La experiencia espacial del sujeto habitante

Following these illustrations of hegemonic Big Pharma/TRIPS‐Plus discourse, it is time to examine the events of the 1999 protests against then‐ US Vice President and Democratic Presidential candidate, Al Gore. The protests were instigated in June 1999 by US‐based AIDS activist organisation, ACT UP (Sawyer, 2002). Formed in the 1980s in response to perceived US government inaction over the AIDS crisis, ACT UP has a well‐ documented history of vibrant and abrasive activism (Gould, 2009; Halchi, 1999). In particular, its approach was recognised in 1990 by TheNewYork Times as “rude, rash [and] effective” in engaging both the news media and the government with its concerns (DeParle, 3 January 1990, n.p.).

In early 1999, ACT UP selected Al Gore as the target for a new wave of protest actions over his involvement in an HIV/AIDS medicines access conflict in South Africa (Sawyer, 2002). Since passing the Medicines and Related SubstancesControl Amendment Act (Medicines Act) in 1997, South Africa’s government had come under increasing pressure from the US government to amend the Act’s provisions for importing generic medicines (CPTech, 1999). As co‐chair of the US/South Africa bi‐national commission, Gore was targeted for his high‐profile role in advocating the US position (Sawyer, 2002).

At the conflict’s centre was Clause 15(c) of the Medicines Act allowing parallel importation and compulsory licensing of medicines in national health emergencies (Barnard, 2002; Bond, 1999). The Act had been introduced to fulfil the newly elected Nelson Mandela‐led government’s campaign promise to ensure access to essential medicines as a constitutional

165 right (Bond, 1999). In light of emerging statistics on the scale of the AIDS crisis in South Africa35_{, the Act had gained increased pertinence (Bond,}

1999). At the insistence of an “outraged” pharmaceutical industry (Sell, 2001, p. 501), however, the USTR condemned the Medicines Act, arguing that it was unconstitutional (Klug, 2008), and that its provisions for generics violated South Africa’s TRIPS obligations (Bond, 1999; CPTech, 1999; Halbert, 2005; Sell, 2001).

While the issue was never taken to the WTO dispute settlement mechanism, despite similar medicines disputes with India in 1997 (Rangnekar, 2005) and Brazil in 2001 (Galvāo, 2005) that were, the USTR pursued various “extra‐institutional” tactics (Shadlen, 2004, p. 80) to persuade South Africa to amend the Act (Richards, 2004). These involved placing South Africa on the USTR’s 301 watch list (CPTech, 1999; Sell, 2001), withholding tariff‐ reduction privileges under the Generalised System of Preferences (GSP) program (Bond, 1999), and passing a new act in the US Congress containing provisions to cease aid to South Africa pending a US State Department report outlining US efforts to negotiate the Medicines Act (United States Congress, 1998). 39 multinational pharmaceutical companies also filed a lawsuit against the South African government to prevent the Act (Barnard, 2002) (see Chapter 6), with further economic pressure applied by pharmaceutical companies threatening to cease investment in South Africa (McNeil, 29 March 1998).

Much of the detail of these efforts was outlined in the State Department report referred to above, unambiguously titled “U.S. Government Efforts to Negotiate the Repeal, Termination, or Withdrawal of Article 15(c) of the South African Medicines and Related Substances Act of 1997” (United States Department of State, 1999). For ACT UP, however, the report became known as “the smoking gun” for its detailed listing of US‐led pressure, and its identification of Al Gore as a key player in the negotiations (Sawyer, 2002, p.

35 _{UNAIDS estimates claimed that by 1999, 4.2 million of South Africa’s 40 million population were HIV‐}

166 98). On 16 June 1999, Gore formally announced his campaign for the 2000 US presidency from the steps of the Smith County courthouse in Carthage, Tennessee, to a crowd of around 5,000 supporters (Seelye, 17 June 1999). Also in attendance, however, were a dozen activists from ACT UP and associated group, AIDS Drugs for Africa (Sawyer, 2002). According to protest leader and ACT UP co‐founder, Eric Sawyer (2002), the goal was to hijack the media attention on Gore in order to publicise the issue of South African HIV/AIDS medicines access.

The Tennessee action was the first of several similar protests as ACT UP, and increasingly more advocacy groups, followed Gore through his summer campaign appointments (Gellman, 21 May 2000; Sawyer, 2002). By autumn 1999, ACT UP leaders had been invited to the White House to discuss their concerns (Gellman, 21 May 2000; Sawyer, 2002), with President Bill Clinton soon announcing the US “shall not seek, through negotiation or otherwise, the revocation of any intellectual property law or policy of a beneficiary sub‐ Saharan African country” (Clinton, 2000, p. 30521). While ACT UP claimed responsibility for the policy reversal (Sawyer, 2002), Gore’s National Security Advisor, Leon Fuerth, claimed Gore had been lobbying for the US to withdraw its opposition to the Medicines Act for months, with a deal pledging as much sitting unsigned on the USTR’s desk for two days before the Tennessee protest (Gellman, 21 May 2000). Then‐USTR, Charlene Barshefsky, however, noted that it was indeed the protesters, not Gore, who put the issue on her agenda (Gellman, 21 May 2000). Concealing the USTR’s prior mobilisation against the Medicines Act, Barshefsky claimed:

Largely it was the activities of ACT‐UP and the AIDS activists that galvanized our attention that there was an absolute crisis. [Until then] I was certainly not aware of this at all ... In years past, this issue was treated purely as a trade issue and an intellectual property rights issue. (Barshefsky, in Gellman, 21 May 2000, p. A01)

167 “undesirable and inappropriate precedent” (PhRMA, 10 May 2000, n.p.)