In developed countries, antiretroviral (ARV) treatments have turned AIDS from a death sentence into something more like a chronic disease, extending the active lives of many of those living with HIV/AIDS by ten years or more. But these revolutionary treatments have reached only a few thousand of the more than 25 million Africans infected with HIV or suffering from full-blown AIDS.

The popular view—embraced by many aid agencies and nongovernmental organizations, as well as some African politicians—blames this problem on the high cost of ARVs. There have even been calls for African governments to override the pharmaceutical companies’ patents and encourage the local manufacture of ARV drugs—an action that some people believe has been sanctioned by the World Trade Organization in countries facing national emergencies. Pharmaceutical companies, which price these treatments at $1,000 to $1,500 a month in the United States, defend their intellectual property by arguing that a return on their R&D investment is essential to finance the continuing development of AIDS treatments and that African countries lack the infrastructure to administer ARVs effectively, no matter what the price. On the latter point, the risks are indeed great: improperly administered ARVs could hasten the mutation of the AIDS...