A review of the partnership between Pfizer Inc. and the South African Ministry of Health to distribute free Diflucan (fluconazole) in the Diflucan Partnership Program (DPP) demonstrates that product donations may be a useful response to AIDS if they are coupled with efforts to build means of drug distribution and enhance professional healthcare capacity to treat patients. Equally important is the creation of a new set of productive working relationships between stakeholders who came to the project with different backgrounds and perspectives, as well as a frankly disparate set of objectives. A decision tree illustrates how these relationships were built into the DPP.
Table 1 describes the status of these partnerships from 2002.
2.
Global AIDS Alliance. AIDS Information. Accessed August 12, 2004 from http://www.globalaidsalliance.org/cd_basic_info.cfm
3.
Pharmaceutical Research and Manufacturers of America (PhRMA). Global partnerships—Humanitarian programs of the pharmaceutical industry in developing nations. March 2003. Page 23. Accessed August 12, 2004 from http://world.phrma.org/global.partnership.2003.pdf
4.
Mitume, Gumisai. Health-South Africa: AIDS threatens human development gains. Inter Press Service. November 30, 1998. Accessed August 12, 2004 from http://www.aegis.com/news/ips/1998/IP981107.html (“The spread of HIV and AIDS in South Africa is fuelled by the apartheid legacy of the migrant labour system, the accompanying spread of sexually transmitted diseases and the subordinate status of women,” says the report sponsored by the United Nations Development Programme (UNDP) and UNAIDS.)
5.
World Health Organization. The World Health Report2002. Page 81. Accessed August 12, 2004 from http://www.who.int/whr/2002/en/ (South Africa is the wealthiest country in Africa, spending about US$237 per capita on healthcare on a total population of 43 million. Between 1992 and 1999, however, the Rand halved in value against the US dollar. Nearly 40 percent of the population lives in Kwazulu-Natal and Gauteng, two districts with the highest AIDS rates.)
6.
Das TK, Teng, BS. A resource-based theory of strategic alliances. Journal of Management2000; 26(1):31-61.
7.
Austin, James E.The collaboration challenge: How nonprofits and businesses succeed through strategic alliances. San Francisco: Jossey-Bass Publishers; 2000. 272 pages.
8.
Reich, Michael R, editor. Public-private partnerships for public health. Cambridge: Harvard University Press; 2002;1-16.
9.
Das TK, Teng BS. Trust, control, and risk in strategic alliances: An integrated framework. Organization Studies 2001;22. Accessed August 17, 2004 from http://www.findarticles.com/p/articles/mi_m4339/is_2_22/ai_76668287
10.
Clinton, WJ. AIDS is Not a Death Sentence. The New York Times. December 1, 2002. Accessed August 17, 2004 from http://www.geocities.com/jhsfocusgroup/clinton.html
11.
United Nations Statistics Division. Millennium indicators database. Millennium development goals 1990-2003. Accessed April 12, 2002 from http://unstats.un.org/unsd/mi/mi_results.asp?row_id=580
12.
Although the partnership does not have dollar or time estimates, Pfizer Inc. has estimated the total cost of its current partnership commitments to be US$103 million. 1) Pfizer Inc. donated or pledged to donate product valued at approximately US$100 million (wholesale price) to provide over two million treatments to HIV/AIDS patients for either cryptococcal meningitis or oesophageal candidiasis. 2) Pfizer Inc. trained more than 9,000 healthcare professionals in the treatment of opportunistic fungal infections. The cost of completed and planned training in 12 countries is approximately US$2 million. 3) Pfizer Inc.’s administrative support of the program is approximately US$1 million. This includes professional staff, consultants, outside services, production of educational materials and brochures, shipping services, audit, and assessment. 4) Since these estimates were figured, the program has expanded to include nine additional countries, two million more doses of Diflucan, and the training of 9,000 additional healthcare workers.
13.
The CIA World Factbook. Brassey’s: Washington, DC. Accessed on August 17, 2004 from http://www.cia.gov/cia/publications/factbook/geos/sf.html
14.
Bollinger L, Stover J. The economic impact of AIDS in South Africa. The POLICY Project. September 1999. Accessed August 12, 2004 from http://www.policyproject.com/pubs/SEImpact/southafri.pdf
15.
Alagiri P, Summers T, Kates J. Spending on the HIV/AIDS epidemic. The Henry J. Kaiser Family Foundation. July 2002. Accessed August 12, 2004 from http://hiv.buffalo.edu/pdf/US_Trends_July_2002.pdf
16.
Schwartlander B, Stover J, Walker N, et al.Resource needs for HIV/AIDS. Science Express2001;292;2434-2436.
17.
Sidibe, Michel. AIDS: A development crisis. European Parliament Conference on AIDS in Africa. December 8, 2003. Brussels, Belgium. Accessed August 12, 2004 from http://www.robertogiraldo.com/brussels/sidibe.doc
18.
Data from the WHO Accelerating Access Initiative (AAI). June 2002. Accessed on August 17, 2004 from http://www.who.int/hiv/pub/prev_care/en/isbin9241210125.pdf
19.
The possibility of overlap between these two conditions is possible, so that the actual outcome figures may be slightly less in sum.
20.
Pfizer Inc.The Diflucan Partnership Programme. Accessed August 12, 2004 from http://www.diflucanpartnership.org/en/welcome/
21.
Potentially economically active people are those between the ages of 20 and 59.
22.
Dependency is an indicator used in population studies to measure the portion of the population which is economically dependent on the active age group.
23.
Outcomes are based on a theoretical model drawing upon researched statistics.
