..."There is no real strategic approach, no real global leadership, and the policymakers are avoiding every thorny issue," says Ellen 't Hoen, head of Médecins sans Frontières' campaign for access to essential medicines...[M]edicines have become more affordable. In 2001, the leading drug companies making HIV treatments were seeking to sue the South African government to defend their patents and prevent generic drugs companies from manufacturing and selling them far more cheaply. Since then, the principal companies have joined the WHO's Accelerating Access Initiative, adopting policies to make their medicines available at far lower prices to the world's poorest countries...A final brake on scale-up remains the pharmaceutical companies. While most have established policies on fairer and more affordable access to HIV drugs, Médecins sans Frontières says their approaches and implementation both vary widely. A study by the UK-based Ethical Investment Research Service concluded that only half of the 12 largest drugs companies producing antiretrovirals extended preferential prices beyond the poorest countries and just five had licensed local manufacturers to produce drugs more cheaply...The cost of newer drugs is likely to prove an explosive issue as patients in poorer countries develop resistance to older drugs. [refers to Cipla, Ranbaxy, Roche, Gilead, GlaxoSmithKline]