Nigeria has defied pressure from multinational pharmaceutical companies by becoming the first African country to import cheap copies of patented Aids drugs in a move watched closely by other states on the continent worst hit by the disease.
The groundbreaking decision will infuriate big drug firms which have been trying to coax African governments into de facto recognition of copyright agreements by offering cut-price medicines.
But Nigeria says it will shortly begin distributing tons of drugs produced by an Indian company, Cipla, at a fraction of the price charged by the major drug firms. The imports will cut the cost of anti-retrovirals from about £4,000 a year for patented medicines to £225 for those Nigerians who benefit from the programme at hospitals in several cities.
Over the coming months, distribution will be expanded to 10,000 people at 100 clinics across the country as part of a trial programme that the government hopes will ultimately reach most of Nigeria's 3.5m citizens with HIV.
Nigeria's announcement coincides with an international conference in west Africa on Aids where several governments have demanded access to affordable anti-HIV drugs.
Aids is now the primary killer in sub-Saharan Africa. Of the 28m people living with HIV in the region, only a few tens of thousands have access to anti-retroviral triple therapy relied on in the west. Many of the others are expected to die within the decade. This year, an estimated 2.3m people succumbed to Aids in sub-Saharan Africa.
The president of Burkina Faso, Blaise Compaore, opened the meeting in Ouagadougou on Sunday by saying that the world is turning a blind eye to Aids, which he described as a "major crisis retarding development in African countries".
Access to medicines, he said, was "the domain of the north and the sick and ailing are left to the south".
Nigeria's move follows the court victory by South Africa earlier this year over a coalition of pharmaceutical firms which established the right of governments to seek cheaper drugs to deal with health emergencies such as Aids. Since then, the multinational drug producers have sought to bind African states into long-term agreements to use their products with offers of reduced prices and the prospect of international aid subsidies.
Botswana - which has the highest rate of HIV infection in the world, and where life expectancy is predicted to fall below 30 by the end of the decade - says it will distribute anti-retroviral drugs to all its citizens who need them within the coming months after reaching pricing agreements with several big pharmaceutical companies.
It is still paying about twice what Nigeria is charged for similar drugs, but Botswana believes that the real costs will be heavily subsidised by donations. The Microsoft billionaire, Bill Gates, has taken a personal interest in the Aids crisis in Botswana and the government fears it could lose his support if it were to defy patent agreements.
Other countries are not so fortunate. Kenya and Ghana in particular will be carefully watching the reaction by the drug companies and western governments to Nigeria's move. Both governments have been discussing prices with generic drug producers.
Nigeria is unlikely to face any immediate legal action by the drugs firms, in part because it does not recognise most of the patents involved. But it may come under strong pressure to abide by international patent agreements.
The French health minister, Bernard Kouchner, has pledged his government's backing if poorer nations are more vocal in demanding access to Aids drugs.
"If the countries of Africa do not themselves say they want the treatment, it is not us who can do that for them," he said.
He urged African states to press the issue at a meeting in Brussels next week to discuss the global fund to fight Aids and other diseases.
The former president of Ghana, Jerry Rawlings, now a roving UN ambassador on Aids, said just $1.5bn (£1.1bn) has been pledged to the fund which leaders such as Tony Blair have said should have $10bn a year to hand out.
© Guardian Newspapers Limited 2001