Developing countries can get into industries with a higher technological component and increased competition will force down prices. It is a cartel and like all cartels they want monopoly power - it is a basic economic tenet that monopolies lead to higher prices which is why many governments try to break them up. The Big Four do not like the idea of cheap drugs coming into the market from Egypt or India for sale in poor countries because, of course, more competition means lower profits for shareholders. The health systems do what they can, but it is like giving a sticking plaster on a haemorrhage. The Western drugs they need are unavailable because they are unaffordable.
Life is priced too high.
In Pretoria, a critical battle is beginning in the South African high court in an action brought by 42 pharmaceutical companies including the big four against the South African government. The case is an attempt to block South Africa from importing the cheap generic medicines from developing countries. Estimates are that the companies have spent three years and millions of American dollars preparing their case. They have retained almost every patent lawyer in the country and on 5 March their barristers will try to stop the South African government from buying the medicines its people so badly need from the countries where the prices are lowest on the grounds that it infringes world trade agreements. The rest of the SADC region and continent will be closely watching this case, as will the rest of the developing world.