Antiretroviral drugs. Photo: shortie 66 (flickr)

An enormous barrier in the fight against HIV/AIDS in developing nations has started to crumble.

Last month, the international drug purchaser and WHO-partner organization UNITAID announced plans to form a patent pool to lower the cost of some of the most expensive medications used to treat HIV, reports the Guardian. The agreement is a blessing for the estimated 14 million people who do not have access to affordable treatment — most of whom live in developing nations, says UNAIDS, a branch of the UN that deals specifically with HIV/AIDS.

The patent pool will allow generic pharmaceutical companies to develop medications that are still protected under patent laws in exchange for royalties. Consequently, the competition between generic manufacturers lowers the overall price of the drug. By UNITAID's estimate, the cost of some drugs will fall from $1,000 a year to as little as $100.

Not only will more people have access to these new drugs, the drugs themselves will become better. Fixed-dose combination medications (FDCs), formed from different compounds that work well when used together but are often developed by competing pharmaceutical companies, have been hard to create under old patent laws, reports UNITAID. In contrast, the pool gives manufacturers access to a variety of different compounds to make more effective and easier-to-use FDCs.

So far, UNITAID has identified 19 drugs from nine different pharmaceutical companies to bring into the pool. Although there has been resistance by a few of the companies — who are in no way obligated to enter the pool — many like Merck and Gilead have already pledged to put some of their top medications into the pool. “Today is a good day for people living with HIV/AIDS in developing countries,” noted one UNITAID official.

This pharmacy at the Evangel Hospital in Jos, Nigeria could be one of the beneficiaries of cheaper drugs and better facilities from GSK. Photo: MikeBlyth (flickr)

Pharmaceutical companies are often seen as villains for making life-saving drugs so expensive the poor can't afford them. But what if a new CEO was making drugs more affordable and sharing secrets that would lower profits but result in more cures?

Andrew Witty is the new chief executive of GlaxoSmithKline (GSK) — the second largest drug company in the world. Witty recently outlined his plan to radically shift GSK policy to make four major changes that will help the developing world:

1. Slash drug prices to 25 percent (or lower) of their current U.S. and UK levels in the world's 50 poorest nations, and make drugs more affordable in middle-income countries like Brazil.

2. Reinvest 20 percent of drug profits made in developing countries to support health clinics and pay medical workers in those same countries.

3. Place their research on neglected diseases (with the exception of HIV) into a patent pool to share with other scientists to dramatically speed up medical breakthroughs.

4. Invite researchers from other governments, companies, and NGOs to participate in their research on tropical diseases at their institute at Tres Cantos in Spain.

So why would GSK do this? Witty told the Guardian he was so tired of hearing speeches about how terrible it is that there has been no progress in tuberculosis research or treatments for other diseases that he decided to do something about it.

We work like crazy to come up with the next great medicine, knowing that it's likely to get used an awful lot in developed countries, but we could do something for developing countries. Are we working as hard on that? I want to be able to say yes we are, and that's what this is all about – trying to make sure we are even-handed in terms of our efforts to find solutions not just for developed but for developing countries.

Lowering drug prices will help — but without adequate health care infrastructure, even cheaper drugs might not be accessible. That's what makes reinvesting profits to support clinics and pay medical workers' salaries so important, because it will increase access to these drugs.

But the most important change Witty has proposed is sharing GSK's research. By placing their research into patent pools, GSK will dramatically increase the speed of early-stage R&D activities and the likelihood of finding cures to neglected diseases.

"This is a gutsy move in a commercial world" said Mike French, World Vision's director of advocacy. "Witty has demonstrated a willingness to make saving lives a business goal along with making money."