Will Merck Honor Its Commitment To African AIDS "Patent Pool"?

The idea is a decidedly noble one: allow generic companies to manufacture and sell cutting-edge HIV treatments in the poorest parts of the globe -- through limited license "patent pools" -- from the multinational branded pharma conglomerates.

Merck, Gilead and Johnson & Johnson are moving -- if gingerly -- toward pooling their patents, for African AIDS sufferers. It could literally save a million lives, by putting truly groundbreaking therapies within economic reach of many many millions there. But now, various groups are urging Unitaid (a drug-purchasing agency in Geneva) that it ought to press pharma to include China and Brazil in the pooling, based on needy populations in each country. Some of the branded pharmas are calling inclusion of those geographies, now in the developing world (which are potentially more lucrative, over time) a "non-starter".

Matt Herper has it all, with Megha Bahree, over at Forbes -- do go read his, but here is a snippet:

. . . .Merck and J&J voiced some support when Alton presented the idea at an AIDS conference last year. In an Oct. 26 letter to the MSF, Merck wrote that it supports the patent pool idea "in principle."

Africa is home to 22 million of the 33 million people worldwide who are infected with HIV. Thanks to aid efforts, cheap Indian generics and discounted drugs, 2.9 million people with AIDS in sub-Saharan Africa are on antiviral therapy. But expensive new drugs like Gilead's Atripla or Merck's Isentress are currently out of the reach of many aid groups. . . .

Here's to the audacity of hope.

The more I think it through, I wonder whether there is actually a fair case for including Brazil, but not China -- at least from Gilead's perspective.

I know, I'm sounding like a bit of a pharma shill here, but I think it emminently fair that pharma should surrender AIDS treatments to the poorest (by a means test) in Brazil. But in China? With the speed at which China is coming up the economic and public health-care curve -- and the sheer size of the market, it will be hard for Gilead, especially, to surrender this geography.

Gilead is significantly smaller than Merck and J&J and Abbott.

This is a more-nuanced question than it may at first appear.