MSF’s experience trying to obtain newer AIDS drugs for patients who need them has proven that they are largely either unaffordable or unavailable in countries where we work.

Why are newer AIDS drugs unaffordable?
The main reason newer drugs are so expensive is that they are brand products under patent. Most of them were developed after countries like Thailand, India and Brazil – major producers of generic medicines – had to start granting pharmaceutical patents to comply with World Trade Organization (WTO) rules. That means that by and large generic manufacturers in those countries cannot now produce affordable generic versions of the newer drugs without infringing the patents held by the originator companies in those countries. So the competition among multiple manufacturers that led to the dramatic drop in prices for the first generation of antiretrovirals (ARVs) cannot take place.

Doha Declaration sets out public health safeguards
There are ways, however, to ensure that production of affordable medicines can continue, and MSF has been helping in this fight.

The member states of the WTO in 2001 confirmed a set of key public health safeguards that exist in trade agreements to ensure that patents do not stand in the way of people’s access to affordable medicines. One such provision allows a country to grant a ‘compulsory license’ to companies to produce a drug under patent in that country in the interests of public health needs. Another allows countries to design patent laws in a way that the interests of public health and patent holders, helping ensure sustained access to affordable medicines.

India patent law to ensure affordable medicines
In India, for example, the government adopted a patent law that is strict in terms of which medicines should be patented and which should not. It also allows any interested party to make a case to ‘oppose’ a patent application while it is under review by the patent examiner. MSF has been actively supporting patient and advocacy groups in India who have been fighting to make sure affordable versions of newer ARVs can continue to be produced in India. India is the key supplier of generic medicines to developing countries.

When pharmaceutical company Novartis took the Indian government to court over its patent law, MSF launched a petition and along with over 400,000 people across the globe spoke out in support of securing India as the ‘pharmacy of the developing world’.