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Simplifying the AIDS Cocktail

WWW – IN A MUDDY SLUM in Cambodia, a mother of two shuffles through a handful of pill bottles several times a day for relief from symptoms of the AIDS virus. If she misses a few doses or mistakenly takes too many pills, her health may waver.

In the world of AIDS treatment, this woman represents a dilemma. Powerful drugs can hold the infection at bay, but the pills are costly and complicated to take. Clearly, medicine, and the politics behind it, can do better.

This problem may be eased by combining medications into a single cocktail pill and chopping the price. Drug patents and safety worries blocked this goal — until now.

The Food and Drug Administration approved two combination pills by GlaxoSmithKline and Gilead Sciences this week that simplify treatment. Each pill lets a patient take two AIDS-fighting drugs in a once-a-day tablet.

Perhaps even bigger is an apparent decision by Ranbaxy Laboratories, a major drug firm in India, to submit its generic combination pill to the FDA for approval. Ranbaxy, like many foreign drugmakers, has stamped out cheap copies of U.S. drugs for use in poor countries. It makes a three-in-one combination pill that AIDS-care groups believe holds huge promise.

Until now, the White House’s $15 billion AIDS program wouldn’t buy foreign generics, which violate drug U.S. patents. So a compromise was struck: If the foreign generics met FDA safety rules, they could be used in poor countries. Ranbaxy is the first major player to seek FDA approvals, which will be speeded up especially for AIDS generics.

This is more than a dry tale of a balky trade dispute. AIDS may have subsided as a health worry in the United States, but it is a raging epidemic in Africa and Asia. Worldwide, nearly 40 million people are infected, and 3 million died from AIDS-caused disease in 2003.

Though a cure doesn’t yet exist, life-prolonging drugs can block the AIDS virus from spreading in the body. This treatment allows adults to hold a job, children to attend school and families to stay together. At present, there are 6 million people who could benefit from anti-AIDS drugs, but only 400,000 receive pills. Providing cheaper combination pills should close this dangerous gap.
 

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