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Pfizer Working Session in Bangkok—Invitation to Richard Stern and Dr. Stern’s reply

15 June 2004
Ann Prochilo
Pfizer and Company
San Francisco, California

Dear Ann:

Thanks for this invitation [posted below this response] to participate in a forum in Bangkok with company representatives of Pfizer. Your invitation makes me wonder to what extent Jackson Peyton accurately conveyed my true sentiments about Pfizer which I expressed in my telephone interview with him several months ago.

  1. During a period of several years I have tried to communicate with Pfizer’s Central American General Manager, Sylvia Varella, and she will not even return my phone calls. That it is to say it seems odd, in fact quite ironic, that I am invited to a Forum in Bangkok, Thailand when I am not even permitted to speak to the person in charge of Pfizer for the region in which I live and work. The Central American headquarters of Pfizer are just a few miles away from where I live, here in San Jose, Costa Rica.(My first contact with Pfizer was a letter sent to Ms. Varela on January 4th, 2000, subsequently forwarded to Jim Brigatitis of Pfizer’s New York office, who promised to reply to my request for a reevaluation of Pfizer pricing policies in Central America, but to this date (4 years and six months later) has never replied. Subsequently, I have left at least 20 messages for Ms. Varela, during the past 4 years, but have yet to receive a return call.)
  2. I made it clear to Jackson Peyton that, to me, Pfizer’s pricing policies in Central American have been particularly cruel and, in my opinion, border on genocidal. I have witnessed or been told about the deaths of dozens of People Living with HIV/AIDS that I have known and cared about because they were unable to purchase Pfizer’s Diflucan because of its outrageous prices in Central America. Such deaths continue to occur regularly TO THIS DAY not only in Honduras, Nicaragua, Panama, but also in Bolivia, Ecuador and Peru, as well as Jamaica and other Caribbean countries because the price of Diflucan ranges from $18-30 per day for the dose necessary to cure life-threatening opportunistic infections such as oral candidiasis, and cryptococcal meningitis. People who are poor and sick with AIDS and out of work do not have $18 to $30 a day to buy Pfizer’s pills and consequently perish from these horrible opportunistic infections.The issues that patents may or may not exist in some of these countries is irrelevant, since in many areas of these countries, urban as well as rural, no generic companies have marketed their products, meaning that Diflucan is the only product available. Pfizer’s local representatives are well aware of this de facto monopoly.
  3. As you are well aware, the death of a 12-year old Honduran boy was documented on British television on April 18th of 2003, by the True Vision documentary company. The boy died (literally on camera) of starvation due to esophageal candidiasis because his family could not afford the $28 per day that the local pharmacies were charging for Diflucan in San Pedro Sula, Honduras. Ann, can you as a human being, imagine what it is like for a 12-year old boy to die of starvation over a period of weeks, strangled by oral candidiasis, a disease that would have been perfectly curable with 15-20 pills if his impoverished family had been able to buy them?? We cannot show this film in Central America because it also shows desperate Honduran People with AIDS attempting to smuggle generic versions of Diflucan into Honduras from another country in order to save the lives of dying people, and they are terrified of reprisals.
  4. At one point I was told that many of Pfizer’s leading company officials receive salaries of $5 to $10 million yearly, which probably accounts for the high prices that Pfizer needs to charge. This corporate greed contributes to the death of impoverished and innocent people.
  5. Pfizer has donation programs in other countries, but not in Latin America. Why not? Why is it that the version of Diflucan manufactured generically can cost as low as 25 cents per tablet, when your own product sells for as much as 100 times that amount?? Whether in South Africa or Ethiopia or Peru or Honduras or Jamaica, Diflucan is still too expensive for most poor people already sick and out of work.
  6. Please note that I refused to accept the $100 payment which Pfizer’s paid consultant, Jackson Peyton, offered me for the interview, but suggested instead that a donation of $100 be made to a leading generic company. As long as you and Pfizer management staff can accept all of the points made above, I will be happy to accept your invitation, but I would be much more interested in hearing what Pfizer is willing to do about prices of Diflucan in the countries I have mentioned above.

As the only way to deal with a situation such as this is to publicize it, I am making this correspondence public.


Richard Stern, Ph.D.
Agua Buena Human Rights Association
San Jose, Costa Rica
Tel/Fax 506-234-2411

Text of Original Pfizer Invitation

—– Original Message —–

Dear Richard,

I am writing to you on behalf of Pfizer. Firstly, I’d like to thank you for speaking with my colleague, Jackson Peyton, earlier this spring. Your broad-ranging inputs and follow-up helped us better understand key issues and concerns and increased Pfizer’s awareness of critical issues and advocates to work with in Latin America and beyond.

As you know, Pfizer has two antiretrovirals in Phase II clinical development — capravirine, an NNRTI, and UK-427,857, a CCR5 co-receptor antagonist. As Pfizer begins evaluating strategic alternatives to maximize access to these compounds in developing countries, they are grappling with critical structural issues that challenge not only the least-developed countries, but the remainder of countries that do not meet formal least-developed criteria.

In anticipation that you will be in Bangkok, Pfizer would like to invite you to participate in a small working session on the evening of Tuesday, July 13th comprised of Pfizer personnel and 10-15 HIV community advocates. The objective of the working session is to share preliminary thoughts and gather information on expectations, perceived best practices, advocate considerations, etc. These discussions will inform recommendations for Pfizer’s HIV developing markets strategy for non least-developed countries.

Pfizer recognizes that country/regional-specific situations vary widely in regards to functional infrastructure, supply chain/distribution integrity, pricing policies and intellectual property positions. Pfizer also recognizes that these are highly complex, high-stakes issues that go far beyond Pfizer’s pipeline focus and will require an ever-broadening, active partnership with HIV advocates to forge a path to meeting unmet needs. This working session will provide one opportunity to gather inputs to inform approaches in middle markets/developing countries. It is Pfizer’s intention to engage advocates in a variety of venues to expand the scope of discussion and participation at local, regional and international levels going forward.

Please let us know as soon as possible if you are interested and able to participate. If you have questions, please do not hesitate to contact me directly at or 1-415-378-3175. Thank you in advance for your consideration.

Details follow:
DATE: Tuesday, July 13, 2004 (6:00 PM to 9:30 PM)
FORMAT: Dinner with facilitated small (roundtables) and large group discussion
LOCATION: Upon confirmation, we’ll send full details

Best regards,
Ann Prochilo

Ann Prochilo
Prochilo Health, Inc.
4104 24th St. #701
San Francisco, CA 94114
w: 1 (415) 378-3175
f: 1 (415) 341-1301


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