Hundreds of farmers, traders, activists, people living with HIV and others protest in New Delhi on Friday against the European Union-India free trade agreement. (Adnan Abidi/Reuters)

Hundreds of people marched in New Delhi on Friday to protest an ambitious free-trade agreement being negotiated between India and the European Union that patient groups and health activists say could severely curtail India’s production and export of affordable drugs for millions living with HIV in developing countries.

About 80 percent of the HIV medicines distributed in poorer African, Latin American and Central Asian nations come from India. In recent years, with the U.S. government, U.N. agencies and organizations such as Doctors Without Borders and the Bill and Melinda Gates Foundation all using the relatively inexpensive Indian-made generic cocktails of antiretroviral drugs in their aid programs, India has earned the nickname “pharmacy of the developing world.”

“A majority of the drugs used by the American government’s PEPFAR HIV treatment program in Africa are from India,” said Leena Menghaney, representative of Doctors Without Borders in India. “Anything that stifles the Indian ability to produce affordable HIV drugs will also affect the American program to create an AIDS-free generation. They will have to rely on expensive patented drugs, which means treating fewer patients.”

Health workers with the medical aid group say that the price of first-line HIV medicines has dropped since 2000 from $10,000 per patient per year to about $150 because of low-cost Indian production.

The proposed free-trade pact between India and the European Union would be the world’s largest, covering about 1.7 billion people. No such pact exists between India and the United States, but the two nations have consulted on bringing about a bilateral investment treaty, which activists say is often the first step toward a free-trade agreement.

Herman Van Rompuy, president of the European Union, left, listens as Manmohan Singh, India's prime minister, speaks during the India-E.U. summit in New Delhi on Friday. (Pankaj Nangia/Bloomberg)

David Lipman, the E.U. ambassador to Thailand, said in a statement Friday that “nothing in the proposed agreement would limit India’s freedom to produce and export medicines.” But activists who have accessed leaked drafts say it includes measures to enforce intellectual property rights — including stricter enforcement of port controls and expansion of drug manufacturers’ ability to challenge Indian government decisions in court — that could do just that.

“There are clauses in the negotiations that will have a huge chilling effect on the production and use of affordable generic HIV medicines,” Menghaney said. “These medicines will be stopped at Indian ports and European transit ports on mere allegations of patent violation.”

In 2009, a Nigeria-bound consignment of the AIDS medicine Abacavir was stopped at a European port, causing a public outcry in India.

Indian Prime Minister Manmohan Singh said Friday that he hoped negotiators could quickly iron out their differences on a stringent intellectual property regime, as well as on issues such as barriers to automobiles and banking.

“There are complex issues involved, but we have both agreed to expedite discussions so that we can conclude an agreement at the very earliest,” Singh said in New Delhi.

The HIV and hepatitis C patients who joined activists in the streets of the capital carried a giant capsule-shaped balloon and urged India to reject the treaty proposals. India has about 2.5 million HIV-infected people, according to the National AIDS Control Organization.

If this free-trade agreement is signed, it is going to be the biggest nightmare in our lives. I pray that our lifeline of affordable medicines is not taken away from us,” said Rosalyn Lalawmpii, a protester whose husband is HIV-positive. “Because of these medicines, my son and I are not infected.”