The scale of HIV infection is such that all actors - government, business, civil society, the medical community - need to be drawn into one massive coordinated effort of life-preserving. In this context, are the big pharmaceutical companies part of the solution or part of the problem, asks Walden Bello from Focus on the Global South in a speech delivered at the debate on patents, drug development, and HIV/AIDS at the XV International AIDS Conference in Bangkok. Big Pharma are less concerned about saving lives and much more concerned about protecting its patents, he says and suggests a new research and development framework, based on a people-oriented approach to patents, maybe coordinated by the UN, in which there is room for participation by many other actors, including governments, government institutes, and civil society organisations.