"I knew it needed to be done"

• Share

On Thursday, former U.S. President Bill Clinton announced a remarkable new program designed to help developing countries clear two major obstacles to AIDS treatment: the high cost of antiretroviral drugs, and the low quality of the countries' health-care systems. The Clinton Foundation has so far signed up four generic-drug companies and helped them cut production costs, reducing by one-third the price of AIDS -fighting drugs. The firms — three in India and one in South Africa — will still profit because of the high volume guaranteed by the Foundation, which is working with Mozambique, Rwanda, South Africa and Tanzania (which account for one-third of the world's AIDS cases), and more than a dozen countries in the Caribbean region. Clinton spoke with TIME Europe editor ERIC POOLEY.

How did this initiative get started? Last year, Nelson Mandela and I were asked to close the International AIDS Conference in Barcelona. While I was there, Denzil Douglas, the Prime Minister of St. Kitts and Nevis, came up to me and said, "We don't have a problem in the Caribbean of [AIDS] denial, we have a problem of capacity. We have neither the money nor the systems necessary to meet this challenge. Will you help us set up nationwide systems of care and treatment?" And I said, "Sure." I had no clue how I was going to do it . . . but I knew it needed to be done. So I called Ira Magaziner, who did health-care policy for me at the White House, and we set to work. He enlisted the help of the Harvard Medical School, the Columbia School of Public Health . . . and global partners like PharmAccess in the Netherlands . . . over 80 people, working for nothing or in one case nearly nothing. They started meeting with [pharmaceutical companies], working on these systems, . . . increasing their productivity. The other thing we did was to work with governments to develop comprehensive plans for treatment and care. And we made a commitment to raise the funds and do the training necessary. And once a government officially approved that approach, we said we'd help them get the medicine. Which is what we did.

South African President Thabo Mbeki had resisted developing a national plan to provide antiretroviral drugs and even questioned the link between HIV and AIDS . What brought him around? There was always in South Africa — including in the government — people who really wanted to do something. I understood how President Mbeki got to where he was.

We need $700 million for Africa and the Caribbean, and I think we'll get it.

Did he get a bad rap? A little bit . . . You can only stay in denial so long . . . He was exposed to two articles by people — I'm ashamed to say they were Americans — who said HIV doesn't cause AIDS , and the medicine could kill you. He also had a legitimate substantive issue: South Africa had given out anti-TB medicine without a proper protocol and they wound up spawning some more virulent, drug-resistant strains. But we just kept on working on it.

When did you know he was going to agree? I went [to Johannesburg] for President Mandela's 85th birthday party [last July]. Mbeki said to me, "Now, if I do this, you'll promise me that these drugs will be administered with the same high quality that the [National Institutes of Health] would use in America?" I said, "I give you my word." He said, "O.K., I'll do it." I give him all the credit. He was always trying to get back there . . . Now we're just waiting for the South African government to approve their final plan.

How did you choose which countries to work with? They chose us. We were asked. When they found out what I was doing, they wanted me to do it in their nations as well. Then the Irish and the Canadians, bless them, said they would fund two of the African projects, and I've talked to six or seven other governments and almost all of them are going to wind up helping us.

What's the price tag? We've probably raised a couple hundred million over the next five years. We need $700 million for Africa and the Caribbean, and I think we'll get it. We could do other countries, but it would require more money. And other people not associated with me could follow the model.

President Bush has called for a $15 billion, five-year U.S. commitment to fight the spread of AIDS. Is the U.S. likely to contribute to your program? I haven't talked to them yet. I've been waiting for the budget year to end and the money to be released. But this is not a political deal for me, so I'd be honored if the U.S. would want to support any of these projects.