Prof David Taylor argued that, although Oxfam and allied aid organisations accuse the international pharmaceutical industry of using its influence to maintain a worldwide system of intellectual property law and enforcement that deny's the world's poor access to essential medicines and block's progress towards health for all, they are wrong. Commercial companies alone cannot solve the health problems of developing countries Enabling all sections of the global population to gain the extended life expectancy enjoyed in developed countries is one of the world's fundamental challenges. But it is not clear that doing away with legitimate intellectual property rights will aid this process in the long term, or that individual companies can carry a responsibility that properly belongs to governments and peoples. The concern of Oxfam and others has been made acute by the HIV-AIDS pandemic in regions where the price of patent protected antiretroviral drugs and drugs for opportunistic infections makes them unaffordable to all but a privileged few. Health gains made in previous decades are being lost. The pharmaceutical industry's critics also blame it for inadequate research investment in diseases relevant to the health of the world's poor. Oxfam criticises current industry programmes to give low cost and free medicines to developing countries for being too small scale and perpetuating the system of intellectual property protection enshrined in the World Trade Organisation's current rules (the trade related aspects of property rights (TRIPS) agreement).

But without patents, medicines such as today's AIDS treatments would not have been developed by privately financed organisations. However, it is also true that in the immediate future rich world citizens have more to gain from intellectual property protection than those of the poorest nations. The important issue is to find ways of providing very poor populations with cheap access to patented essential medicines in ways that do not permit "leak back" sales of such products to richer countries and so undermine research for the future.

Suggestions that pharmaceutical company managers responsible for protecting pension fund and other shareholder interests should invest in areas likely to yield low returns are also questionable economically. It would be more logical to argue that if medicines like antiretrovirals can if supplied free or at marginal cost contribute to the control of AIDS in areas such as subSaharan Africa then governments and electorates of the rich world (who are key stakeholders in the modern pharmaceutical industry) share a common moral responsibility to meet their price.

No commercial company can act as a charity without running the risk that it would soon have no more than good intentions to offer either its customers or its owners. But if policymakers can create purchasing funds, ensure that patented medicines supplied at low cost to poor populations do not "leak back" to rich world markets, and restrain medicine price negotiators in prosperous countries from demanding savings to match those offered to the poorest, progress could and should be made. Given appropriate incentives, the profit motivated pharmaceutical industry provides a powerful force for improving both public health and private wealth throughout the global community.

Professor Taylor is currently Professor of Pharmaceutical and Public Health Policy at the School of Pharmacy, University of London, and Chairman of a central London NHS Trust.

His previous positions have included Associate Director of Health Studies at the UK Audit Commission; Director of Public and Economic Affairs at the Association of the British Pharmaceutical Industry; and Deputy Director of the Office of Health Economics.