South Africa: Pfizer Betrays Promises, Puts Profits Before People

US-based pharmaceutical giant Pfizer has promised free HIV drugs to South Africa, but under conditions so limiting as to make a mockery of the "donation." IGLHRC joins South African activists in urging immediate protests against Pfizer. Fax or call Pfizer officials to express outrage at their denial of the essential human right to health. Demand that they offer long-term and life-saving solutions, not short-term and self-interested "charity." Urge them to reject monopolistic practices; to lower the price of fluconazole to rates consistent with generic prices on the world market; and to allow South Africa to obtain cheap generic versions of HIV drugs where necessary. Only an end to pharmaceutical price-gouging will represent a responsible answer to Africa's, and the world's, AIDS crisis.

Fax or call:

William Steere (Chief Executive Officer, Pfizer)
fax +1-212-573-7851
Jim Brigaitis (Diflucan Team Leader, Pfizer)
phone +1-212-573-7789; fax +1-212 573-3253
Chuck Hardwick (Vice-President for Government and Public Affairs, Pfizer)
phone +1-212-573-7834
Pfizer switchboard: phone +1-212-573-1000

Or write to all the above names at:

Pfizer, Inc.
235 East 42nd Street
New York, NY 10017-5755

Below is a detailed account of Pfizer's actions, as well as IGLHRC's statement on corporate responsibility and the right to health.


On March 31, 2000 Pfizer, the New York-based pharmaceutical company, announced that it would give away its expensive antifungal drug, Diflucan, for free to thousands of people living with HIV/AIDS in South Africa. Pfizer's promise came in response to months of pressure from activists outraged by the high prices Prizer charged for the drug. Pfizer holds the patent on Diflucan, the trade name for fluconazole. In 1999 it sold approximately $1 billion of the drug. It is the only drug effective in treating cryptococcal meningitis, an opportunistic and lethal brain infection which afflicts over two million of the estimated 27 million people living with AIDS in sub-Saharan Africa. The medication must be taken on a daily basis for the infected person's entire life. Pfizer charged USD $13-17 for a daily dose--a price which put it beyond the reach of all but the tiniest minority of South Africans. Generic versions of the drug are made in Thailand, where Pfizer's patent is not enforced; those versions cost less than one-tenth of what Pfizer charges. Pfizer had joined other pharmaceutical companies in applying political and legal pressure to South Africa in response to the government's attempts to obtain AIDS medications at cheaper rates. Pfizer's promised donation, however, proved a false blessing. In subsequent negotiations, the corporation has reportedly imposed conditions which render the "gift" meaningless:

  1. Pfizer insists on limiting the donations to a thirty-month period--exactly the point at which their patent on fluconazole expires. The time limit makes it impossible for the South African government to develop a long-term program for treating the disease. It also raises suspicions that Pfizer actually is giving away samples in the hopes of getting South African doctors accustomed to using the brand-name drug even after the patent expires.
  2. Pfizer will only allow the free drugs to be used for cryptococcal meningitis, not to treat esophagal thrush or other even more common fungal infections which endanger people living with AIDS. It also insists that the drugs only be used in government hospitals, and only for people diagnosed with meningitis through specific medical procedures that require expensive equipment and specialized training--placing further strains on South Africa's health-care system.
  3. Pfizer insists on limiting the offer to South Africa and not extending it to other countries.
  4. Pfizer refuses to reduce the price of Diflucan for non-meningitis-related uses to a price comparable to what the South African government could pay for generic versions. It also refuses to lift the threat of legal and other political actions against South Africa if it pursues that alternative route.

Activists in South Africa's Treatment Access Campaign (TAC), as well as in the United States, reject this duplicitous donation. Pfizer's "gift" was not a message of good will but a mask for greed. Drug donations are a stop-gap solution: they are no substitute for reducing monopolistic prices to a fair rate. Pfizer's actions place millions of lives at risk in the name of an exorbitant and extortionary pricing system. As the next section explains, they also place Pfizer in violation of fundamental human rights.


The framework of human rights has developed as a way of binding States to respect and protect the freedoms and well-being of their peoples. The right to health is an internationally recognized part of that framework. Article 25 of the Universal Declaration of Human Rights affirms that "Everyone has the right to a standard of living adequate for the health and well-being of himself and of his family," and stipulates the right to medical care as an aspect of this right. Article 12 of the International Covenant on Economic, Social and Cultural Rights recognizes "the right of everyone to the enjoyment of the highest available standard of mental and physical health." It mandates States, among other steps, to take necessary measures for the "prevention, treatment, and control of epidemic, endemic, occupational and other diseases," as well as to create "conditions which would assure to all medical service and medical attention in the event of sickness."

At the same time, the work of ensuring the fulfillment and the free enjoyment of human rights is a wide one; and its requirements do not fall upon governments alone. This is particularly true of economic, social, and cultural rights, of which the right to health is one. Governments are constrained in their capacity to give meaning to those rights by the enforced injustices of a global economic system. To acknowledge this fact, however, is not to excuse inequity or its often murderous effects. Rather, it places a broader burden on the global community: to assist vulnerable populations, and to enable governments in protecting the general welfare of their societies. The Universal Declaration recognizes this in affirming, in its Article 22, that "Everyone, as a member of society, has the right to social security and is entitled to realization, through national effort and international co-operation and in accordance with the organization and resources of each State, of the economic, social and cultural rights indispensable for his dignity and the free development of his personality." The Covenant on Economic, Social and Cultural Rights also obliges each State to engage in "international assistance and co-operation, especially economic and technical, to the maximum of its available resources."

With the wealth they have accrued through the economic dislocations and social transformations of globalization, and with the political power such wealth entails in a period of revolutionary change, transnational corporations are major actors in the international community. Their power obliges them to be responsible agents of international cooperation. A number of international bodies--and a growing number of businesses--have acknowledged this requirement. The International Labor Organization, in 1977, adopted a "Tripartite Declaration of Principles Concerning Multinational Enterprises and Social Policy." The declaration (which was drafted with the participation and assent of business sector representatives) mandates corporations to "respect the sovereign rights of States, obey the national laws and regulations, give due consideration to local practices, and respect relevant international standards. They should respect the Universal Declaration of Human Rights and the corresponding international covenants . . . They should also honour commitments which they have freely entered into, in conformity with the national law and accepted international obligations." Pfizer's actions represent a betrayal of these principles.

The United Nations has also drafted a Code of Conduct on Transnational Corporations, which would require such corporations to "respect human rights and fundamental freedoms in the countries in which they operate." These affirmations have been accompanied by growing publicity over, and condemnation of, cases in which corporations grossly fail in these obligations.

In many such cases, corporations violate human rights by acting in collusion with the State--for instance, in using (or buying) police power to suppress workers' rights to organize. Yet corporations can also endanger human rights by working against the State. Corporations can deploy their power to make it impossible for States to meet their obligations: they can strip States of the means to enact or preserve effective rights protections. By promising life-saving medications to South Africa, Pfizer admitted its own responsibility for ensuring the right to health. By duplicitously refusing to follow through, by undermining the efficacy of that promise, Pfizer prevents South Africa from realizing the right to health for a large segment of its population.

Moreover, rights protections must be universal, cannot be piecemeal. Once a human rights claim - such as to the right to health - is recognized as valid, it is incumbent rapidly to render its enjoyment general and permanent, rather than particular and transient. Sporadic and specialized acts of seeming generosity do not last. What is needed is a comprehensive and enduring change in a pricing system which bars the majority of the world's people from potential access to essential drugs. By inhibiting such change, Pfizer has failed in its acknowledged obligations to the international community.

International law increasingly recognizes that non-State or parastatal entities--such as belligerents in internal armed conflicts--can and should be held responsible for violating people's civil and political rights, even though their actions escape State consent or control. IGLHRC believes that comparable standards of responsibility should apply when such parastatal entities prevent the enjoyment of essential economic and social rights, including the right to health. Transnational corporations which recognize no obligation to respect or realize basic human rights implicitly assert that they are less accountable to legal or moral norms than are armed insurgencies or terrorist organizations. In some cases, this may accurately reflect those corporations' working methods. It does not reflect the spirit of international law.