By: Mark Leon Goldberg on January 03, 2012 At the end of 2011, there were about 15 million people who needed HIV/AIDS treatment, but only about 6 million people received proper care. Part of the reason is that it is costly to treat HIV/AIDS and most people living with HIV/AIDS are poor and live in countries that simply don’t have the means to provide treatment to everyone who needs it. Although the cost of standard HIV/AIDS treatments have gone down significantly over the years, there are still certain specialized medicines or specialized combinations of medicines that are really expensive. One idea that humanity drew up to reduce the costs of these expensive treatments is something called the Medicines Patent Pool. The idea is pretty basic. Patent holders from western pharmaceutical giants voluntarily give up their patents for expensive AIDS drugs. A World Health Organization-certified drug manufacturer in say, in India or Kenya, produces cheap generic versions of these expensive drugs for the exclusive sale in the developing world. They pay a royalty to the original western patent holder, but nothing too onerous. The western pharma giant gets paid (and gains access to new markets). HIV patients in the developing world get their medicines cheap. Everyone wins, right? Not so, says Johnson & Johnson which is refusing to turn over three of its patents to the pool. Doctors Without Borders explains the medical significance of Johnson & Johnson’s decision: Treating HIV is complex and often requires patients to take multiple drug cocktails. But by combining the different drugs into one easy-to-take pill, it is easier for patients to stick to their treatment. At the moment, it can be a struggle for generic producers to develop these much needed fixed–dose combinations, because different companies own the patents on the various drugs. By putting these patents under collective management, the Patent Pool will make it possible for many more combination therapies to be developed. Although Johnson & Johnson is already engaging in voluntary licensing with some generic companies they decided against taking the extra step of joining the Pool to improve access for people living with HIV. The company’s proposal to expand access to its HIV medicines does not go far enough, and they know it. In saying no to the Medicines Patent Pool, Johnson & Johnson has made a conscious, willful decision to turn its back on people living with HIV in the developing world. Last year, the National Institutes of Health (NIH), which holds a partial patent on the Johnson & Johnson drug darunavir, licensed its part of the darunavir patent to the Pool. By refusing to join the Patent Pool, Johnson & Johnson has effectively made this NIH license useless. What is particularly perplexing about this decision is that aside from the bad press Johnson & Johnson will receive, they are basically inviting foreign generic manufacturers to violate their patents without any recourse to compensation. A foreign drug manufacturer may just start manufacturing these drugs anyway, in which case Johnson & Johnson will be cut out of royalties all together. Back in July, the pharmaceutical giant Gilead Sciences thought differently and turned over two of its patents to the pool. This is what we might called the far-signed position on the issue compared to Johnson & Johnson’s rather myopic view. I would encourage people to visit the decidedly a-political Doctors without Borders to learn more about why this is a very potentially harmful decision by Johnson & Johnson.