There is, and has rightly been a long and drawn out debate on the price barriers faced by poorer consumers. And for good reason too. Access to medicines is a phrase that's come to be thrown around quite often, almost driving it into rhetoric - with people not stopping anymore to think about what it represents. It has come to be used any time there is talk of high priced medicines. And, although it's most commonly associated with AIDS medicines, of the deaths caused by developing world diseases less than 1/3rd are caused by HIV/AIDS. What seems to me to be a bigger problem due to simple logistics is the fact that there are several developing world diseases for which nearly no effective treatment exists in the first place. There are also several developing world diseases for which treatments exist but barriers aside from price are the hindering factors. And of course, most importantly, the fact that the extra focus on the "access" part takes away focus from the fact that trade-offs exist in intellectual property for a reason. (Of course there are those who purposefully use rhetoric for purposes of influencing the broader public while actually understanding the situation) For purposes of clarity, I'll state the tradeoff (for not only medicinal patents, but IP more broadly) as the following:
A restriction on information in the form of an IP right is only useful if it serves to produce information that would not have otherwise been produced. Therefore it only makes sense in allowing restrictions (i.e., IP rights - and only if they are required at all) on any information so as to allow the production of information that would not have otherwise been produced. This is the tradeoff that is made - restrictions that produce more total information than would have been produced without the restrictions - and this is what always must be looked at.
It does not make sense to talk about one half of the equation, without considering the other half. It may seem at this point, that I'm 'siding' with the drug companies here - since this is their standard argument as well. But I’m arguing that the problem is too multifaceted to simply have this side and that side. But focusing only on the 'access' part seems to artificially reduce the extent of the problem to one that seems it can be solved by simply reducing prices - be it through compulsory licensing, price differentiation or subsidies. In other words, it only provides a short term solution, and in fact adds to the longer term problem. The rest of the problem gets undermined by what is becoming the rhetoric of 'access to medicines'. The problem with the drug innovation and delivery system is manifold - including lack of innovation, infra-structural barriers, drugs not being tailored to local conditions, diversion of huge amount of funds towards debatable 'advertisement' purposes, slower rates of drug discovery, etc.
To wrap things up - there is no doubt in my mind that a good number of drugs out there are priced higher than they could reasonably be expected to, and pressure on drug companies either through generics or due to the public eye is most definitely a good thing. But the larger picture includes several problems, and these should not be forgotten as it is important that these are addressed as well. It's not sustainable to keep expecting price cuts (or compulsory licenses) to solve the problem that the drug innovation and delivery system has. (For a broader picture on the aid versus business as methods to fight poverty, check this article) Framing it differently - it makes more sense to change the business model, in this case, the innovation system itself, than to keep relying on aid (price cuts) to keep trying to fix it.
Of course, its impractical to expect the whole system to change, but only if problem is suitably understood and kept in mind can it be better addressed at least.
[Disclaimer: I'm not talking about any particular organisation - but the general public and the opinions I've heard people speaking about personally. If it's so happened that I've somehow managed to get the minority opinion on this, I'm happy for this post to have been largely unnecessary]