Item #9: Is it Okay That the Elizabeth Glaser Pediatric AIDS Foundation Takes Money from the Nevirapine Manufacturer?

Front and center were organizations like the Elizabeth Glaser Pediatric AIDS Foundation, which extolled the importance of nevirapine. Elizabeth Glaser's nevirapine defenders apparently didn't encounter a single media professional who knew, or cared, that the organization had received $1 million from nevirapine's maker, Boehringer Ingelheim, in 2000. This was no scandal but simply part of a landscape. Pharmaceutical companies fund AIDS organizations, which in turn are quoted uncritically in the media about how many lives their drugs save.

Farber points out that Elizabeth Glaser Pediatric AIDS Foundation (EGPAF) has taken money from Boehringer Ingelheim and implies this disqualifies them from commenting on the safety of short-course nevirapine.

It is the function of the EGPAF, a registered charity, to prevent MTCT. The fact that the EGPAF has taken money from Boehringer Ingelheim does not disqualify it from commenting on the safety of nevirapine. The EGPAF is not selling nevirapine on behalf of Boehringer, but distributing it free of charge to those without access to it. Farber only mentions the EGPAF with respect to affirming the safety and efficacy nevirapine and links this to their Boehringer grant. But many organisations affirmed the safety and efficacy of single-dose nevirapine, including ones without financial connections to the pharmaceutical industry such as the World Health Organisation, the nobel peace prize-winning organisation, Medecins Sans Frontieres, and the Treatment Action Campaign.

[This supposed error relies on a footnote (number 4) which notes that AIDS is defined differently in Africa.] It is true that as more was learnt about AIDS, the definition of the disease changed. There is nothing unusual in this; AIDS was only discovered in 1981. It is a testimony to scientific methodology that it only took a few years to discover its cause. An accurate diagnosis of AIDS, throughout the world, does require an HIV-positive test. While there are facilities in Africa which do not even have HIV tests (one of the cheapest components of the medical response to HIV), our knowledge of HIV in Africa is based on studies that have used HIV tests. (Incidentally, facilities that cannot offer HIV testing do not offer ARVs either.) We show later that numerous studies conducted in Africa have demonstrated that people with HIV have much higher morbidity and mortality than people without HIV. Also see Nicoll and Killewo (2000). 24

Farber was not commenting so much on the appropriateness of the Glaser foundation taking drug company money, but on the lack of concern in the press that this might cause the organization to avoid criticism of its paymasters. AIDS foundations will only consider the morality of taking drug company handouts when they are called to account for this conflict of interest. While the mainstream media is becoming increasingly critical of the money-driven medical system in many areas, HIV/AIDS is an exception, apparently immune from criticism.