From Kaiser: A recent opinion piece by Sally Pipes -- president and CEO of the Pacific Research Institute, a think tank that receives some funding from drug companies -- about intellectual property rights and compulsory licenses for patented antiretroviral drugs is "frightening," Andrew Green, a publishing fellow, writes in the American Prospect. If Pipes were "just running a think tank with pharmaceutical funding, it could be read as a shill piece and dismissed. But there's more to Pipes' biography: She is also a health care adviser to Rudy Giuliani," the former New York City mayor who is running for the Republican presidential nomination, Green adds (Green, American Prospect, 11/15).

In her opinion piece, Pipes says it was a "staggering display of cluelessness" for Rep. Tom Allen (D-Maine) and Sen. Sherrod Brown (D-Ohio) to sponsor a resolution that praises the Thai government for its decision to issue compulsory licenses to make generic versions of patented antiretroviral drugs. She adds that Thailand's actions "threaten to upset the economic incentives that allow Western firms to produce novel cures," saying, "Without patent protections, the drug industry as we know it would collapse, and development of new drugs would be significantly curtailed" (Kaiser Daily HIV/AIDS Report, 10/18).

Pipes opinion piece "can be read both as a signal that her role is expanding and as a preview of the HIV/AIDS policy she is encouraging Giuliani to adopt, specifically one without regard for the immediate need for as many cheap generic antiretrovirals as possible," Green writes. According to Green, while this is "cause for concern," the "real crisis" is that "Giuliani might actually be receptive to her arguments."

Giuliani has "expressed an interest in continuing and possibly expanding the President's Emergency Plan for AIDS Relief," but it is "apparent" he has "thought little about what that actually means," Green says. In addition, Giuliani has not described his HIV prevention strategy or whether he would expand treatment options, according to Green. "His lack of investment or concern about the issue leaves him vulnerable to insiders like Pipes, whose business-first agendas are prepackaged," Green writes. He adds that it is "not outlandish to think that [Giuliani] might make AIDS relief contingent on buying brand-name antiretrovirals" or "levy trade restrictions and financial penalties on countries, like Thailand, that determine the best way to immediately reach the most HIV/AIDS patients is to produce their own antiretrovirals."

Green suggests that all presidential candidates "study the AIDS policy Democrat John Edwards has introduced," adding that the "first move Giuliani should make, though, is to send Pipes back to the sideline and hire some advisers whose values aren't predicated on profit margins" (American Prospect, 11/15).