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Getting a traditional pharmaceutical to the market can cost a billion dollars or more. Newer, more tailored and targeted drugs called biologics are even more complex and expensive. Simple economics dictates that companies and venture funds will invest more in products that can generate a sufficient return.

Drug companies say they need to charge ever-higher prices to cover their research costs, but they spend far less on research and development than they do on marketing and administration, and afterwards they actually keep more in profits.

For a decade, makers of AIDS medicines had rejected the idea of lowering prices in poor countries for fear of eroding profits in rich ones. The position required a balancing act, because the companies had to deflect attacks on the global reach of their patents, which granted exclusive marketing rights for antiretroviral drugs.

It is very clear that the present system of innovation for medicines is very inefficient and really somewhat corrupt. It benefits shareholders over patients; it produces for the rich markets and not for the poor and does not produce for minority diseases.

Huge sums are invested globally in medical research and development - and with good reason.

I take it to heart that, for example, there aren't enough funds for AIDS research, but people pay 20 times the value of an item of clothing.

I keep encouraging the pharmaceutical companies to put more money into R&D.

Drug manufacturers could afford to sell AIDS drugs in Africa at virtually any discount. The companies said they did not do so because Africa lacked the requisite infrastructure.

In general, drug companies are reasonably good at developing new treatments, and there's also a lot of good in the industry.

Over the years, HIV/AIDS activists and their allies have been pioneers in creating new frontiers in the medical establishment. Through their efforts, the FDA drug approval procedures were reformed so promising new therapies could reach desperate patients quicker.