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Treating Aids: A Global Ethical Dilemma

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Key Issue:

The vast majority of the people infected with HIV and has AIDS do not live in developed countries and do not have an access to therapies. Local governments cannot afford vast reimbursements of health care products and that dispense the citizens of the lifesaving "cocktails". The issue is complicated by the fact that developing countries have poor infrastructure, poor health care systems and poverty that prevent the distribution of anti-AIDS drugs. The international community is facing a dilemma - How to balance the problem of drug accessibility in the developing world with the need to promote and fund research and development of new drugs in the developed world? Is the cost factor the only issue related to access to medicines?


As of January 2006, UNAIDS and the World Health Organization (WHO) estimate that AIDS has killed more than 25 million people since it was first recognized on December 1, 1981, making it one of the most destructive pandemics in recorded history. In 2005 alone, AIDS claimed between an estimated 2.8 and 3.6 million, of which more than 570,000 were children. (

Drug accessibility for the poor nations has become a vast economic and political issue. The UN, WHO and numerous health care organizations from all over the world, are putting pressure of pharmaceutical companies to reduce pricing on the anti-AIDS drugs. Meanwhile, in order to gain access to medical treatment, governments are importing inexpensive generic drugs and give the right to manufacture drugs domestically, without enforcement of patent requirements.

Many pharmaceutical giants like Glaxo-Smith Kline, Pfizer INC, Merck and Co. make concessions in the form of drastic price reductions, as well as dismissing numerous lawsuits related to patent protections of their products. The companies not only agree to reduce prices for African countries, but comply to offer the drugs at cost without any expectation of profit. Also, an important concession has been undertaken within the WTO - the Doha declaration of 2001, that "give the poor nations the right to protect public health and to promote the access to medicines for all" and that "the TRIPS (Trade-related aspects of intellectual property rights) agreement does not and should not prevent members from taking measures to protect public health." A balance between the patent protection laws and access to medication for developing countries has been reached.


Despite all the measures administered but the UN and the WTO and the price reductions undertaken by the pharmaceutical companies, African countries continue to buy discounted drugs from small generic companies, whose medications not only are insufficient with the demand but also are subject of quality concerns. Many of them fail to receive a certification. They are often unregulated, offering poor safety standards.

The impact of the African price reductions leads to an international issue. As a result of the discount offered in the developing countries, many of the pharmaceutical companies expose themselves to criticism because of the high pricing of their products in the developed markets. The issue of the differential pricing begins to rise. The pharmaceutical companies state that without such differential pricing they will not be able to continue investing in patented drugs, research and development of new drugs and cure for AIDS. According to studies the cost of developing a new pharmaceutical product is estimated at $600-$800 million. The ability to recoup research and development becomes even more critical considering that competition usually will occur within one year of two. (Robert Pier, Research Cost for New Pharmaceutical Drug Said to Soar, NY Times, Dec.1, 2001)

These events are primary related to the cost factor in accessing medical treatment. But reducing the price of anti - AIDS drugs is not the solution



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