Public attention and debate recently have focused on access to treatment
of acquired immunodeficiency syndrome (AIDS) in poor, severely affected countries,
such as those in Africa. Whether patents on antiretroviral drugs in Africa
are impeding access to lifesaving treatment for the 25 million Africans with
human immunodeficiency virus infection is unknown. We studied the patent statuses
of 15 antiretroviral drugs in 53 African countries. Using a survey method,
we found that these antiretroviral drugs are patented in few African countries
(median, 3; mode, 0) and that in countries where antiretroviral drug patents
exist, generally only a small subset of antiretroviral drugs are patented
(median and mode, 4). The observed scarcity of patents cannot be simply explained
by a lack of patent laws because most African countries have offered patent
protection for pharmaceuticals for many years. Furthermore, in this particular
case, geographic patent coverage does not appear to correlate with antiretroviral
treatment access in Africa, suggesting that patents and patent law are not
a major barrier to treatment access in and of themselves. We conclude that
a variety of de facto barriers are more responsible for impeding access to
antiretroviral treatment, including but not limited to the poverty of African
countries, the high cost of antiretroviral treatment, national regulatory
requirements for medicines, tariffs and sales taxes, and, above all, a lack
of sufficient international financial aid to fund antiretroviral treatment.
We consider these findings in light of policies for enhancing antiretroviral
treatment access in poor countries.
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