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EDITORIALS: Allyson M Pollock and David Price New deal from the World Trade Organisation BMJ 2003; 327: 571-572 [Full text]

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Low Prices only one step forward

Peter A West   (12 September 2003)

Low Prices only one step forward 12 September 2003
Peter A West, Director York Health Economics Consortium Send response to journal: Re: Low Prices only one step forward	Anything which cuts the price of medicines for HIV treatment is potentially beneficial to the millions of sufferers in the third world. But it remains only one step on a long and complex path. In many developing countries, the health systems have broken down, nationally or regionally. Expenditure per head on health care is minute. There is a major lack of infrastructure and skills through which to deliver complex health care. Education levels may also frustrate the most effective use of complex therapies, for example due to inappropriate sharing of medication or lack of compliance with strict treatment regimes, (pheonomena that can also be found in better educated Western populations). There is a risk that by focusing so much attention on the price of complex medicines, we will overlook the massive investment needed in education and health systems generally in developing countries faced with HIV. Low price drugs look like a magic bullet and a costless one, as the cost falls on the pharmaceutical industry. But without massive state aid, international stabilisation and reduced weapons sales, to name but a few of the factors needed for social development around the world, better access to medicines, which may yet be unaffordable even at their lowest price in future, is not a panacea. Competing interests:   YHEC is a contract reseach company owned by the University of York. Clients include pharmaceutical companies, governments and the NHS. YHEC has undertaken no work on patent and related issues for pharmaceutical companies or governments linked to current WTO negotiations. YHEC has estimated savings from parallel trade in medicines in Europe for parallel traders. The author has researched the cost effectiveness of HIV prevention strategies for NGOs and the UK government in many third world countries.