheap (patent infringement is admitted in the article)

NIH report 2015 on the danger of counterfeit medicine
Poor quality medicines are a real and urgent threat that could undermine decades of successful efforts to combat HIV/AIDS, malaria and tuberculosis, according to the editors of a collection of journal articles published today. Scientists report up to 41 percent of specimens failed to meet quality standards in global studies of about 17,000 drug samples. Among the collection is an article describing the discovery of falsified and substandard malaria drugs that caused an estimated 122,350 deaths in African children in 2013. Other studies identified poor quality antibiotics, which may harm health and increase antimicrobial resistance. 
full report HERE.

the problem is worse, because substandard drugs (i.e. where the medicine is in the pill, but either is in too low a dose or in a form that the body can't absorb) increases the mutation of antibiotic/ anti malaria resistance.

The Zimbabwe Herald notes that drug resistance to HIV is becoming more common, and attributes that to poor compliance in taking medicine.

more about their program HERE. which is run by USAID PEPFAR and the UN. No mention of the Clintons.

Ironically, it notes that often the blood levels of the drugs are higher in Africans (probably due to lack of body fat or because the liver metabolism is slower) Presumably that fact comes from a single study in Malawi. but it would mean that mildly substandard medicine might work.

AHO report: various studies mention: one, in 2005, the HIV medicine problem was tiny 2%  in comparison to 10 to 37 percent in Malaria medicine.

But you know, there are very few articles about African patients and their response to treatment.

Australian reporter MichaelSmith has a long article about the HIV medicine problem.
including the Clinton Foundation using HIV meds from Ranbaxy for people in Papua New Guinea.

This article lists Australian taxpayer money going to the foundation, and notes a small problem: Bill Clinton signed a lot of papers when he was not officially head of the Clinton Foundation and did not have the legal standing to do this.... and notes other irregularities having to do with money.

Australia gave 70 million dollars.

His sidebar also has lots of links about fraud on his sidebar, including Clinton fraud for a hospital that never was in Papua New Guinea.

and the most WTF article on the money trail:

Trump and family donated 100 thousand to the Clintons (2015).

finally, no discussion of HIV in Africa could be complete without noting a lot of quackery is out there

when HIV epidemic started, a lot of people went to native healers because one: western medicine didn't help and two: the symptoms of HIV (getting thinner and thinner) was a known symptom of witchcraft associated illness (no quite superstition: Think Slow poison by an enemy).

But with Presidentw  Bush's program, hope arrived. Not much in the US press about this because of their political bias of course.

but this might be behind the Clinton's wish to be seen as do gooders: Envy.

Whatever. I don't care if they do it for the wrong reasons, my question is if the money is actually going to the ones it is supposed to help.

And no, I don't give to many charities: But I do send school fees to a friend in Zimabwe for her nephews and nieces who were made fatherless by HIV before anyone was aware of the problem.

not well organized but I started posting this to my other blog and it sort of grew..

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