Bill Clinton on Treating AIDS in Developing Countries
STEVE INSKEEP, host:
Former President Bill Clinton joined President Bush's father to raise money after Katrina, but that's just one of his projects. Yesterday Mr. Clinton sat down to talk with us about some other issues. He's become so active overseas that some observers ask if he is campaigning for secretary-general of the United Nations. His foundation is focused on a specific effort to improve treatment for AIDS. It brought together 50 developing nations from Africa to Asia to Latin America. Together they've been negotiating with drug companies. Their goal is to lower the cost of drugs to treat people with AIDS. And yesterday the foundation announced that a number of drug companies agreed to sell for less.
Former President BILL CLINTON: The so-called first-line treatments, the drugs you initially take inevitably wear off, and when they do, a patient has to go to second-line treatments to stay alive for the rest of his or her life. These second-line drugs are much, much more expensive.
INSKEEP: We're talking about drugs that might be 1,500, 1,600, $2,000 per year per patient. Is that about right?
Mr. CLINTON: Yes. In the case of one of our drugs that we lowered to $240, the typical price is a hundred dollars more than that. When you're dealing with a country with a per-capita income of a dollar a day or less, these are huge numbers. So that's the first big thing.
The second thing is we're trying to get rapid tests that give you results when you're right there on site at an affordable price. Ninety percent of the HIV-positive people in the world don't know they have the infection. An enormous amount of infections--and last year there were five million new ones--are being perpetrated by people who don't know they themselves are HIV positive.
INSKEEP: Something you just said points out some of the difficulty here, though. You've worked with about 50 different countries. They've negotiated together with major drug companies. They've gotten a discount in the price. That price, depending on the drug, might now be 200 to $400 a year. Well, that still be around a dollar a day, which, as you point out, is the per-capita income in a lot of developing countries. This is still beyond the means of a lot of people and maybe a lot of governments.
Mr. CLINTON: Well, it's beyond their means, but keep in mind, they're getting help from the Global Fund on AIDS, TB and Malaria, from the Bush program, from the Bill and Melinda Gates Foundation. That's right. At these prices, very few developing countries can afford to pay these prices, but that's what these other funds are for, to give them the money to do it.
INSKEEP: The companies that you negotiated with appear to be foreign companies. Did you try to get American firms to sign on to the lower prices?
Mr. CLINTON: Yeah. We do have--we have one American firm involved in the testing, a New York firm, and he gave a great speech today about how they're going to add jobs in New York because of this contract. But keep in mind the American companies are basically big pharmaceutical companies who were not in the generic business. Indirectly, one of them is involved, Merck. Merck gave a license to one of the companies that's producing one of our drugs, and I'm very grateful to them for it.
INSKEEP: Why are they resisting deeper involvement in the drug program itself?
Mr. CLINTON: Well, partly because they don't want to meet these prices.
INSKEEP: And, Mr. President, we're talking about health care. I want to move to a question about health care here in the United States. President Bush has been talking about making improvement of health care in the US a top priority in this election year and beyond. I wonder if you might have any advice for him.
Mr. CLINTON: Well, I don't know if I have any advice for him, but I think that what we tried to do back in '93 and '94 still has some relevance. The real problem was, we didn't have any money 'cause we had a big deficit, so we couldn't provide universal coverage without some sort of employer mandate.
INSKEEP: Also couldn't build enough political support for a specific solution in 1994.
Mr. CLINTON: Yeah, well--but that was because we had big opposition from the health insurance companies. I think people now see that for what it is. We are spending 16 percent of our income on health care. No other country spends more than 11. We spend more money on the last two months of life than anybody else, and we also have a lot of defensive medicine. Because malpractice insurance is so expensive, we need--if we had more self-insurance and big pools, we could bring that price way, way down.
INSKEEP: Do you think that American corporations, who are paying a lot of the health-care bills for their employees, can become allies in the effort to improve the system?
Mr. CLINTON: They have to be. You know, if you look at--Toyota just announced a North American plant. They put it in Canada instead of the United States because they didn't want to pay the extra $1,500 a car in health-care costs. But if you want to shift away from an employer-based system, then you have to look at what our options are. You could allow people without insurance to buy into a version of the federal employees healthcare plan, and for lower income working families, you could let them buy into the children's health insurance programs the states run that insure their children. But it'd be a huge mass bargain we could make, because it would take a big, big burden off a lot of employers.
INSKEEP: Mr. President, can't let you go without asking about one other thing, something that's on the minds of a lot of people in certain places. Without dealing with any specific individual, what would have to happen, in your mind, for an American to become the next secretary-general of the United Nations?
Mr. CLINTON: Oh, well, first of all, they'd have to abandon over a half-century of precedent, because the permanent members of the Security Council have a veto power, and in return for that, nobody from any of those countries has ever run for the secretary-general of the United Nations.
INSKEEP: Highly unlikely to happen, even for you?
Mr. CLINTON: Yeah, even for me. I also have a wife in the United States Senate, and I don't want any conflicts there.
INSKEEP: Well, Mr. President, it's good to talk to you.
Mr. CLINTON: Thank you.
INSKEEP: Former President Bill Clinton spoke to us yesterday on the line from New York.
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