This is not about profits and patents; it's about poverty and a devastating disease." That statement did not come from AIDS activists struggling to provide sub-Saharan Africa's 25 million HIV-positive people with access to life-extending medications. It came from the executive vice president of Bristol-Myers Squibb, which recently announced it would slash prices on its two AIDS drugs and forgo patents on one of them. A week earlier, Merck & Co. said it would lower prices on its two AIDS drugs not just in Africa but, pending review, in other heavily affected countries as well.

What's going on is not a change of heart on the part of "Big Pharma"--which John le Carré describes in this issue as a group of "multibillion-dollar multinational corporations that view the exploitation of the world's sick and dying as a sacred duty to their shareholders." Far from being a humanitarian action, the price reductions represent an attempt to preserve patent rights by diffusing international pressure for generic manufacturing. Revealingly, neither BMS nor Merck has withdrawn from a suit against the South African government brought by thirty-nine pharmaceuticals seeking to prohibit importation of generic drugs, which they claim would violate their patents.

The Indian generic manufacturer Cipla announced in February that it would sell the entire AIDS triple-therapy combination at $350 per person, per year, and other generic manufacturers, in Thailand and Brazil, currently offer AIDS drugs at a fraction of multinational prices. By comparison, the Wall Street Journal reported that a combination of AIDS drugs from BMS and Merck would cost between $865 and $965 per person, per year. If those prices were multiplied by the number of AIDS patients in, say, Zimbabwe, a relatively prosperous country by African standards, the total would come to about 20 percent of its GDP. And that sum doesn't include the investments in healthcare infrastructure needed to distribute and monitor the drugs' use.

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