Zimbabwe's government announced yesterday that it was taking a first step toward lifting patent monopolies on AIDS drugs by declaring the HIV epidemic there a "state of emergency." HIV kills 300 people daily in Zimbabwe and 20% of the population is HIV positive. Life-extending treatment including antiretroviral medicines is unaffordable to all but the wealthiest people living with HIV.

"The Zimbabwean government's action, though long overdue, is an imperative first step to securing access to lowest cost supplies of quality, life- extending drugs," said Allison Dinsmore of Health GAP. "AIDS is devastating Zimbabwe. Squandering limited resources on high-priced drugs is unacceptable when lower-cost, quality generics are available."

Zimbabwe appears poised to be the first country to issue compulsory licenses for production of AIDS drugs. Compulsory licensing authorizes the manufacture of a patented medicine without the permission of the patent holder. By authorizing multiple suppliers of a patent-protected drug, compulsory licensing creates competition, driving prices down and increasing the number of people who can benefit from life-extending, essential medicines.

Activists noted that the 6 month time limit to Zimbabwe's state of emergency should be eliminated. "Unfortunately the crisis caused by AIDS in Zimbabwe will persist after a short half year," said Brook Baker of Health GAP. "6 months is too little time to extract the full benefits of compulsory licensing on price reductions."

Activists predict that the price reductions that will accompany compulsory licensing will exceed the limited, conditional price cuts that have been offered by brand name drug companies.

AZT+3TC (brand name: Combivir), for example, two drugs in a typical three-drug combination regimen for treating HIV, is available for as little as 75 cents per day from generic Indian manufacturers. But GlaxoSmithKline's patent monopoly on Combivir in Zimbabwe means the cheapest price--only available to HIV-positive people who meet Glaxo's program criteria--is almost three times as expensive at $2.00 per day.

"International public health organizations like the WHO and UNAIDS must provide the technical guidance necessary to assist Zimbabwe in fast-tracking access to affordable, generic versions of patented AIDS drugs," said Phillip Machingura, Health GAP activist and native of Zimbabwe. "Too many people have died needlessly with AIDS, waiting for treatment access--positive change can't come fast enough."

Zimbabwe's announcement comes just after its award of $5.3 million from the first round of grants by the new Global Fund to fight AIDS, Tuberculosis, and Malaria, and just before the June meeting of the World Trade Organization's TRIPS Council.

The TRIPS Council, the WTO body monitoring implementation of WTO rules on patents, is wrapped up in debate on the issue of patents and drug access for countries like Zimbabwe, that have limited-to-no capacity for local production of medicines. WTO rules stipulate that compulsory licensing must be used predominately for supply of the domestic market; countries like Zimbabwe without adequate domestic capacity will be unable to import new drugs that are patent protected in manufacturing countries like India and Thailand, once TRIPS rules are fully implemented.

U.S. trade negotiators are opposing solutions to this problem proposed by developing countries, including Zimbabwe, that would streamline access to drugs exported under compulsory licensing in producing countries. Instead the U.S. is calling for a limited, conditional moratorium on WTO dispute settlement regarding this issue, a proposal activists call a non-starter.

"The USTR must support Zimbabwe and other developing countries' proposals for ensuring that affordable generic drugs are available to all impoverished countries facing critical health problems--not just the handful of countries with domestic capacity for drug manufacture," said Dr. Alan Berkman of Health GAP.