Former President Bill Clinton is today announcing an AIDS program that tackles both high drug prices and low quality health infrastructures in the developing world. Engineered by Clinton advisor Ira Magaziner, the Clinton Foundation HIV/AIDS Initiative agreement will cut the price of a commonly used triple-drug regimen by almost a third, to about 38 cents a day per patient, from current developing world discounted rates for generic (55 cents) and brand-name ($1.54) drugs. The price of nevirapine will be cut by almost half.

The companies involved - Indian firms Ranbaxy Laboratories, Cipla and Matrix Laboratories, and South Africa's Aspen Pharmacare Holdings - opened their books and manufacturing processes to a group of Clinton business advisors. Then the companies and advisors hunted for ways to cut costs, starting with raw materials suppliers in China and ending with the products' packaging.

Under Magaziner's supervision, the foundation also helped several Caribbean states and three African countries prepare detailed national drug treatment plans, including preparing budgets for hiring and training nurses and doctors, building and upgrading laboratories and clinics, developing patient- information systems, and improving drug warehousing and delivery.

To pay for the program, Clinton has secured partial funding by personally lobbying leaders of rich nations and has raised more than $1 million from private sources. The money will go directly to the governments receiving assistance. Rwanda, Mozambique and Tanzania have partial funding from sources including the World Bank and the Global Fund to Fight AIDS, Tuberculosis and Malaria.

National treatment plans were key to the deal, because the program promised drug makers large volumes of patients over time - up to 1.5 million by 2008.

Magaziner said he first approached patent-holding pharmaceutical firms "because President Clinton believes in intellectual property." So far, none of the Western companies is involved. Bristol-Myers Squibb said it never received a proposal, and Merck said it is in initial talks.

While there is a chance that the Western companies could charge the initiative with patent infringement, in the past such attempts have damaged their public images.

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