Do patents for antiretroviral drugs constrain access to AIDS treatment in Africa?

Public attention and debate recently have focused on access to treatment of acquired immunodeficiency syndrome (AIDS) in poor, severely affected count ries, such as those in Africa. Whether patents on antiretroviral drugs In A frica are impeding access to lifesaving treatment for the 25 million Africa ns with human immunodeficiency virus infection is unknown. We studied the p atent statuses of 15 antiretroviral drugs in 53 African countries. Using a survey method, we found that these antiretroviral drugs are patented in few African countries (median, 3; mode, 0) and that in countries where antiret roviral drug patents exist, generally only a small subset of antiretroviral drugs are patented (median and mode, 4). The observed scarcity of patents cannot be simply explained by a lack of patent laws because most African co untries have offered patent protection for pharmaceuticals for many years. Furthermore, in this particular case, geographic patent coverage does not a ppear to correlate with antiretroviral treatment access in Africa, suggesti ng that patents and patent law are not a major barrier to treatment access in and of themselves. We conclude that a variety of de facto barriers are m ore responsible for impeding access to antiretroviral treatment, including but not limited to the poverty of African countries, the high cost of antir etroviral treatment, national regulatory requirements for medicines, tariff s and sales taxes, and, above all, a lack of sufficient international finan cial aid to fund anti-retroviral treatment. We consider these findings in l ight of policies for enhancing antiretroviral treatment access in poor coun tries.