Not too long ago – as recently as the late 1990s– it was taboo in international development circles to even mention market forces when discussing pharmaceuticals for poor countries. The doctrine was clear: the free market must be kept out; the international drug trade was exploitative, destructive, and offered little to help the poor.
Drugs to treat HIV and AIDS – then costing more than $15,000 per person, per year – primarily drove the debate. Most in the development industry vociferously agreed that doctors and drugs had to be supplied, but no one could cope with the astronomical prices involved. Eventually, as it had to, the discussion came to center on how to reduce the cost of drugs so that those with the greatest need – the world’s poorest – could get access to life-saving medicines that would protect their health and slow the pandemic’s death march.
Today a year of HIV/AIDS medication costs less than $100. Generic drug companies largely drove this change. By some estimates, generics account for more than 90% of the market for AIDS medications. How exactly did this happen?
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