Under a new deal brokered by former US President Bill Clinton, four pharmaceutical companies in India and South Africa have agreed to provide generic antiretroviral drugs to poor countries at substantially reduced prices. "The agreement will allow the delivery of a triple-drug treatment at about 38 cents, which is almost half the current price of inexpensive commonly used drugs", Clinton said. The plan will help provide about 2 million people in the Caribbean and Africa with cheaper antiretroviral drugs by 2008.

As the market expands, Clinton said, his foundation would find ways to reduce prices further. "The agreements we signed last week already provide for additional reductions in prices as volumes increase", he told TLID. "And if we can get other pharmaceutical companies interested in competing for business in the developing world, the market effect could push prices even lower." Clinton said he had secured partial funding from rich countries to help their poor counterparts pay for the drugs and for improvements in health systems.

According to Nathan Ford of the charity Medecins Sans Frontieres, bulk procurement initiatives such as this are essential if international agencies and governments are going to scale-up antiretroviral production to get the high quantities and low prices that are needed. "Generic companies continue to offer the most affordable prices. They are also willing to combine drugs in fixed-dose combinations, something that will be vital to the scaling-up efforts to simplify treatment and ensure compliance. Let's hope the initiative has as much success with diagnostics", Ford noted.

Carlos Correa (University of Buenos Aires, Argentina) described the price cuts as an important step, but cautioned that efforts should continue to get sustainable solutions to the problem of access to all types of drugs in poor countries, not only those HIV-related. "This will require a review of patent policies, particularly to discuss whether there is any justification to impose standards of protection that may only be suitable in the context of rich countries", Correa concluded.