Pharmaceutical companies Roche and Gilead fielded a whopping dose of health activists’ wrath in January for breaking promises to offer affordable AIDS meds. “In the past four years, pressure on companies to do their part in providing drug access has increased,” says Kate Evans of the nongovernmental organization (NGO) Médecins Sans Frontières. “But we repeatedly see no follow-up.” Advocates contend that companies dangle access policies for PR cred, then don’t implement them.

In April 2003, Gilead said it would file to distribute the HIV med tenofovir in needy countries. But by January 2006, the company had registered in only six of the 97 countries named. Gilead says it will hit the others this year. In January, Roche announced plans to give developing countries technical tips on producing saquinavir. But the Berne Declaration, a Swiss NGO, declared the tips irrelevant, since many nations lack the basic capacity to produce drugs and added that Roche hadn’t even relinquished the patent. Roche countered that it doesn’t enforce the patent in the countries and that many can crank out the drugs. Regardless, accountability is one pill they may have to swallow.