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Cheap AIDS drugs for the first world now! (Oct 2003)

The agreement finally thrashed out on cheap HIV drugs for developing countries at the World Trade Organisation talks is historic, and welcome. (See World News)

It strengthens, if not sets in stone, the idea that medicine is too important, and denying it too grave an offence against human rights, to allow normal marketing forces to rule. You can’t sell nelfinavir like Nikes.

The agreement comes with many strings attached. And it’s only good as it stands for two years. In 2005 countries like India have to sign the TRIPS agreement, which means that, from then on, they won’t be allowed to copy any newly-patented drugs. The result will be that - once again - developing countries will be palmed off with treatments that will steadily become more obsolete, and in time we will be back to two-tier world medicine.

And rich and middle-income countries are excluded from the agreement and will pay the same old high prices.

So they should, you’re thinking. The rich world has a moral obligation to pay the market rate. To bring a single new medicine to market can cost hundreds of millions of dollars. Someone needs to pay the R&D costs of the drug companies. Well, the companies may find their hands forced over their prices - and not just in the ‘third world’.

The recent furore about asylum seekers with HIV was fuelled partly by xenophobia, partly by public health paranoia. But what really scares the powers-that-be is the spiralling cost of HIV treatment. One large HIV clinic recently told PN it was vetoing patients’ applications for compassionate release of new, unlicensed HIV drugs like atazanavir and fosamprenavir - because of the likely future cost.In the USA, because of bankrupt state budgets, treatment rationing is already a reality for the unemployed. There are people in Texas as effectively excluded from antiretrovirals as people in Tanzania.

HIV is incurable, so needs lifelong treatment. It’s recent, so requires expensive hi-tech drugs. And it continues an apparently relentless advance. In 10 years’ time there will be a lot more of us around and we will be much, much more expensive to treat. HIV badly needs cheaper answers.

Even rich governments may, in the end, find themselves locked in battle with the pharmacos over the cost of HIV drugs.

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