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Tuesday, 08/26/2008 3:49:02 PM

Tuesday, August 26, 2008 3:49:02 PM

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Dr. Seymour is here in Hawaii, and having a few days between the end of summer classes and the beginning of fall semester I had time to make my way to the part of the state where he is spending the week. Though he is on vacation with his family--you know beach, surfing, biking, eating, umbrella drinks-- he was kind enough to make lunch available for us to meet and small-talk.

One thing he was very excited about and wanted to spend most of the time discussing is NNVC's role in the global community. With HIV/AIDS currently dominating NNVC's news over the recent months, most of that discussion focused on what happens when (!) HIVCide is approved? Considering the current regimen's annual cost to patients is upwards of $35K a year, what might a licensed Big Pharma charge for a more effective cure? Further, the most rampant spread of the virus and disease is in the third world, and mostly Africa, what impact might HIVCide have there? Especially if the licensed drug company decides to continue to charge what it knows first world health care and insurance providers will gladly pay for a more effective and non-toxic drug, upwards of $35K a year. Would NNVC even have any say in the discussion of what a licensed company might charge?

His answers to these questions were actually rather long-winded, and breath taking, whence a 1 hour lunch quickly became 3 hours of rather fascinating discussion, to me, anyway. First, he said he was inclined to allow the licensing company to continue to get those upwards of $35K per year in receipts per patient. *Gasp!* He then elaborated how he might require that pharma to then use those huge funds to provide HIVCide at cost, or even free, to those areas hardest hit by HIV/AIDS. Thus, countries where $35K a year is a lot of money, but not unaffordable, would finance the use of a life (and economy) saving therapy in regions where $35 a year is unaffordable.

Whoa. How is that even fair? What justification can there possibly be for extorting money from critically needed patient care in developed countries to pay for that same patient care in poverty stricken areas? He said he wouldn't use the word "extortion" since it is in the interest of the first world to control the disease in the rest of the world. That was when he started rattling off statistics (Never allow a doctor to start in with statistics. My advice: call the waitress, order another round of drinks, excuse yourself to the restroom, and when you return, change the subject. I didn't do that).

Over 1 million people* (See footnote) in the US are infected with HIV, the success of current treatments mean there is a lower die-off, which is a good thing, but it also has some rather distressing consequences. Some 40K new infections occur each year, so with far fewer people dying of the disease, but still walking around with it, in less than 20 years there will be 2 million walking cases of HIV infection. Consequently, as the number of people infected increases, the likelihood of infection increases (no-brainer); however, the likelihood of mutations and new emergent, resistant strains also increases. This increases the rate of decline in efficacy for any current or new drug that is susceptible to shifts and changes in the virus. Not a good situation for any of us.

That's in America; now the doc started in on Africa and other regions with emerging countries. Worldwide, there are over 40 million people living with HIV/AIDS, and some 75% percent of these people live in sub-Saharan Africa. By 2010, Ethiopia, Nigeria, China, India, and Russia--all totaling 40 percent of the world's population--will add 50 to 75 million infected people to the worldwide pool. If doubling from 1 million to 2 million in less than 20 years will significantly stress our ability to control AIDS in the U.S., what will more than doubling the number of infected people in only 2 years do? Especially, what will it do when the more than doubling takes place in countries representing less than half the world's population? Imagine what that increase in likelihood of mutation will do to long-term drug efficacy.

What is our interest? Our economy (U.S., Canada, Britain, France, Germany, Sweden, Italy, Japan, etc.) is globally linked to those other economies. Our economic health is tied to their economic health and thus tied to their social and physical health. We travel and trade freely, for the moment. It is in our economic, social, cultural and health interest to do what we can to eradicate the disease in those other regions, even if it means paying the cost of that eradication ourselves.

Now, from a purely selfish and materialistic perspective, think in terms of the goodwill generated by a U.S. based corporation flooding those regions with free or nearly free drugs. Think of the positive effect it will have on global opinion. Then think of the positive effect it will have on the corporate images of those companies participating in such an effort. *Gasp!* Breathtaking.


*1 million infected people times $10K per regimen for person, holy crap!




doc.feelgoode@yahoo.com

If you've got the fever; we've got the cure --NNVC

"Beginner's luck, gentlemen...although I have devoted some time to the game."
--WC Fields


doc.feelgoode@yahoo.com

"It ain't what they call you, it's what you answer to." --WC Fields


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