Zimbabwe - In Zimbabwe, where over 2,000 people die of the disease every single week, AIDS is threatening the very future of the country. Life expectancy has dropped to less than 41 years, compared to 70 years before the epidemic.

Given this context, the May 27th decision by the Zimbabwean government to declare a state of national emergency is more than welcome. Médecins Sans Frontières (MSF) fully supports this action, which will allow Zimbabweans to use generic antiretroviral drugs even if they are under patent in the country.

"The government has decided to override patent protection on antiretrovirals and use generics - this means that the price of the first-line AIDS cocktails recommended by the World Health Organization will plummet from US$1,168 to US$412 These prices are for triple combination with AZT/3TC nevirapine and are expressed in US dollars per patient per year. All these medicines are patented in Zimbabwe. Before yesterday's announcement, the lowest prices available in the country were those offered by the proprietary companies. The lowest price indicated here is the cost of internationally available generic versions of these medicines.," said Carmen Pérez Casas, pharmacist coordinator at the MSF Access Campaign. "Although prices are just one barrier to overcome to increase access to antiretrovirals, this measure will allow available resources to treat more than twice as many patients".

Zimbabwe's announcement marks the first time that a government has gone beyond using the threat of compulsory licensing as a negotiating tool, and actually declared that it will override patents to increase access to needed medicines when the prices are too high as a result of patent protection. Zimbabwe has been slow to react to the rampant AIDS crisis, but the government has now taken several steps that should allow it to begin scaling up treatment.

For instance, Zimbabwe this year successfully applied for and will receive a Global Fund grant of US$5.3 million to strengthen and extend disease prevention and care for HIV/AIDS, tuberculosis and malaria.

The right to take all measures necessary to protect public health - including overriding pharmaceutical patents - was reinforced by the World Trade Organisation (WTO) in the Doha Declaration on Trade-Related Aspects of Intellectual Property Rights (TRIPS) and Public Health.

The procedure Zimbabwe has chosen allows a swift action without the need to engage in lengthy negotiations with the patent holder. This is the model other countries should follow.

"Zimbabwe doesn't manufacture antiretrovirals, so it will need to import them from other countries which produce cheaper generics," said Ellen 'T Hoen from MSF. "Exporting generics is still permissible for these countries under international trade regulations - but this will change as the TRIPS Agreement is fully implemented in all WTO members.

Unless the TRIPS Council finds a swift and workable solution to this question of production for export, measures such as those taken by Zimbabwe to deal with health care needs may become impossible".

MSF and Zimbabwean health authorities have been preparing a project to support implementation of prevention of mother-to-child transmission of HIV/AIDS (PMTCT) protocols in Bulawayo. This will eventually be expanded to include treatment with antiretroviral drugs. Details are being finalised, and this government emergency decree can only facilitate this and similar undertakings in Zimbabwe.

Among the antiretrovirals under patent or where patent is pending in Zimbabwe are: GlaxoSmithKline's zidovudine (AZT), lamivudine (3TC), abacavir (ABC), AZT/3TC, and AZT/3TC/ABC, and Boehringer-Ingelheim's nevirapine.