INSIGHTS | PERSPECTIVES

Abstract

Fishing for peroxidase protons Where are the protons in heme protein catalysis? mass produce these treatments for use in low-income countries at a cost close to the cost of production, with a small royalty paid back to the pharmaceutical companies. This is the same mechanism used to sell vaccines in low-income countries. In some countries, reductions in the price of HIV-1 treatments were only achieved after long legal battles with pharmaceutical companies. In some cases, countries overruled company patents on drugs and started importing generic drugs at lower costs—so-called compulsory licensing—which is permitted in cases of national medical emergencies. Creating a new funding mechanism for poor nations is difficult in the current eco-nomic climate, but HIV has left a legacy of structures ready to adapt to hepatitis C to complement government and private-sec-tor efforts. UNITAID, the United Nations agency created in 2006 to overcome market barriers for treatments of HIV, tuberculosis, and malaria, recently announced its first funding for hepatitis C, with an aim of re-ducing treatment costs to $500 to$1000 per patient ( 14). It plans to scale up treat-ment through a multinational group of HIV programs run by Médicins Sans Frontières, the international medical humanitarian organization. The Global Fund, which ad-dresses HIV/AIDS, tuberculosis, and ma-laria, has funded treatment programs with old-generation HCV drugs in several devel-oping countries for the past 3 years. If we can learn from the lessons of HIV/ AIDS, mass production of generics can save millions of lives. This has been an inspiring medical success story which need not stand alone but can be repeated, even more rap-idly, for hepatitis C.