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Companies reduce prices AIDS lead healthier and more productive lives,’’ said Dr Peter Piot, Executive Director for HIV drugs in developing of the Joint Programme on countries HIV/AIDS (UNAIDS). ‘‘We need signifi- In an unprecedented effort to combat cant new funding that is on a level with acquired immunodeficiency syndrome the enormous human, social and economic (AIDS) in sub-Saharan Africa, five of the challenges now being imposed by world’s leading pharmaceutical companies the epidemic.’’ have agreed to decrease the price of drugs Getting these medications to the used to treat those infected with the human world’s developing nations has become immunodeficiency virus (HIV). Some of a rallying cry for AIDS activists around the the companies have pledged to sell the world. In recent months, they have disrupted pharmaceuticals at prices just above manu- drug firms’ annual shareholder meetings facturing costs, at discounts as great as 90%. and pressured the Clinton Administration Glaxo Wellcome said it would offer its to force the industry to offer the drugs at drug Combivir — a mixture of more affordable prices. Earlier this month, and zidovudine — for US$ 3 a day in many President Clinton issued an executive order of the world’s developing countries. The suggesting that the United States Trade drug currently costs about US$ 11 a day Representative’s office no longer would in Canada and US$ 25 in the United States. threaten trade sanctions against developing ‘‘The HIV epidemic in developing nations that use the World Trade Organiza- countries threatens to wipe out development tion’s intellectual property rules to gain and economic gains made in the second access to cheaper drugs. The World Trade half of the last century,’’ Richard Sykes, Organization allows countries to manufac- Chairman of Glaxo Wellcome, said in ture generic versions of patented drugs a prepared statement. ‘‘The private sector if they are used to combat national health has a role to play in contributing to a emergencies and some countries like South multisector response to this epidemic,’’ Africa are considering this option. he said. As a result, industry insiders say the ‘‘It’s really a very exciting announce- pharmaceutical companies had little choice ment,’’ said Dr Mark Wainberg, a physi- but to act quickly. Some developing nations cian and President of the International were poised to manufacture their own cheap AIDS Society. ‘‘It’s something that a lot versions of HIV drugs. Brazil, India and of pharmaceutical companies have been Thailand already make generic zidovudine under pressure to do for a long time.’’ at 10% of the price in the United States. However, Wainberg said, even at these Another proposed United States trade policy prices, the drugs will be beyond the would have given authority to companies in Africa to make generic AIDS drugs, financial grasp of many in Africa, whose n average per-capita income is less than regardless of patents. US$ 80 a month. Some experts also Scott Gottlieb, New York fear Africa does not have enough trained medical personnel to administer the drugs.‘‘Ifthedrugsarenottakenproperly, then resistance almost certainly will be an aftermath,’’ Wainberg said. In addition to Glaxo Wellcome, the participating companies include Boehringer Ingelheim, Bristol-Myers Squibb, Hoffman- La Roche and Merck & Co. Other companies are preparing to join the group. Experts say that new efforts to improve prevention, medical infrastructure, inter- national funding and political will are also needed. ‘‘Lowering the price of medicines ... is only one critical factor in what must become a much broader and more urgent effort to help people living with HIV and

862 # World Health Organization 2000 Bulletin of the World Health Organization, 2000, 78 (6)