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HIV/AIDS: Trade and access to anti-retroviral treatment  

The World Trade Organization (WTO) was formed on January 1, 1995 to regulate trade between member countries, settle trade disputes between nations, and act as a forum at which governments negotiate trade agreements.

Rules of trade are set at the WTO and each of the 146 member countries signs those agreements and is required to abide to them by formulating trade policies that are in-line with WTO trade rules or agreements.

One of the responsibilities of the WTO is to ensure the protection of ideas created by people, and it does this under what is known as Trade Related Aspects of Intellectual Property Rights (TRIPS). Intellectual property refers to legal entitlements aimed at protecting ideas or information that someone or some people generated. This is done in order for those who generated it to benefit from their ideas, and reinvest their profits in research and development. Their ideas may be in form of a manufactured product (e.g. a drug), or written in books. One of the ways in which WTO protects intellectual property under TRIPS is through patent system.

Regarding access to essential drugs, the existence of a patent system encourages pharmaceutical companies to introduce new drugs and do more research and development work. However, some people have argued that there is need for striking a balance between the production of new drugs, and addressing public health problems by ensuring that people in poor communities and countries have access to those drugs. Basically, under TRIPS, member states of the WTO are required to grant pharmaceutical companies 20-year monopolies on all technological innovations and to submit to a binding system of WTO dispute resolution; and countries who are or will become TRIPS-compliant and who wish to lower drug prices by introducing available generic drugs into their domestic markets must either obtain the consent of patent-holders or work within the framework set forth in the TRIPS agreement (Human Rights Watch 2002).

This has created a major problem concerning AIDS treatment and TRIPS today. Countries that have been hardest hit by the HIV/AIDS pandemic, particularly African nations, have called for an examination of the tension between the intellectual property regime and the global health crisis in order to address HIV/AIDS crisis. However, pharmaceutical companies, with support from some industrialized countries, do not agree instead they argue that the patent system is essential, because it enables them reap what they sowed, which they then re-invest in pharmaceutical research and development. In doing so, pharmaceutical companies argue, they promote public health.

The pharmaceutical companies sell AIDS drugs at exorbitant prices, which in turn limit people, especially poor people, from accessing this life prolonging treatment. When Brazil and India looked at the rising numbers of people living with HIV/AIDS in their countries who were in need of ARVs, they decided to start producing cheap generic AIDS drugs in order to save lives. This move did not go well with pharmaceutical companies and some few developed countries. In spite of that opposition, Brazil and India continued with their production of generic AIDS drugs to date. As a result, these two countries have registered successes with regard to provision of AIDS treatment to, and improving lives of, people living with HIV/AIDS.

After observing what was happening in Brazil and India, African countries sought permission from the WTO to be allowed to purchase generic AIDS drugs from India and Brazil. This met with opposition from the U.S., which feared that its pharmaceutical/ drug companies would lose control of their patents. But in the end WTO granted African countries permission to procure drugs from the above-mentioned countries, but by following certain protocols.

The Office of the U.S. Trade Representative (USTR) has since embarked on a mission, outside of the WTO, of signing bilateral and multilateral agreements with different countries in order to protect patents of its pharmaceutical companies. Some have expressed concern at this development, because of its clear hindrance to public health by way of limiting access to health care and health care technologies (Human Rights Watch 2007). This would obviously result in deaths that could have been delayed if ARVs were made available. Other resultant effects, such as an increase in the number of orphans in communities, and lowering economic growth of poor countries, are well known.


What needs to be done?


  • More advocacy is needed to strike a balance between the international patent system under TRIPS of the WTO and greater access to antiretroviral treatment by people living with HIV/AIDS, so that many people living with HIV/AIDS who do not have access to ARVs can receive treatment.
  • Encourage governments to disavow trade agreements or policies that would undermine their obligations to ensure that their citizens are accorded their right to health and have access to health care services.
  • Ask governments to make use of the provisions of the same TRIPS, which allows them to issue licenses, by issuing licenses to pharmaceuticals to produce cheap generic ARVs as one way of safeguarding public health.
  • Appeal to pharmaceutical companies to consider generating more cheap AIDS drugs for people in low-income countries.
  • Advocate for more funding from rich nations and the donor community that should go towards production and distribution of antiretroviral drugs, as well as research and development.  


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