AIDS activists say perhaps millions of people in Sub-Saharan Africa lack access to anti-retrovirals, in part because of the high cost of the drugs.  Some say drug companies and their governments discourage developing countries from exercising their rights under World Trade Agreement rules to purchase or manufacture anti-retrovirals in case of a health emergency.  These critics, including Oxfam, accuse governments of pressuring poor countries to honor the often-higher costs linked to intellectual property rights for the drugs in exchange for favorable free trade agreements.

But John Pender of GlaxoSmithKline (GSK) disagrees.  He says the lack of access to medications can largely be blamed on two things: poverty and poor health care infrastructure in the developing world.

Pender, who is in charge of accessibility and intellectual property issues at the multi-national company, says “Intellectual property [rights] are not the main reason people in the developing world are denied access to medicines.  The problem really is rooted in poverty and the fact that people don’t have access to clean water or sanitation, never mind adequate health care.  So, a solution that is based around intellectual property is never going to solve the problem in its entirety.”

Pender says GSK is working to help the poor gain access to expensive medications with a not-for-profit pricing policy on the anti-retrovirals.  He says the vast majority of pharmaceuticals also provide the medications at cost.  He says it is GSK’s ability to make profits in wealthier countries that  enables the company to provide anti-retrovirals at lower prices to Africa.

But he says drugs offered at lower prices, and even donated drugs, are still not reaching the numbers who need them. 

He quotes the head of HIV / AIDS at the World Health Organization, Dr. Kevin Dekock who said recently, “if you work in these countries, it is very obvious very quickly that the elephant in the room is not the current prices of drugs.  The real obstacle is the fragility of the health systems, particularly in Africa.”

For long-term solutions, Pender recommends a fundamental campaign to address the roots of poverty. “What we need is a partnership approach by all sectors of society, but particularly governments of the developed world who need to provide the resources to overcome the fundamental causes of poverty that are causing this problem.” And he calls on African governments to prioritize health care in their national budgets. “It’s still far too low a percentage,”he says, “ far too [few] clinics, doctors and nurses for the health care needs of the population.”

For an opposing view go to: Few Inexpensive HIV/AIDS Drugs for World's Poor.