To save lives, Johnson & Johnson should jump into the patent pool of suppling HIV Drugs in poor countries

The high cost of HIV drugs puts patients in poor countries — where the virus is most widespread — at a huge disadvantage.

Many must still take older, more toxic medicines no longer used in the United States. And when patients build up a resistance to the drugs they’re already using, they don’t have the option of switching to a new medication.

That’s why world health advocates came up with the idea of a “patent pool.” It’s meant to drive down costs to improve access to newer HIV drugs, including medicines for children. Participating drug makers can make their patents more widely available to generic manufacturers in developing countries, in exchange for royalty fees. The increased competition would greatly reduce drug costs.

But including middle-income countries like India, Brazil or China in the patent pool has become a sticking point: patent holders worry it might undermine their future profits in potentially lucrative markets.

Still, it’s vital to include as many developing countries as possible, to reach the most patients in desperate need. While a country like South Africa might fall into the middle-income category, its government struggles with one of the highest burdens of HIV in the world. And allowing more generics to be sold in many poor countries won’t hurt the primary market for these patent holders: more than 90 percent of their profits on HIV drugs come from the United States and Europe.

So far, Roche, ViiV Healthcare and Gilead have agreed to help the patent pool, but Merck and Bristol-Myers Squibb, along with Johnson & Johnson, have refused to negotiate. Johnson & Johnson holds the patents to three HIV drugs that Doctors Without Borders say are desperately needed. Even though the New Brunswick-based company has made deals with some generic companies to provide HIV drugs at reduced cost, the price is still prohibitive for the poorest countries and the agreement covers only part of Africa.

The patent pool is a better solution: Johnson & Johnson and these other companies should sit down at the negotiating table. By joining up, they can make a huge impact on public health at a price they can easily afford.