Since the development of antiretroviral drugs in the 1990s, the battle against AIDS has largely been fought over the question of how to distribute the drugs fairly. The drugs save lives, with recent research suggesting that the risk of spreading the virus is reduced to almost nil if people infected with HIV start therapy quickly enough. Furthermore, if uninfected people living in a high-risk area take just one antiretroviral pill a day, they greatly reduce their chances of contracting HIV in the first place. Yet the possibility of containing the epidemic has usually run up against the hard reality of cash. Western medical companies have been reluctant to sell their drugs at the sort of knockdown prices that developing countries can afford. The Bush-era United States President’s Emergency Plan for AIDS Relief committed $15 billion between 2003 and 2008, providing over 1.2 million people, primarily in Africa, with access to antiretroviral drugs. Such demand has led to competition in the antiretroviral market. A course of the drugs can cost as little as $143, but that is beyond the means of many of the 22.5 million sufferers in sub-Saharan Africa.
However, that dynamic looks set to change with the announcement last year that Gilead Sciences, a large antiretroviral manufacturer, has joined the Medicines Patent Pool, which will allow pharmaceutical companies to produce the drugs at much lower prices. Inspired by a patent pool created by aircraft manufacturers during World War I, the idea of sharing medical knowledge in the fight against AIDS was first proposed a decade ago. It became reality in 2009, when the NGO UNITAID established the organization. Since then, the Medicines Patent Pool has gained support from the Obama administration, which last year prompted the National Institutes of Health to become the first AIDS-patent donor.
A patent pool promises to reduce the cost of such programs in the future and to enable developing countries to gain quick access to new medicine. Gilead has given four patents to the organization, of which two are still in development. Instead of waiting for generic versions of the drugs to emerge, people in developing countries will have immediate access to generic versions. Gilead will receive a small royalty on each drug treatment sold. Research giants like Gilead hope that, by joining the Medicines Patent Pool, they can maintain some control over the drug patents and preempt any sweeping government intervention to make AIDS drugs and other treatments more widely available in the developing world. Significantly, middle-income countries like China and Egypt are not covered under the agreement, and still have to pay high prices for AIDS treatments.