PRIVATE PATENTS AND PUBLIC HEALTH

Fifteen years later, more than 13 million people globally receive
ARV treatment, mostly in the form of low-cost generic medicines. 17 In
sub-Saharan Africa, 87% of the people who know their HIV status are
receiving ARVs. Almost 76% of those on ARVs have achieved viral
suppression, according to UNAIDS. 18 Globally, however, 61–63% of people
who need treatment still do not yet receive it. 19
In 2011, the US National Institutes of Health published a report 20 that
found treatment with ARVs decreased the chance of HIV transmission to
a partner by 96%. This news finally promised a way to break the back of
the AIDS epidemic, if all who needed medicines could get access to them.
At the same time, improved tolerability profiles of new HIV medicines
and continued studies allowed the WHO to continue recommending HIV
positive people start on therapy earlier in the disease progression,
culminating in a new recommendation on 30 September 2015 to “treat
all” people exposed to or at high risk of HIV exposure. 21
But the 2005 deadline for developing countries (with the exception of
least-developed countries) to fully implement the TRIPS Agreement
meant a closing window for many of the generic medicines manufacturers
who had become the leading drug suppliers to people living with HIV in
the developing world. Generic versions of drugs brought to market before
TRIPS went into effect could still be manufactured. But newer, better
tolerated treatment regimens preferred by the WHO faced patent barriers.
INTRODUCTION
• For more on this closing policy space, see Chapter 4
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