The Global Governance of HIV/AIDS
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The Global Governance of HIV/AIDS

Intellectual Property and Access to Essential Medicines

Edited by Obijiofor Aginam, John Harrington and Peter K. Yu

The Global Governance of HIV/AIDS explores the implications of high international intellectual property standards for access to essential medicines in developing countries. With a focus on HIV/AIDS governance, the volume provides a timely analysis of the international legal and political landscape, the relationship between human rights and intellectual property, and emerging issues in global health policy. It concludes with concrete strategies on how to improve access to HIV/AIDS medicines.
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Chapter 3: Is AIDS treatment sustainable?

Kenneth C. Shadlen


The first decade of the twenty-first century witnessed a remarkable extension of antiretroviral (ARV) treatment to people living with HIV/ AIDS in the developing world. Whereas ARVs reached less than five per cent of people in need of treatment as of 2002, by the end of the decade nearly half of those needing treatment were receiving these life-saving drugs. But to what extent can AIDS treatment continue to be increased? Can increased treatment be sustained? In this chapter I present a cautionary view, focusing on fundamental changes that are transpiring in treatment regimens and the generic pharmaceutical industry. These changes could create a mismatch between the demand for and the supply of high-quality and affordable ARVs. To be sure, financial commitments for scaling-up treatment, the sense of urgency with which the international donor community has come to view the HIV/AIDS epidemic, and alleviation of some significant legal obstacles to accessing affordable medicines can all provide bases for optimism. Yet what has worked so far may not continue to work; more of the same may not be enough.1 As the demand for treatment throughout the developing world increases and evolves, the world’s ability to respond effectively may be limited. The reason why has to do with the effects that changes in the global political economy of intellectual property (IP) are likely to have on the availability of affordable ARVs. The key issue regards the changing relationship between the demand and supply of particular sets of ARVs.

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