12/01/2006 11:29 am ET Updated May 25, 2011

Best AIDS Drugs Still Unavailable to Global Poor

Even though Indian and Brazilian generic drugs for HIV/AIDS are finally flooding the developing the world (there's now more than a million people receiving treatments), the best drugs for this life-destroying disease are still out of reach to many people.

Earlier this week, Doctors Without Borders (Medicins Sans Frontieres) launched a broadside against several drugmakers who have failed to make the latest and best versions of these crucial drugs available to poor people around the world. The World Health Organization endorsed a new heat-stable regimen for AIDS, which would be ideal for Third World countries. It's made by Abbott Laboratories. However, the company has not registered this product with a single less developed country and its list price in "second-tier" markets like Thailand is $2,200 a year. Despite protests from groups like MSF, a Washington meeting this week that brought together donor organizations like WHO, UNAIDS, and the World Bank did not take up the pricing issue.

"Donor money should not be squandered to pay for overpriced drugs. The priority is to make drug prices come down as much as possible," said one MSF official. "International organizations, donors, and industry must overhaul their strategies to ensure that universal access to AIDS treatment for life becomes a reality - this means confronting companies and their patents."

It's especially galling that Abbott isn't making its latest drug combination available at generic (the cost of manufacturing) rates. The Chicago-based company only got into AIDS research in the late 1980s because one of its scientists applied for a government grant. They probably spent less than $150 million in bringing an analog of this first drug, ritonavir, to market. They've since generated billions of dollars in sales from this spawn of government-funding. Why? It turns out that every AIDS cocktail can benefit from a dash of ritonavir because it has the positive side effect of keeping all drugs in the blood stream longer. That's a good thing when you have to take lots of pills every day.

When I was writing my book, The $800 Million Pill, which contains the story of the development of ritonavir and all of the early AIDS drugs, I interviewed an AIDS activist who had sat through numerous meetings in the early 1990s with Abbott officials as U.S. PWAs (people with AIDS) pressed the pharmaceutical industry to tackle the then untreatable disease. By the time I interviewed him, his group, like many AIDS advocacy groups, had forged financial alliances with the drug industry. So he searched for a charitable phrase to describe their behavior in the early days. "They would never get the 'plays well with others' award," he said.

They're still not playing well with others.