AIDS at 25: Wall Street Darling Is Target of Third World Critics

In the United States, doctors now prescribe Truvada to 60 percent of all newly diagnosed HIV patients. The once-a-day treatment combines the two drugs known generically as tenofovir and emtricitabine. Sales of the two drugs, separately and together as Truvada, racked up nearly $2 billion last year, half the estimated $4 billion global AIDS drug market. Truvada's maker, Gilead Sciences Inc. of California, will likely see further gains with the Food and Drug Administration's approval, expected this year, of its combination of Truvada and Bristol-Myers Squibb Co.'s Sustiva.

Three years ago, Gilead announced its Gilead Access Program (GAP) for developing nations, and in 2003 promised to make tenofovir available "at no profit" to all of Africa and dozens of poor countries elsewhere.

Some advocates, however, have branded this an empty promise. In February, a report from Doctors Without Borders charged Gilead had failed to get regulatory approval in almost all the needy nations it had vowed to assist. Concurrently, demonstrators in New Delhi protested Gilead's application to patent tenofovir in India; they say this would result in the disappearance of cheaper, generic tenofovir, which became available there last year.

Gilead CEO John Martin responded, "On principle we believe that our product should be patented." He also called on the company's critics to give it a chance to gain regulatory approval in the GAP-targeted countries, some of which he said have been reviewing Gilead's applications for two years.

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