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make sense to tinker with the manufacturing process to lower the cost of making the product-- by reducing the number of steps involved, for example--because that would require going through some of the regulatory process again. This can mean that the cost stays too high for developing countries, and it's why it sometimes takes decades for drugs that are widely available in the rich countries to reach poor ones. This is where low-cost generic manufacturers come in. Their mission is to help people in poor countries get access to the same drugs and other lifesaving inventions that are widely available in rich countries.* Generics made their mark on global health around two decades ago. At the time, lifesaving HIV drugs were too expensive for countries like Brazil and South Africa, which meant millions of people living with HIV were priced out of the market. So, the governments in those countries had generic manufacturers duplicate the drugs, violating the intellectual property rights of the companies that had invented them. At first, the companies resisted, but they eventually backed off after realizing that a tiered pricing approach would work better. They made all the information about their drugs available to low-cost generic manufacturers, which were allowed to sell to developing countries without paying any royalties. This is what's known as tiered pricing: the highest price for rich countries, a lower price for middle-income countries, and the lowest possible price--one that matches the cost of manufacturing--for low-income countries.. One problem is that once a drug is made generic, no one has an incentive to invest in reducing the manufacturing cost since other companies could immediately copy their * Generic manufacturers are also the reason why you might be able to get significantly cheaper versions of some of the prescriptions you take.