tuberculosis. the high price of antiretroviral drugs may act as a barrier to hiv treatment, thereby increasing the likelihood of developing an opportunistic infection. taking the recommended drug regimen for hiv is particularly useful in the prevention and treatment costly opportunistic infections. for example, antiretroviral therapy has been able to assist in the prevention of tuberculosis, pneumocystis pneumonia, kaposi sarcoma, and severe bacterial infections, and may be useful in treating tuberculosis. activism to reduce antiretroviral therapy costs main article: hiv/aids activism throughout the past decade, there have been activist movements that have influenced the procurement lower hiv drug prices at greater accessibility. in 2000, the cost for first-line treatment was over $10,000 per patient per year, and nearly two decades later in 2018, the cost has decreased to as low as $75 per patient per year. an advertisement for the silence = death project of act up to bring about hiv treatment reform in 1987, aids coalition to unleash power (act up) was the first international organization designed to advocate for people with hiv. on september 14, 1989, members of act up protested at the new york stock exchange over the burroughs wellcome's setting a price of us$10,000 per year for azt, which was the only effective treatment for hiv discovered and was unaffordable to many hiv positive persons. several days later in response to the protest the company lowered the price of azt to $6,400 per patient per year, a 20% reduction. in 1997, the south african government attempted to make legal amendments to import patented hiv drugs at more affordable prices due to their severe inaccessibility in developed countries. in response, 39 pharmaceutical companies filed a class action lawsuit. the lawsuit would eventually be dropped years later in 2001 due to public backlash. the government's legal challenge was an important case which brought attention and urgency to the issue of unaffordable antiretroviral therapy, spurring greater activism in reducing hiv drug prices. in 1999 at the united nations in geneva, aids activists proposed compulsory licensing for antiretroviral drugs, which would enable other non-patent holders to produce the drugs at lower market costs. the idea of taking legal measures to limit the price of hiv treatment continued to spread globally. in 1998, brazil was the first developing nation to implement a national hiv-reduction program which produced generic versions of originator drugs, allowing consumers to purchase antiretroviral drugs at prices that were on average 79% lower than the market price before. in 2000, the treatment action campaign of the international aids conference in durban prioritized increasing access to antiretroviral drugs and created the global march for treatment. later on that year, a global summit in okinawa, japan, founded the global fund to optimize international funding for curbing hiv and other diseases. in response to rising public pressures, pharmaceutical companies began to sell antiretroviral drugs at discounted prices through the accelerating access initiative; however, even at the discounted prices the brand name drugs still were not as affordable as their generic counterparts. in 2001, india released a generic antiretroviral drug treatment for $350 per patient per year at a time when the originator version would have cost approximately $1000 per patient per year. this great price difference demonstrated the possibility of considerably more affordable antiretroviral drug costs to the public, prompting greater widespread activism. that same year at the world trade organization ministerial conference, the doha declaration was adopted, emphasizing that nations should not be hindered by intellectual property rights when promoting public health. in 2003, hiv/aids was officially declared a global health emergency by the who, and for the next several years, with the combined effort and funding from organizations such as national governments, the global fund, and pepfar, the cost of hiv treatment was able to decline and accessibility to generic drug brands increased, especially in developing nations. in 2010, the medicines patent pool (mpp) was founded for the purpose of negotiating with pharmaceutical companies to reduce drug prices for treatment of hiv as well as other diseases, allowing countries who are part of the agreement to further offer reduced drug prices to consumers.