Making a “killing”

By: Marcus Ostermiller

We live in a world with tremendous economic disparities, so it is understandable that poorer countries struggle to tap into cutting edge treatments.  It is encouraging to see how global spending for HIV/AIDS has skyrocketed in recent years, allowing millions more people to receive the antiretroviral treatment (ART) they so desperately need.  However, this increase in spending fails to address the fundamental obstacle that prevents millions of others from obtaining ART: pharmaceutical patents.

Virtually all HIV medications are name-brand products for which their respective pharmaceutical companies earn gigantic profits.  Research over the past ten years has unveiled significantly more effective ART with minimal side effects.  Each of these cutting edge medications are patented by large pharmaceutical companies, all which charge exorbitant amounts for them.  In 2006 Gilead Sciences and Bristol-Myers Squibb joined forces to release the first once-daily pill regimen under the product name Atripla (emtricitabine/tenofovir/efavirenz).  A single month supply of Atripla costs just under $2000 in the United States.  Due to the patent on this drug, no generic form of Atripla exists, as is the case for all other relevant forms of ART in use today.

The recent hikes in global spending for HIV/AIDS are encouraging, but recent studies suggest that we still fall short and will continue to do so because of the tremendous gap between resources needed and resources available.  Just yesterday, Secretary of State Hillary Rodham Clinton called for a more aggressive effort to strive for an “AIDS-free generation” through the use of new scientific discoveries and diplomatic efforts in other countries.  What her speech failed to address, however, was the actual logistics of paying for these increased efforts.  New medications are generally patented products and, therefore, extremely expensive.  This prohibits the majority of those afflicted with HIV from accessing the new medications on their own, thus necessitating a financial intermediary (government, NGO, or other organization) to pay for the medications.  Considering the high prices of new HIV medications, we can scarce expect that external funding will ever meet the level of global need.  New technologies are wonderful, but what use are they if nobody can afford to use them?

The problem with HIV/AIDS funding has less to do with the total amount of money currently available to subsidize global treatment, and more to do with the way pharmaceutical companies control these crucial medications through profit-driven patents.  These companies are making billions of dollars while entire populations – particularly those in the developing world – are being killed due to their inability to procure expensive name-brand medications.  India’s recent manufacturing of generic HIV medications has accounted for the majority of ART currently being supplied to Sub-Saharan Africa.  Sadly, however, the legal framework that allows for this is changing soon due to a World Trade Organization Agreement, so India will no longer be able to assist in such an effective way.

Perhaps this aspect of our free-market, capitalist system isn’t working very well after all.  It is time for us to stop protecting the interests of overly profitable pharmaceutical companies at the expense of millions of human lives.


Donald G. McNeil Jr.  “Clinton aims for ‘AIDS-Free Generation’.”  New York Times [New York] November 9, 2011, New York edition: A16.

Brenda Waning et al. “A lifeline to treatment: the role of Indian generic manufacturers in supplying antiretroviral medicines to developing countries.” Journal of the International AIDS Society 2010 13:35.


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