Right Program Wrong Pills

Still at the Washington Post. The WHO is trying to get 3000000 HIV infected people under anti-retroviral therapy by 2005. I guess this is partly a response to more money from Bush (first praise of Bush in this blog) and partly because it is clear that you can't get people to get tested for AIDS if diagnosis is just a death sentence. The thing that bothers me is

"An expert panel assembled by WHO recommends four drug combinations, out of about 35 available. The one likely to be most popular contains stavudine (d4T), lamivudine (3TC) and nevirapine in a single pill. None of the four combinations includes a protease inhibitor. Drugs in that class are generally more expensive. In many places, including rich countries, they are often held back and used only if first-line treatment fails. "

My impression was that protease inhibitors were necessary for multidrug therapy to work. Now why are they expensive ? Not, I think, because they cost that much to make, but because they are under patent. Now with some billions to work with couldn't the Bush administration buy in bulk at a huge discount. I don't mean a normal volume discount. I mean a discount negotiated by any means necessary. As in
"gee you like the medicare benefit plan but you know some people think we should have medicare bargain tough with you. However, I will veto that if you sell us protease inhibitors for 3 million people a year at cost. Oh they are under patent ? Hmm we haven't looked at patent law reform in years."

Not like Bush but I doubt anything like that would be necessary. It's not like pharamceutical companies are making money out of treating AIDS in the third world now anyway. The only risk is re-importation. I don't see why they can't make the pills a different color size and shape to hamper smuggling them back.

I really don't see why that hasn't been done some how.