After an uproar, price of AIDS drug falls in Africa

A drug discovered in a Yale laboratory made headlines this spring in the ongoing debate about the provision of AIDS medications in the Third World. The physicians’ group Doctors Without Borders called on the University, which holds the patent for d4T, and Bristol-Myers Squibb (BMS), which has a license to market it, to allow cheaper or generic versions to be sold in Africa. At a cost of between $10,000 and $15,000 a year, antiretroviral therapy is out of the reach of most of the 25 million people in sub-Saharan Africa who have AIDS and the 3.8 million who are infected with HIV.

BMS said in mid-March, after discussions with the University, that it would make its two AIDS drugs, d4T and ddI, available throughout Africa for $1 per day and allow generic versions to be sold as well.

The issue surfaced when an Indian pharmaceutical company, Cipla, made an offer to provide triple-therapy AIDS cocktails at $350 per year per patient in developing countries. That package included d4T at 5 cents a tablet. Doctors Without Borders, however, was unwilling to distribute the generic drug because of concerns over infringement of patent rights in South Africa. The humanitarian group pressed both the University and BMS for a solution, and Yale students later joined in calls for price relief. The discussions reached senior levels of the University and BMS, which modified the license agreement in order to make the drug more affordable and widely available. Although BMS was free to set the price of the drug, the company also sought permission from the University to offer patent relief in Africa. In recent years the drug, known generically as stavudine and marketed as Zerit, has brought Yale about $40 million a year in royalty income.

Joining the voices clamoring for low-cost drugs was William Prusoff, Ph.D., emeritus professor of pharmacology, who with his collaborator, the late Tai-Shun Lin, Ph.D., discovered the drug’s value as an antiviral in 1986. “We weren’t doing this to make money. We were interested in developing a compound that would be a benefit to society,” Prusoff said.