[Letter to numerous pharmaceutical companies from Asia Russell, Mark Harrington, Gregg Gonsalves]

Bayer Bristol-Myers Squibb Eli Lilly & Company GlaxoSmithKline Hoecsht Marion Roussel Janssen-Cilag Pharmaceutica Merck, Sharp, & Dohme Novartis Pharmacia & Upjohn Rhone-Poulenc Rorer Roche Products Schering-Plough Warner-Lambert Wyeth Zeneca, South Africa Boehringer-Ingelheim F. Hoffman-La Roche The Pharmaceutical Manufacturers' Association of South Africa January 29 2001 To the Chief Operating Executives of the aforementioned entities: We the undersigned are HIV/AIDS treatment activists, human rights advocates, women's organizations, and other concerned individuals and groups. You are receiving this letter because you are suing the government of South Africa in an effort to maintain high prices for patented pharmaceuticals, which will prevent millions of people from obtaining life extending treatment (Pharmaceutical Manufacturers Association of South Africa versus the President of South Africa, case no. 4183/98). As you know, oral arguments on this case will begin March 5, 2001 before the High Court in Pretoria. This three-year lawsuit, a protracted effort to derail implementation of South African Medicines and Related Substances Control Act ("the Medicines Act"), is having a deadly impact on South African people and citizens of poor countries around the world. Therefore we demand you immediately remove yourself as a plaintiff from this lawsuit. The Medicines Act is an effort by the South Africa government to reform apartheid-era legislation and to increase affordable medication access for its people through familiar provisions including parallel importing, compulsory licensing, and generic drug substitution. The grave crisis in lack of access to medication in South Africa cannot be overemphasized: in the case of HIV disease, more than 4.3 million South Africans are infected with HIV but less than 0.2 percent of infected people have access to drug treatment to stabilize disease progression and extend life. Your lawsuit has tied the hands of the South African government, making it unable to implement potentially life-saving reforms while South African citizens die preventable deaths every day. The Medicines Act, you claim, would unfairly infringe on the intellectual property rights of drug makers and would cost substantial profits. In fact, the entire continent of Africa generates less than 1.3 percent of global profits from drug sales. Clearly your concern lies not with the lives of the tens of millions of poor people who have no access to drugs, but with protecting your unfettered access to the few in the North who are willing to pay top dollar, no questions asked. 5571095.0291.031

While a slim minority of people with HIV in wealthy countries reap the life extending benefits of overpriced HIV medications, 90 percent of the world's 36 million people with HIV have absolutely no hope of anything beyond a death sentence, including virtually all of the 4.3 million people with HIV living in South Africa. But companies-including yours-claim they are doing enough to increase HIV drug access for the tens of millions of people who have no access to HIV treatment. For example, the much-hyped UN/drug company HIV medication price reduction initiative, touted by industry as a far reaching, innovative program, has been roundly criticized as moving too slowly, subjecting individual countries to prolonged imbalanced negotiations, and having an unacceptably narrow impact. You and the other 41 plaintiffs in this case are preventing South Africa from implementing its domestic plan to end inequity in medication access. Battling the extraordinary devastation wreaked by the AIDS crisis requires many strategies and modes of attack-not only industrycontrolled charity programs. We do not claim that affordable drugs are a panacea in the fight to end the global AIDS crisis. But truly affordable medication is the foundation of any meaningful effort that will actually save lives. The shameful three-year battle by your company and the other plaintiffs is a wholehearted effort to ensure that medication is denied to those who need it most. This lawsuit stands squarely in the path of South Africans, as well as millions from other countries who are closly watching this precendent-setting case and who are desperately seeking access to life extending, affordable medication. You have a choice: unless you take action and remove yourself from the lawsuit, you will be known forever as the company who sued to prevent the South African government from daring to increase the availability of life-extending medication for its citizens. Your lawsuit directly threatens the lives of millions. We therefore call on you to withdraw from the PMA of South Africa lawsuit without further delay. Sincerely, Asia Russell, Health GAP Coalition, USA Mark Harrington, Senior Policy Director, Treatment Action Group (TAG), New York, NY Gregg Gonsalves, Treatment Advocacy Director, Gay Men's Health Crisis, New York, NY AIDS Action, Washington, DC American Foundation for AIDS Research (AmFAR), USA Project Inform, San Francisco, CA ACT UP Paris, France ACT UP New York, NY ACT UP Philadelphia, PA ACT UP East Bay, Oakland, CA Survive AIDS (formerly ACT UP Golden Gate), San Francisco, CA ACT UP Cleveland Latino Commission on AIDS, New York, NY VIVO POSITIVO, National Coordinating Committee of PWAs, Santiago, Chile Alternative Information & Development Center (AIDC), Cape Town, South Africa Associaci6n Agua Buena, San Jose, Costa Rica Colombian Lesbian and Gay Association, New York, NY Canadian Treatment Advocates Council, Toronto, Canada Salih Booker, Executive Director, Mfrica Policy Information Center (APIC), Washington, D.C. Africa Fund/American Committee on Africa, New York, NY Donna Rae Palmer, Director, Mobilization Against AIDS, San Francisco, CA David Scondras, Director, Search for a Cure, Boston, MA Julie Davids, Director, Critical Path AIDS Project, Philadelphia, PA

Jennifer Flynn, Director, New York City AIDS Housing Network, NY John James, AIDS Treatment News, Philadelphia, PA African American AIDS Policy and Training Institute, Los Angeles, CA Robin Gorna, Executive Director, Australian Federation of AIDS Organizations Claire Slatter, General Coordinator, Development Alternatives with Women for a New Era (DAWN) Provincetown Positive People with AIDS Coalition, Provincetown, MA Joint Clinical Research Center, Kampala, Uganda Homer Hobi, Director, Positive Humanists and Friends, San Francisco, CA Brook K. Baker, Boston Global Action Network Africa AIDS Project Alissa Pines Batson, New York City Council Rubens Duda, President, Sao Paulo State AIDS/NGO Forum, Sdo Paulo, Brazil Olexiy Buyadgie, Director, New Names, Odessa, Ukraine Children's Rights Centre, South Africa Coalition for Children's Rights in an HIV Positive World, South Africa Lynda Dee, Executive Director, AIDS Action Baltimore, MD Dawn Averitt, Founder, WISE, USA Jacqueline Ambrosini, Director, Youth Health Empowerment Project, Philadelphia, PA Lark Lands, POZ Magazine Phill Wilson, AIDS Social Policy Archive of the University of Southern California, USA Linda Grinberg, President,-Foundation for AIDS & Immune Research, Los Angeles, CA Robert Weissman, Essential Action, Washington DC Jeff Getty, San Francisco, CA Bill Arnold, Title II Community AIDS National Network Jim Jenkins, Founder, Children With AIDS Project of America, Tempe, AZ Lillian Thiemann, Community Prescription Service Donna Rae Palmer, Mobilization Against AIDS San Francisco, CA David Scondras, Search for a Cure, Boston, MA Lee Wildes, Director, African AIDS Network Julie Davids, Critical Path AIDS Project, Philadelphia, PA Jennifer Flynn, New York City AIDS Housing Network, New York, NY Kenneth Fornataro, Executive Director, AIDS Treatment Data Network, New York, NY John James, AIDS Treatment News, Philadelphia, PA New York AIDS Coalition, New York, NY Richard Jeffries, Access Project Director, AIDS Treatment Data Network, New York, NY Susan Rodriguez, SMART University, New York, NY Nate Miley, Alameda County Supervisor, Oakland, CA Mike Palmedo, Consumer Project on Technology, Washington DC Andres Duque, Mano a Mano Network of Latino LGBT Activists, New York, NY Emily Bass, Cindra Feuer, Global AIDS Collaborative for Care Treatment and Support, New York, NY Canadian HIV/AIDS Legal Network, Quebec, Canada David Henry, Professor of Clinical Pharmacology, Head, School of Population Health Sciences, The University of Newcastle, New South Wales, Australia Walton Senterfitt, Being Alive: People with HIV/AIDS Action Coalition of Los Angeles, CA Vern Abraham, Chair, Western North Carolina HIV/STD Prevention & Planning Network, NC Judie Blair, South Africa Development Fund, Boston, MA Anuar Luna, Mexican Network of People Living with HIV/AIDS/Red Mexicana de Personas que Viven con VIHISIDA Chatinkha Nkhoma and Paul Zeitz, Co-Directors, Organizing Committee of Global AIDS Alliance Richard Jackman, Resist The List, Seattle, WA Father Bill O'Donnell, St. Joseph the Worker Catholic Church, Berkeley, CA Rev. Mark Wilson, McGee Avenue Baptist Church, Berkeley, CA Kriss Worthington, Berkeley City Council, Berkeley, CA

Middle East Childrens Alliance, Berkeley, CA Peter Singer, DeCamp Professor of Bioethics, Princeton University, Princeton, NJ Vice Mayor Maudelle Shirek, Berkeley, CA John Iversen, former co-chair, HIV Services Planning Council, Oakland, CA Paul Boneberg, Director, Global AIDS Action Network Ezio Tavora dos Santos Filho, Grupo Pela VIDDA, Rio de Janeiro, Brazil AIDS Research Alliance, West Hollywood, CA VOICE, Dublin, Ireland Kirsten Myhr, MScPharm, MPH, Oslo, Norway Carol DeVoe, Globalvision, Inc. Jean Dussault, Nota Bene Communication, Quebec, Canada Megan Gottemoeller, Global Campaign for Microbicides, USA Joe Thomas.PhD. Melbourne. Australia Nicole Fritz, South Africa Chris Collins, San Francisco, CA Gifford Miller, USA Anne Peticolas, Austin, TX Michael Amabile, Washington D.C. Merrill Cole, Ph.D. Seattle, WA Eve Remba, New York, NY Luis G. Santiago, New York, NY Patricia Siplon, PhD, Burlington, VT Helen Epstein, PhD, New York, NY Ann Northrup, New York, NY Marion Banzhaf, New York, NY David Jones Staten Island, NY Tom Hemmingsen, Woodridge, IL Edward B. Davids, Seattle, Washington. cc: The Honorable Thabo Mbeki, President, Republic of South Africa Dr. Manto Tshabalala-Msimang, Minister of Health, Republic of South Africa Zackie Achmat, Chairperson, Treatment Action Campaign The Honorable Kofi Annan, Secretary General, United Nations James Wolfensohn, President, The World Bank Dr. Gro Harlem Brundtland, Secretary General, World Health Organization Dr. Peter Piot, Executive Director, UNAIDS The Honorable Colin Powell, Secretary of State, USA Robert Zoellick, United State Trade Representative Congressional Black Caucus