title: Affordable access to essential medication in developing countries: conflicts between ethical and economic imperatives.
abstract: Recent economic and political advances in developing countries on the African continent and South East Asia are threatened by the rising death and morbidity rates of HIV/AIDS. In the first part of this paper we explain the reasons for the absence of affordable access to essential AIDS medication. In the second part we take a closer look at some of the pivotal frameworks relevant for this situation and undertake an ethical analysis of these frameworks. In the third part we discuss a few of the proposed solutions to the problem and conclude with an argument in support of our preferred course of action. In this article we argue for compulsory licensing of essential AIDS medications in the current conditions of public health emergency. We argue on broadly consequentialist grounds that compulsory licensing is preferable both morally and pragmatically to the alternatives, notably the currently offered price cuts and drug donation schemes.
authors.affiliation: University of the Witwatersrand, Faculty of Health Sciences, Johannesburg, South Africa. bioethic@chiron.wits.ac.za
authors.forename: Udo
authors.initials: U
authors.lastname: Schüklenk
authors.forename: Richard E
authors.initials: RE
authors.lastname: Ashcroft
mesh_terms: D000163:Acquired Immunodeficiency Syndrome / Q000188:drug therapy* / Q000191:economics / Q000453:epidemiology; D017954:Africa South of the Sahara / Q000453:epidemiology; D019380:Anti-HIV Agents / Q000191:economics / Q000600:supply & distribution*; D001210:Asia, Southeastern / Q000453:epidemiology; D003220:Conflict, Psychological; D003299:Cooperative Behavior; D003906:Developing Countries; D017277:Drug Approval / Q000331:legislation & jurisprudence; D016527:Drug Costs; D004345:Drug Industry / Q000191:economics; D004989:Ethics; D015658:HIV Infections / Q000188:drug therapy / Q000191:economics / Q000453:epidemiology; D015276:Health Care Rationing; D006297:Health Services Accessibility / Q000191:economics*; D006801:Humans; D010330:Patents as Topic; D011203:Poverty; D017149:Private Sector; D011635:Public Health Administration / Q000191:economics; D017150:Public Sector
chemical_list: D019380:Anti-HIV Agents