PFIZER LIMITS SCOPE OF DONATION OF HIV DRUG IN SOUTH AFRICA -
MSF Reiterates Demand that Pfizer Unconditionally Reduce Price or Issue Voluntary License for Fluconazole -

Geneva (June 20, 2000) - The international medical aid agency Medecins Sans Frontieres (MSF) today admonished Pfizer for not making good on its promise to provide fluconazole (brand name Diflucan) for free to people with HIV/AIDS in South Africa.

As negotiations proceed with the South African government on the details of how the donation will be structured, the highly restrictive nature of the offer is becoming clearer.

"The cumbersome conditions that Pfizer is imposing on its much-publicized offer to provide fluconazole for free to people with AIDS is disappointing," said Eric Goemaere, M.D., MSF, South Africa. "Most outrageous is Pfizer's attempt to structure this donation like a clinical trial, adding onerous reporting and training requirements. South African physicians are experienced professionals and it is patronizing to require special training for routine treatments. South African physicians are currently diagnosing opportunistic infections that can effectively be treated by fluconazole, but are unable to do so because of the price."

In the ongoing negotiations between the South African government and Pfizer, the company has placed other significant limitations and restrictions on the proposed donation. Contrary to the initial demand, the donation is being restricted to cryptococcal meningitis, which means that oral thrush and life-threatening oesophageal candidiasis will not be included. The company has also put a time limitation on the offer.

If the South African government is not satisfied with Pfizer's proposal to increase access to fluconazole, it could decide to issue a compulsory license, granting the right of production or import to one or more producers/suppliers. As Dr. Manto Tshabalala-Msimang, the South African Minister of Health, explained at a World Health Organization (WHO) conference this week, compulsory licensing is a crucial tool to make HIV/AIDS drugs more widely available.

Generic fluconazole is currently sold for US$0.29 (daily dose for cryptococcal meningitis) in Thailand. If Pfizer was to grant a voluntary license to the South African government to import or manufacture quality fluconazole the South Africans would be able to independently meet the needs of AIDS patients who have both cryptococcal meningitis and candidiasis.

Cryptococcal meningitis is a fungal infection of the brain that, if left untreated, is fatal within two months. In South Africa the government pays R29 (US$4.15) for a daily dose, a price which the government can not afford to pay.

"South Africa is facing one of the world's most acute AIDS epidemics with more than 10% of the population infected with HIV. More than 100,000 people died here of AIDS last year," said Dr. Goemaere. "It is unacceptable that Pfizer still refuses to sell this product at an affordable price in poor countries, or to let others have the legal right to do so."

Sales of Diflucan were more than US$1 billion in 1999.

MSF continues to support TAC's initial request: Pfizer should reduce the daily price of Diflucan in South Africa to below R4 (US$0.60) or issue TAC a voluntary license to allow generic competition to reduce prices to affordable levels. Pfizer has also rebuked similar requests from other countries around the world.

Medecins Sans Frontieres (MSF) is conducting an international campaign to improve access to essential medicines in poor countries. For more information, see www.accessmed-msf.org.

For additional comment, contact: Daniel Berman (Geneva): 41 79 286 9649 Toby Kasper (South Africa): 27 82 370 5307