Diary Prequel Package — page 103

give the FDA a chance to show that they could give an expedited review. We were asking for clinical data that Medicines Sans Frontiers already has and has published, plus biochemical equivalency and pharmacokinetic data and plant inspection, all of which are real easy to get. However, no generic company has thus submitted applications. They say that they do not have to since WHO has prequalified them. The real reason is that they are afraid that the FDA will actually find that the product may not be good. I think the product likely is fine, but the mistrust on the part of the rest of the world for FDA and the USA is palpable. This likely relates to the situation in Iraq. The other source of contention is the situation of Global Fund versus PEPFAR. I took great issue with the incredibly inappropriate public statement by Kofi Annan about the lack of USA Leadership in Global AIDS (Kofi, did you forget your leadership on the Rwanda genocide??). I tactfully blasted him and this concept on BBC radio and TV and CNN. I was quite discouraged by this Conference. The science was irrelevant although my Special Lecture on HIV Pathogenesis went very well and was extremely well-received. A major issue is that the USA is doing some stupid things like allowing the restriction of numbers of scientists at the meeting and by having the far-right people act like they are representing the USA. However, this time, the activists and the international community are even worse. They are totally misinformed about what is really going on, but they are louder than ever. This in turn feeds the far-right and it becomes a vicious cycle. The following is a Washington Post article that summarizes the situation very well: Subject: [HEALTHGAP] WashPost: AIDS Activists Misfiring AIDS Activists Misfiring By Sebastian Mallaby Monday, July 19, 2004; Page A17 In the past few years, global AIDS activists have worked miracles. They have shaken rich governments awake, causing international AIDS funding to rise 15-fold. They have beaten back big pharma's jihad against cheap, non-brand medicines, creating an opportunity to treat millions of people in poor countries. But the activists, or at least some of them, are in danger of tipping from heroism into shrill anti-Americanism. The sound bites from last week's AIDS conference in Bangkok were straight out of a Michael Moore movie. Inconveniently for those who enjoy stereotypes, the Bush administration is far and away the leader in the global AIDS fight. This year the United States will spend $2.4 billion on the pandemic, nearly twice as much as all other donor governments combined; attacking the Bush team for indifference to AIDS is like attacking it for inadequate defense spending. But when Randall Tobias, the U.S. global AIDS coordinator, addressed the Bangkok gathering last week, he had to endure 10 minutes of furious heckling before he could get a word in edgewise.