THAILAND'S health minister recently announced that the nation's state-run drug manufacturer, the Government Pharmaceutical Organisation, would continue to violate the patents on four key cancer drugs. Health activists from across the world applauded the move, apparently believing that intellectual property rights are an obstacle to bringing medicine to the world's poorest and sickest citizens.

But drug patents and drug prices aren't the main obstacle to third-world patients seeking treatment. The truth is that even if medicine were completely free, most developing nations lack the infrastructure to deliver it effectively.

As Kevin De Cock, HIV/AIDS director at the World Health Organisation, explained to Reuters last year, "You have health infrastructure that is dilapidated, and supply chains that don't exist."

For instance, cold storage is essential to preserving the effectiveness of many drugs. It's estimated that about 50,000 people die annually in India from snake bites, primarily because the anti-venom serum cannot be stored in most rural clinics because of lack of refrigeration. And refrigeration is not possible because of extremely unreliable supply of electricity, particularly in rural India.

Diagnostic facilities are also often ignored. It was recently estimated that of the 22 million pathological tests carried out across India each day, only one million may be done at accredited laboratories. In addition, there is very little information about the validity and reliability of many of these tests.

Regularly, drugs are not administered safely in hospitals. In India, the government admitted recently that nearly 70% of the injections they give might be unsafe. Often, patients stay away from hospitals – even when sick – out of fear that they may get infected with HIV. Indeed, a 10-year-old boy from a poor family in eastern India was infected with HIV at one of Delhi's premier hospitals.

This is one reason why the Indian government failed miserably in its efforts to increase access to medicines even after abolishing product patents in 1972.

Thirty years later, when the debate began as to whether India would be better served by re-establishing patent rights, less than 10% of the nation's estimated 3.5 million AIDS patients were receiving any treatment whatsoever.

Then there is the issue of greed – not so much of the patent-holders, but that of many governments in poor countries.

Kenya, one of the world's most vocal proponent of patent is the problem for patients notion, levies a 38% tax on imported medicines – an enormous mark-up that needlessly makes drugs too expensive for many sick Kenyans. Morocco and Tanzania tax medicines at a similar rate. Brazil, also a habitual offender of intellectual property, imposes a 28% tax. Peru's tax is 29%.

In Thailand, the former government turned down an offer from the Global Fund (an international philanthropy) that would have provided resources to purchase generic medications certified by the WHO – preferring instead to produce the drugs domestically.

The reality is that regardless of whether a nation respects drug patents, someone somewhere must pay the high research and development costs of the pharmaceutical industry. Otherwise, drugs cannot be developed.

Right now, American patients pay for most research costs through high drug prices. It's estimated that it costs US$800 million to develop a new drug today. Many drug makers already sell many medications at much lower prices to poor countries. If the use of compulsory licences increases, they'll have little choice but to reduce humanitarian drug sales or increase prices in poor nations – as they would have to find a way to recoup that lost revenue.

The health activists who are urging a number of governments that are systematically confiscating patents from international drug companies may have good intentions. But if governments continue to expropriate patents, they will essentially kill the goose that lays the golden eggs – and along with it, the hopes of hundreds of millions of the world's sick who await tomorrow's cures.

By focusing on patents, rather than the wider ills that seriously affect healthcare service to the poor, we will not help improve the lot of the ordinary patients.