When dealing with serious, highly complicated issues such as AIDS in Africa, controversy abounds. One clear fact is that only a small percentage of HIV-positive Africans receive necessary treatment; only 1 in 1000 receive even one antiretroviral drug for the disease. Still disputed is the root of the problem. Some believe high prices make patented drugs unattainable for impoverished residents in these countries. However, while drug prices in Africa are high, patents are the least likely cause, and other key issues are to blame.
First of all, although readily available in African countries, few patents actually exist. Of 795 possible patents only 172 are active. It is assumed more exist solely because patent applications are filed for these countries; however, most were abandoned at the time the fee was due. There is also no evidence that antiretroviral drugs are more accessible in countries with few or no patents. Access is uniformly poor, and given the extremely small number of treated Africans, the lack of access cannot be attributed to patents existing in so few countries.
It is also unlikely future patents will be exercised. It is illogical for companies to waste time and money in countries where patents will not be enforced and the overall drug consumption percentage is negligible. The motivation to patent remains in the lucrative markets of North American and Europe. Even with patents in effect, drug companies such as Merk, Bristol-Meyers Squibb and Abbott have discounted prices to costs not above production and distribution. The problem stems from the sheer poverty of these countries. Some have annual national health budgets of less than $8 per capita, and a lucrative drug supply plan costs at least $1200 per patient-year. Political will is also a huge barrier. High tariffs and sales taxes keep prices high even with brand name and generic drugs available at prices 90 percent cheaper than in the United States. If a single global brokering facility was established, orders could be received and put to a competitive tender among suppliers. This method has been effective in Third World countries with tuberculosis drugs, and companies have also expressed willingness to allow generic companies to manufacture drugs to ensure their availability in poor countries at a low cost. For this type of organization, aid needs to increase substantially, and developed countries should worry about this instead of patents. Current funds, providing $3 per infected African, do not provide even inexpensive AIDS treatment. With their financial capabilities, poor aid nearly violates medical ethics and human rights. With 25 million Africans infected, the United States and others with financial resources must prioritize funding to ensure drugs become more available to Africans.