Amid ongoing controversy, UNITAID has signed off on a patent pool that will start operating in mid-2010 with $4 million. Drugmakers will be asked to place patents for 19 HIV meds into a pool that could be licensed to select generic makers, which would pay inventors a small royalty and sell copycats only in certain developing countries. Presumably, prices would fall sharply, but inventors would still get some revenue.

“This is an historic day,” Philippe Douste-Blazy, who chairs UNITAID’s executive board, in a statement. “UNITAID has now put in place a mechanism that will make medical advances work for the poor, while compensating companies for sharing their technology.”

But hard work is still ahead. UNITAID hopes the pool will facilitate development of fixed-dose cominbation drugs and, importantly, must obtain agreements from brand-name drugmakers. So far, the international drug-purchasing agency has had consultations include Gilead, Tibotec, Merck and Sequoia, but others have reportedly dragged their corporate feet (see here).

“We’ve been encouraged by the positive responses from a number of companies to our campaign in support of the pool,” says Michelle Childs, policy and advocacy director at Medicines Sans Frontieres, also known as Doctors Without Borders. “Now that the pool has been given a green light, patent holders need to move from expressions of general support to firm and formal license commitments. We urge them to do so.