Every now and then, an issue comes along that is so profound and so fundamental to the cause of justice that the world's conscience is stirred. It was because they finally accepted the weakness of their case in the face of a humanitarian disaster that 39 multinational drug companies dropped their legal action in South Africa over copyright. This enables the country to table laws permitting the import and manufacture of cheap generic versions of patented drugs. To the four million South Africans suffering from HIV, this is more than a victory, it is the rebirth of hope. Of 34 million people infected with HIV across the globe, 25 million live in Africa. Yet only 25,000 African victims receive the anti-retrovirals that can control the disease. It was former president Nelson Mandela who in 1997 proposed laws giving his country the right to buy or make generic versions of expensive drugs that are beyond the means of people in poor countries, where they are most urgently needed. The drug companies' lawsuit was the response. Aids is only one example. Tuberculosis, childhood diarrhoea and other endemic diseases continue to ravage the developing world, although there are medicines that can cure them - at a cost. For example, a year's treatment with a triple drug combination effective against HIV costs US$10,000 (HK$78,000), while copies of the same drugs can be bought for US$300 - far cheaper than even the US$1,000 the drug firms are now charging after they were compelled to cut back on profits because of international criticism. South Africa is not the first developing nation to take on the pharmaceutical multinationals. Former Indian prime minister Indira Gandhi decided 30 years ago to refuse to honour the patents of the international drug giants. As a result of that, India's leading drug manufacturer, Cipla, was recently able to offer the three-drug, anti-Aids cocktail to governments for US$600 and to the French volunteer doctor organisation Medecins Sans Frontieres for its Aids clinics in Africa. Thailand, struggling to contain its own HIV epidemic, attempted to produce a home-made version of the drug DDI in 1998 but the American pharmaceutical industry blocked the scheme, claiming it could not recoup the US$350 million to US$500 million costs involved in developing the new medicine. In fact, the pharmaceutical industry spends twice as much on marketing as it does on research and development. And the multinationals are not out of the picture yet. Part of the deal with South Africa is that they will be consulted when the new laws are tabled. There will be tough talking ahead. And a further note of caution: US President George W. Bush has received massive backing from drug companies and if his pharmaceutical priorities are like his environmental credentials, the United States could revert to old habits, threatening sanctions against countries that defy the patent laws, as it did with Thailand in 1998.