Treating HIV in the developing world: getting ahead of the drug development curve.

At the 2006 International AIDS Conference (http://www.aids2006.org/), an impressive range of new therapeutic developments for HIV/AIDS were described. Several new drugs, and new drug classes (entry and fusion inhibitors, integrase inhibitors, and maturation antagonists) are offering great hope for more effective treatment [1]. At the same time, however, the conference also saw unrest among treatment activists, who were vocally campaigning for increased access to lopinavir/r, a five-year-old drug recently reformulated but priced out of reach of most developing countries [2]. Ensuring access to affordable antiretrovirals has been on the agenda of the International AIDS Conference for almost 20 years. At the 1988 conference in Stockholm, there was debate about how to ensure people in the developing world could access the treatment of that time, zidovidine monotherapy, which cost ~ US$8000 a year [3]. Today, zidovudine, which is only used as part of a three-drug combination therapy, costs ~US$103 a year [4].