In 1997, the South African government led by President Nelson Mandela had passed an act that allowed the minister of health, under certain circumstances, to cancel patent rights to drugs or import generic versions in order to make low-cost medicines available to those who need them. Soon afterward, the Pharmaceutical Manufacturers’ Association (PMA)—a group representing 39 pharmaceutical corporations, including Bristol-Myers Squibb, GlaxoSmithKline, and Merck—sued the South African government. The PMA claimed that this act contradicted the country’s constitution and a new international agreement on intellectual property rights. This challenge began a protracted legal battle that would unite MSF and activist groups like TAC in a fight to bring cheaper generic drugs to patients in South Africa—and around the world.
The case dragged on for years, but a turning point came in 2001 when MSF launched a global advocacy campaign called “Drop the Case.” In a matter of weeks, MSF’s online petition collected 250,000 signatures from people in 130 countries, including many celebrities and public figures. MSF and TAC activists attended a PMA press conference the day before legal arguments in the case were set to resume. Dr. Eric Goemaere was in attendance with a printout of the petition signatures, thick as a phone book. “We are speaking on behalf of 250,000 people across the world,” he said. “And they are telling you: we don’t understand your position.”
The speech was picked up by the media and reported around the world. It had an immediate effect. In a court in the South African city of Pretoria on April 19, 2001, the PMA formally dropped the case. “The court was filled with people . . . and they started to sing,” remembers former Access Campaign policy advocacy director Ellen ‘t Hoen. “Every hair on my body was standing on end. It was in the air that they were going to drop the case; that we had won. And when [it happened], the whole thing just broke out in one big dancing party.” South Africa now had the right to import generic drugs and break patents to improve access to medicines. Although the fight to bring these lifesaving drugs to the people who needed them would continue, a major hurdle had been overcome.
In 2002, the MSF team presented results from the Khayelitsha project at the Barcelona AIDS Conference. The findings were explosive: Two years after the program’s launch, 91 percent of patients were still adhering to their treatment and had an undetectable viral load, allowing HIV-positive people to live longer, healthier lives and preventing transmission of the virus. Later that year, the Joint United Nations Program on HIV/AIDS and the World Health Organization published the “Khayelitsha model” as part of their best-practices series. The project now served as the bedrock on which resource-poor HIV/AIDS treatment programs could be built worldwide.
In 2003, the South African government announced the universal rollout of ARVs. That December, former president Mandela visited a new MSF clinic in Lusikisiki. “The HIV-positive people we see here today are alive, they are healthy, and they are happy. What we see is proof that there is life after HIV/AIDS.”