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Surgeon general to the plague that decimated Europe in the fourteenth century. • Combination of available pharmaceuticals—too expensive for nearly all of the infected people in the developing world—could enable many afflicted with HIV/AIDS to live relatively normal lives. • Compulsory licensing and parallel importing policies could help developing country governments make essential medicines more affordable to their citizens. S. has actively opposed developing country efforts to implement compulsory licensing, parallel imports, or other measures to make life-saving HIV/AIDS drugs more affordable and available in their countries.

But not all patients and not all countries can afford them. Effective responses to the HIV/AIDS challenge in developing nations must take into consideration all the relevant factors, including medical infrastructure, available resources, disease awareness and prevention initiatives and, most importantly, national commitment and leadership to make HIV/AIDS a public health priority. S. S. pharmaceutical industry in confronting HIV/AIDS world-wide is to continue what it does best—to AI AIDS/Dev. Countries INT 46 5/9/03 1:19 PM Page 46 At Issue marshal the expertise and capacity in applied biomedical research and drug development to discover new and more effective treatments.

Among the pertinent questions: Have TRIPS rules undermined the ability of developing countries to maintain domestic pharmaceutical industries? If so, what impact has this had on consumers? Have TRIPS rules promoted new multinational corporate investment in research to treat and prevent diseases of particular concern to developing countries? S. S. government holds patent or other intellectual property rights. Existing law permits Washington to take such steps. With a license, the WHO could contract with private generic makers to produce the medicines and distribute them widely in the developing world.

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