The countries of southern Africa have the world’s highest rates of AIDS infection. They have a special need to make or buy low-cost generic drugs to save their citizens. World trade rules are amenable, containing safeguards that allow countries to use generics to preserve public hea-lth. But the US is now negotiating a free trade accord with the Southern African Customs Union. It is important that the US does not restrict the ability of poor people to get generic drugs.

For many years, American trade policy on medicines has been a struggle between the drug companies and the social imperative to provide developing nations with cheaper and easier access to vital drugs. In 2000, President Bill Clinton, under pressure from global health campaigners and developing countries, signed an executive order that barred Washington from asking sub-Saharan Africa to accept tighter restrictions on generics than the WTO requires. President Bush reaffirmed that decision when he came into office in 2001.

The trade representative’s negotiator says that the subject has not yet come to the table, and that the US, well aware that southern Africa faces unique health challen-ges, intends to respect the executive order. These are welcome words, and it is imperative that US be held to that promise.