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In 2002, a group of treatment activists met

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to discuss the early development of the airplane.

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The Wright Brothers, in the beginning of the last century,

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had for the first time managed

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to make one of those devices fly.

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They also had taken out numerous patents

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on essential parts of the airplane.

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They were not the only ones.

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That was common practice in the industry,

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and those who held patents on airplanes

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were defending them fiercely

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and suing competitors left and right.

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This actually wasn't so great for the development of the aviation industry,

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and this was at a time that in particular the U.S. government

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was interested in ramping up

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the production of military airplanes.

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So there was a bit of a conflict there.

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The U.S. government decided to take action,

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and forced those patent holders

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to make their patents available to share with others

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to enable the production of airplanes.

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So what has this

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got to do with this?

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In 2002, Nelson Otwoma, a Kenyan social scientist,

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discovered he had HIV and needed access to treatment.

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He was told that a cure did not exist.

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AIDS, he heard, was lethal,

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and treatment was not offered. This was at a time

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that treatment actually existed in rich countries.

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AIDS had become a chronic disease.

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People in our countries here in Europe, in North America,

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were living with HIV, healthy lives.

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Not so for Nelson. He wasn't rich enough,

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and not so for his three-year-old son, who he discovered a year later

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also had HIV.

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Nelson decided to become a treatment activist

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and join up with other groups.

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In 2002, they were facing a different battle.

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Prices for ARVs, the drugs needed to treat HIV,

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cost about 12,000 [dollars] per patient per year.

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The patents on those drugs were held

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by a number of Western pharmaceutical companies

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that were not necessarily willing

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to make those patents available.

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When you have a patent, you can exclude

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anyone else from making, from producing or making

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low-cost versions, for example,

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available of those medications.

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Clearly this led to patent wars breaking out

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all over the globe.

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Luckily, those patents did not exist everywhere.

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There were countries that did not recognize

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pharmaceutical product patents, such as India,

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and Indian pharmaceutical companies

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started to produce so-called generic versions,

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low-cost copies of antiretroviral medicines,

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and make them available in the developing world,

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and within a year the price had come down

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from 10,000 dollars per patient per year

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to 350 dollars per patient per year,

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and today that same triple pill cocktail

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is available for 60 dollars per patient per year,

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and of course that started to have an enormous effect

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on the number of people who could afford access

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to those medicines.

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Treatment programs became possible,

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funding became available, and the number of people

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on antiretroviral drugs started to increase very rapidly.

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Today, eight million people

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have access to antiretroviral drugs.

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Thirty-four million are infected with HIV.

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Never has this number been so high,

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but actually this is good news,

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because what it means is people stop dying.

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People who have access to these drugs stop dying.

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And there's something else.

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They also stop passing on the virus.

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This is fairly recent science that has shown that.

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What that means is we have the tools

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to break the back of this epidemic.

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So what's the problem?

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Well, things have changed.

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First of all, the rules have changed.

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Today, all countries are obliged to provide

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patents for pharmaceuticals that last at least 20 years.

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This is as a result of the intellectual property rules

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of the World Trade Organization.

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So what India did is no longer possible.

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Second, the practice of patent-holding companies have changed.

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Here you see the patent practices

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before the World Trade Organization's rules, before '95,

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before antiretroviral drugs.

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This is what you see today,

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and this is in developing countries, so what that means is,

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unless we do something deliberate

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and unless we do something now,

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we will very soon be faced with another drug price crisis,

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because new drugs are developed,

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new drugs go to market, but these medicines are patented

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in a much wider range of countries.

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So unless we act, unless we do something today,

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we will soon be faced [with] what some have termed

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the treatment time bomb.

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It isn't only the number of drugs that are patented.

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There's something else that can really scare

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generic manufacturers away.

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This shows you a patent landscape.

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This is the landscape of one medicine.

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So you can imagine that if you are a generic company

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about to decide whether to invest

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in the development of this product, unless you know

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that the licenses to these patents

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are actually going to be available,

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you will probably choose to do something else.

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Again, deliberate action is needed.

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So surely

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if a patent pool could be established

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to ramp up the production of military airplanes,

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we should be able to do something similar

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to tackle the HIV/AIDS epidemic.

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And we did.

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In 2010, UNITAID established the Medicines Patent Pool

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for HIV.

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And this is how it works:

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Patent holders, inventors

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that develop new medicines

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patent those inventions,

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but make those patents available

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to the Medicines Patent Pool. The Medicines Patent Pool

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then license those out to whoever needs access to those patents.

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That can be generic manufacturers.

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It can also be not-for-profit drug development agencies,

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for example.

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Those manufacturers can then sell those medicines

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at much lower cost to people who need access to them,

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to treatment programs that need access to them.

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They pay royalties over the sales to the patent holders,

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so they are remunerated for sharing their intellectual property.

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There is one key difference

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with the airplane patent pool.

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The Medicines Patent Pool is a voluntary mechanism.

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The airplane patent holders were not left a choice

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whether they'd license their patents or not.

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They were forced to do so.

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That is something that the Medicines Patent Pool cannot do.

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It relies on the willingness of pharmaceutical companies

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to license their patents and make them available

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for others to use.

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Today, Nelson Otwoma is healthy.

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He has access to antiretroviral drugs.

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His son will soon be 14 years old.

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Nelson is a member of the expert advisory group

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of the Medicines Patent Pool,

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and he told me not so long ago,

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"Ellen, we rely in Kenya and in many other countries

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on the Medicines Patent Pool to make sure

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that new medicines also become available to us,

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that new medicines, without delay, become available to us."

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And this is no longer fantasy.

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Already, I'll give you an example.

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In August of this year, the United States drug agency

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approved a new four-in-one AIDS medication.

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The company, Gilead, that holds the patents,

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has licensed the intellectual property to the Medicines Patent Pool.

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The pool is already working today, two months later,

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with generic manufacturers to make sure that this product

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can go to market at low cost

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where and when it is needed. This is unprecedented.

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This has never been done before.

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The rule is about a 10-year delay for a new product

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to go to market in developing countries, if at all.

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This has never been seen before.

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Nelson's expectations are very high,

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and quite rightly so. He and his son will need access

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to the next generation of antiretrovirals

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and the next, throughout their lifetime,

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so that he and many others in Kenya and other countries

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can continue to live healthy, active lives.

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Now we count on the willingness of drug companies

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to make that happen. We count on those companies

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that understand that it is in the interest, not only in the interest

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of the global good, but also in their own interest,

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to move from conflict to collaboration,

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and through the Medicines Patent Pool they can make that happen.

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They can also choose not to do that,

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but those that go down that road may end up

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in a similar situation the Wright brothers ended up with

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early last century, facing forcible measures

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by government. So they'd better jump now.

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Thank you. (Applause)