Since the development of antiretroviral drugs in the 1990s, the
battle against AIDS has largely been fought over the question of
how to distribute the drugs fairly. The drugs save lives, with
recent research suggesting that the risk of spreading the virus
is reduced to almost nil if people infected with HIV start
therapy quickly enough. Furthermore, if uninfected people living
in a high-risk area take just one antiretroviral pill a day,
they greatly reduce their chances of contracting HIV in the
first place. Yet the possibility of containing the epidemic has
usually run up against the hard reality of cash. Western medical
companies have been reluctant to sell their drugs at the sort of
knockdown prices that developing countries can afford. The Bush-
era United States President’s Emergency Plan for AIDS Relief
committed $15 billion between 2003 and 2008, providing over 1.2
million people, primarily in Africa, with access to
antiretroviral drugs. Such demand has led to competition in the
antiretroviral market. A