Indian firms in Africa point the way.

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Perhaps the biggest driver for improved access to medicine has been India's emergence as the pharmacy of the world. Indian companies, such as Cipla and Ranbaxy, have produced cheap and effective generic drugs for sale at a fraction of the cost of their European, Japanese and North American competitors. This has generated substantial opposition from the industry's established giants, who claim with some justification that developing new drugs costs billions of dollars and that they need to recoup this outlay through sales in order to fund the development of new pharmaceuticals.

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However, Indian manufacturers and opponents of vested interests in the pharmaceutical industry argue that there is a huge need for these medications among the millions of Africans who have little ability to pay. Manufacturing is actually relatively cheap; it is R&D that is expensive. International patents and intellectual property law form the battleground of this debate, which often becomes subsumed in wider trade agreements between India, the EU and North America, particularly now that India has joined the World Trade Organisation (WTO).

The WTO currently gives pharmaceutical patent protection for 20 years. In 2000, Cipla began to market a combination of three drug anti-retrovirals in Africa at $800 per patient for a year's supply, in comparison with the international going rate of about $12,000 a year. Luminaries such as former US president Bill Clinton have praised the company for its efforts in the fight against HIV-AIDS.

Chandru Chawla, the head of corporate strategy at Cipla...

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