Patents are not divine rights, they are a societal tool that must be balanced to benefit everyone. Of the 40 million people living with HIV/AIDS worldwide, only 10% currently have access to antiretroviral therapy. Every effort must be made to increase access to these medicines for the remaining 90%. If patented antiretrovirals are too expensive, countries should produce or import generic drugs - as is their acknowledged right under the World Trade Organisation TRIPS Agreement.

The use of generic AIDS drugs in the developing world will not dissuade the pharmaceutical industry from developing new AIDS drugs. Drug sale profits come from wealthy countries, which represent 80% of the worldwide drug market. With Africa accounting for only 1% of drug sales, it is ludicrous to suggest that the use of generics in Africa diminishes the economic incentive for multinationals to conduct research. The patent system can be an important fuel for innovation, but fails dramatically when there is no profitable market.

The private sector has long neglected the major killers of the developing world: only 1% of drugs approved in the last twenty-five years were for tropical diseases such as sleeping sickness and kala-azar. New cures are desperately needed for these diseases, but promising compounds are rarely pursued because they promise no return on investment.

Médecins Sans Frontières (MSF) has signed an agreement with FarManguinhos (which is part of Fiocruz, a public entity funded by the Federal Government and associated with the Ministry of Health) to use their generic drugs, including antiretrovirals, in MSF projects. In return, MSF contributes finances to FarManguinhos' efforts to find new cures for neglected diseases.

Brazilian antiretroviral prices are low because FarManguinhos is a public entity which aims to ensure that antiretroviral treatment is available to all people living with HIV/AIDS in Brazil. This approach has enabled over 100,000 people in Brazil to gain access to life-saving drugs.

The current agreement between MSF and FarManguinhos extends these benefits to others in need outside Brazil, and contributes to the development of much needed medicines for diseases that are being ignored by multinational drug companies. Dr Bernard Pécoul Director Campaign for Access to Essential Medicines Médecins Sans Frontières Geneva