Pharmaceutical Companies Should ‘Broaden’ Efforts To Provide Access to Antiretrovirals, Other Drugs in Developing Countries, Opinion Piece Says

The "history of HIV drugs has not been pretty," and the international community is now "in the throes of another round of HIV drug battles," Atul Gawande -- a surgeon at Brigham and Women's Hospital and staff writer for the New Yorker -- writes in a New York Times opinion piece. The current dispute is over "advanced" and "expensive" antiretroviral drugs produced by Merck and Abbott Laboratories, Gawande writes, adding that the "fight has become vicious." According to Gawande, it is "hard to see how the confrontation could be avoided" because companies "do need profit margins to recoup" the cost of developing new drugs and "encourage new innovation." However, "once a life-saving discovery is made, it is clearly grotesque to make millions suffer or die while waiting for a 20-year patent to expire," Gawande writes.

According to Gawande, there has been a "spectrum of behavior" among drug manufacturers, and the "experience" with some antiretrovirals has been "oddly heartening." Gilead Sciences has granted licenses to generic drug makers to develop its antiretroviral Viread in the world's 100 poorest nations for a royalty of 5% of sales, and Bristol-Meyers Squibb has granted licenses to drug makers in India and Southern Africa to develop its antiretroviral Reyataz for no royalties, Gawande writes. In addition, the World Health Organization has established bulk vaccine purchasing plans through which drug companies have made "significant profits" selling vaccines at low costs in large volumes, Gawande writes. These partnerships are the "progress we want to build upon," Gawande writes, adding, "Pressure to broaden these efforts will grow and it should." Agreements on regional pricing tiers and dispensing networks for antiretrovirals "show likelihood of solidifying in ways that make drugs available and support innovation," he writes. He adds, "Meanwhile, the world is changing," and people in developing countries need access to drugs for diseases such as cancer, heart disease and lung disease. According to Gawande, "Manufacturers need to show the same willingness to make these life-saving technologies available to the poor" (Gawande, New York Times, 5/17).