Without a word of protest from the national AIDS organizations, the Bush administration, behind closed doors, has been sabotaging the ability of the world’s poorest countries to produce or buy cheap, generic AIDS meds. Here’s the background: In November 2001, after a long fight against Big Pharma’s monopolization of AIDS-drug production, a World Trade Organization meeting in Doha, Qatar, agreed that poor countries should have the right to break the multinational drug companies’ patent monopoly if they declared a national AIDS emergency. The U.S. was among the 142 countries signing this breakthrough agreement, under which poor countries could make their own AIDS meds cheaply or buy generic versions from a producing country (like India), thus bypassing Big Pharma.

This was a huge victory, won after years of struggle by AIDS and nongovernmental public-health-advocacy organizations around the world. The Doha Declaration began to save thousands of lives, by getting cheap, life-prolonging meds into the hands of HIV positive people in poorer nations. But the Bush administration is morbidly blackmailing poor countries into forfeiting their production rights under that treaty if they want (so-called) Free Trade Agreements with the U.S. Either the poor countries refuse to knuckle under and scuttle these bilateral and regional trade deals—worth billions—with Washington, or they accept the deals and raise the price of AIDS meds beyond the reach of the poor.

This unconscionable blackmail has made many countries, including six in Latin America, cede their rights to break the Big Pharma AIDS drug monopoly. Washington has launched tough negotiations with a raft of poor countries hard hit by AIDS, from Thailand to five southern African lands, including Botswana and South Africa. If Thailand signs the U.S. trade proposal, “Those who require the essential drugs but cannot afford them-—they will have to die,” says Suwit Wibulpolpraset, MD, the Thai Public Health Ministry official coordinating his country’s response to the Bush administration’s arm-breaking trade deal that rolls back the Doha agreement. And the same goes for the other nations beaten with Washington’s big stick.

Bush and his cronies “began this trade blackmail in 2002, after a group of the largest Big Pharma companies—headed by Pfizer CEO Hank McKinnell—raised $30 million for the Republicans’ congressional campaigns that year,” says James Love, of the Consumer Project on Technology, the international point man in winning the patent-breaking Doha agreement and an unsung hero in the fight for cheap AIDS meds. The effect of these deals, Love says, is to force poor countries into enacting “superpatents” that prolong U.S. drugmakers’ monopolies and sharply limit the conditions under which their AIDS patents can be broken.

Though millions of lives are at stake in these sordid and lethal trade deals, the major U.S. AIDS organizations, like AIDS Action—which calls itself “the national voice on AIDS”—and the National Association of People With AIDS, have been AWOL from the fight against them. And since the AIDS advocates are silent, Washington can negotiate these murderous deals at economic gunpoint with little media notice.

I’m angry at our national AIDS groups for their isolationism, for their failure to lead a huge public outcry against the iniquitous Bush administration, which values Big Pharma’s profits ahead of the lives of poor people with HIV.

Washington should not be allowed to tear up its commitments without any protest from those who pretend to speak for us on AIDS.