In his April 23 editorial-page piece "Fight AIDS With Reason, Not Rhetoric," Robert M. Goldberg calls the dropping of a lawsuit filed by 39 pharmaceutical companies against the South African government a "tragedy." But for whom exactly is it a tragedy?

Certainly not the 4.7 million HIV-positive South Africans currently facing almost certain death because they cannot afford the antiretroviral medicines that have turned HIV/AIDS into a manageable illness in the U.S. and Europe. The end of the court case removes barriers preventing the South African government from securing cheaper AIDS drugs. And, contrary to Mr. Goldberg's accusation, the South African laws are fully compliant with the World Trade Organization's TRIPS Agreement.

The case is also a victory for the nearly 30 million other people in the developing world living with HIV. Armed with a newfound understanding of international trade law and boosted by the groundswell of international public support that the South African case has generated, AIDS activists can now demand that their own governments do everything possible to make treatment available. These governments should now feel emboldened to take advantage of legal means to obtain AIDS medicines without the fear of provoking similar lawsuits or threats of trade sanctions from wealthy nations.

Is the South African settlement a tragedy for the drug companies and the future of AIDS research? Mr. Goldberg seems to think so. But he overlooks the fact that research and development for many antiretrovirals were largely financed by the public sector, primarily U.S. taxpayer dollars. This, together with the reality that Africa represents little more than 1% of the world-wide drug market, ensures that companies can prosper and continue research and development into new AIDS drugs and vaccines even if drug prices are lower in poor countries.

Mr. Goldberg also accuses Medecins Sans Frontieres (Doctors Without Borders) of "balking" at an exclusive offer made by Cipla, an Indian generic drug producer, to provide antiretroviral therapy at $350 per patient per year. MSF doctors working around the world are painfully aware that we alone do not have the capacity to provide treatment for all patients affected by the pandemic, even if pills were given to us for free. This is why MSF has joined activists from South Africa to Thailand in calling for global access to HIV/AIDS drugs and pressing the U.N. to facilitate drug distribution. Developing countries must now commit to securing the medicines and boosting health infrastructures to begin seriously combating the epidemic, and all countries, especially wealthy ones, must come forward with the funds necessary to make this happen.

Anne-Valerie Kaninda, M.D.
Medical Adviser
Doctors Without Borders' Access to Essential Medicines Campaign
New York