The newly created Medicines Patent Pool promises to increase access to HIV/AIDS medications in developing markets. Based in Geneva, Switzerland, the pool operates a scheme in which pharmaceutical patent holders voluntarily licence their drugs to generic manufacturers who then produce more affordable versions for patients in poorer countries.

The Medicines Patent Pool was initiated and is funded by UNITAID, an organisation created to contribute to the scaling up of access to treatment for HIV/AIDS, malaria and tuberculosis, primarily for people in low-income countries.

According to the patent pool’s website, its goal is to “improve the health of people living in low- and middle-income countries” by increasing “access to quality, safe, efficacious, more appropriate and affordable medicines, focussing on HIV/AIDS.”

A landmark step towards this goal was made on 1 December, when the Medicines Patent Pool sent out letters inviting key patent holders to negotiations. Potential participants were chosen based on the appearance of their drugs on a list of “priority missing essential medicines for HIV” that was compiled by the World Health Organization (WHO) and UNITAID.

The patent pool’s website also confirms that the organization has entered, or will soon be entering, into negotiations with F. Hoffman-La Roche, Gilead Sciences, Sequoia Pharmaceuticals, and ViiV Healthcare, which is a joint venture of GlaxoSmithKline and Pfizer.

The need for such a patent pool is urgent. Though five million people in developing countries are receiving anti-retroviral therapy (ART) for HIV, nearly 10 million do not have ready access to treatment. This group could die over the next few years if access to treatment is not expedited. Scaling up treatment to accommodate the demand for ART therapy is critical.

The Medicines Patent Pool is expected to help accomplish this result in several ways. First, the lowered transaction costs achieved by centralising the administration and licensing of patents will be passed on to patients in the form of lower drug prices.

Second, the reduced logistical barriers provided by patent pooling will likely foster increased competition in the market, which will further drive down drug prices. It was due to the intense competition by generic drug manufacturers in countries such as India that the prices of first generation HIV medications dropped by more than 99 percent.

Third, the pooling and collective licensing of patents will speed development of new “fixed dose combination” (FDC) treatments. By allowing generic licensees to freely combine different formulations of patents in the same pool, this will facilitate the creation of new compound treatments that are more effective than any of their constituent medications.

The impact of FDCs extends beyond the enhanced operational flexibility of generic manufacturers. FDCs allow for the amalgamation of several drugs into single doses that patients only need to take once a day. This increased convenience significantly improves patient’s compliance with their treatment regimes, thus impeding the rapid drug resistance that tends to follows inconsistent usage.

Though some FDCs currently exist, these tend to contain older ARV drugs that are not as effective as the latest versions. Therefore, there is an urgent need to create new drug combinations incorporating the newest drugs. Unfortunately, they are still under patent protection and tend to be priced out of the reach of patients in developing countries. It is these medications that the patent pool is keen to obtain.

Beyond FDCs, the Medicines Patent Pool is focusing its efforts on encouraging greater research and development in pediatric HIV medications as well as drug formulations that are adapted for warmer climates where refrigeration is not readily available.

According to Executive Director Ellen ‘t Hoen, though the patent pool was only established in 2010, its results so far have been impressive. To date, the pool has received patent donations from the United States National Institutes of Health. The material benefits from these patents have been complemented by the public endorsement of the US government.

In a posting on the of Science and Technology Policy website, White House Office official Hillary Chen expressed the administration’s support for the Medicines Patent Pool. “As a global leader in research and development, the United States has an important catalyzing role to play in promoting voluntary mechanisms that will increase competition to provide innovative, affordable health technologies to people in low- and middle-income countries,” she said.

During the 128th WHO Executive Board Meeting, on the draft WHO HIV/AIDS Strategy, the US government also urged the WHO to support the Medicines Patent Pool.

The backing of the US government is significant given that the US is home to major players in the pharmaceutical industry. According to ‘t Hoen, this endorsement has helped to bring several key players in the AIDS drugs industry to the negotiating table. Though negotiations with patent holders will be conducted on a one-on-one basis, the pool will publicly disclose the details of all completed licensing agreements.

‘t Hoen believes that ultimately, the success of the Pool depends on the participation of all major patent holders in the negotiations. As a collaborative rather than confrontational approach, she is confident that the voluntary licensing model will prove to be highly effective in facilitating the expedient provision of affordable medicines in poorer countries.

Basically, in the patent pooling approach, everybody is supposed to win. Patent holders receive royalties for their patents, generic drug manufacturers gain market access, and patients are granted access to essential life saving medicines.

Tavengwa Runyowa was an intern with Intellectual Property Watch from January to March 2011.