A leaked email shows that the Innovative Pharmaceuticals Association of South Africa (IPASA) colluded with the U.S.-based pharmaceutical industry lobbying group PhRMA in an apparently successful plot to derail reforms to South Africa's liberal patent laws. HIV advocates have sought these legal changes for years in hopes of bringing down costs for, and thus likely improving access to, antiretrovirals (ARV) for HIV in that hard-hit nation.

IPASA reps ARV-producing companies such as Merck, Sanofi, Pfizer, Roche and Novartis.

An email sent by Michael Azrak, the managing director of Merck Southern and East Africa and the head of IPASA's intellectual property committee, indicated that IPASA, in consultation with PhRMA, engaged consultancy group Public Affairs Engagement to influence the intellectual property reform process in South Africa. All this was in contrast to IPASA's previous denials.

Despite a media firestorm—which landed the affair with the moniker “Pharmagate”—the South African cabinet still did not bring the reform package to a vote before the May 7 national elections, leaving it in limbo for the near future.

“We're concerned the plots may have worked, that the government may have bowed to pressure,” says Lotti Rutter, a senior researcher at the Treatment Action Campaign in South Africa.

IPASA's actions, Rutter says, represent “just a shocking disregard for human life in South Africa.”