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PROTESTORS: Novartis's greed kills people in need! Drop the case now!

KAI RYSSDAL: That was the scene in Washington today outside the offices of the Swiss drug maker Novartis.

Hundreds of AIDS activists took to the streets of New Delhi, India, as well. They're protesting a court challenge the company filed there today.

Novartis is looking for patent protection for a new version of a leukemia drug it makes. India's standards for what constitutes a new drug are stricter than in most other countries. It's also got a bigger generic drug industry than most other countries do.

From New Delhi, Shia Levitt reports.

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SHIA LEVITT: India's controversial patent law says drug companies can't patent an already-existing substance simply by making a new form of the drug. Say, turning a solid into a liquid, or by finding a new use for it. Say, discovering that a cancer drug can also be used to fight HIV.

Companies have to develop a true innovation with clinically-improved results in order to earn a new patent in India.

BRYAN LIANG: That's the idea. However, that conception is contrary to most intellectual property regimes around the world. Different forms actually do get patented in the E.U., in the United States, in Australia and so forth.

Bryan Liang from the California Western School of Law advises drug companies on competition, pricing and access. He agrees with many pharmaceutical companies that these rules violate international trade law.

But patient advocates like Chan Park see it differently. He's with the Lawyer's Collective HIV/AIDS Unit in Delhi, India.

CHAN PARK: It's a unique provision in Indian patent law, and it was designed to prevent a practice called "evergreening," which pharmaceutical companies engage in all too often. Which concerns patenting trivial improvements to already-existing drugs to artificially extend the 20-year monopoly beyond the 20 years already granted to it.

Swiss pharmaceutical company Novartis is behind the court challenge of India's patent law.

The company says it uses profits from its patented drugs to fund the research and development of new medicines, and to give free or reduced-cost drugs to millions of people in developing countries.

And health policy expert Bryan Liang says that's more helpful to the world's poor than low-cost generics.

LIANG: Even generic prices do not create access to many of these particular drugs for the people who need them the most, people in Africa, Southeast Asia and India themselves. When you're talking about people accessing the drug, you really have to give it at virtually no cost. Even a generic company that claims that it will be one-tenth the price of Novartis' price, that's still not low enough.

Still, a lot of people do depend on generics.

Activist Loon Gangte runs a group for HIV-positive people in Delhi.

LOON GANGTE: My life is going to be at risk.

He says the Novartis court challenge could have a devastating impact on millions of lives, including his own. He now pays 800 rupees — about $18 per month — for generic HIV drugs. Brand name therapies would cost him about eight times that price, far beyond his reach.

The aid agency Doctors Without Borders says generics, many of them produced by Indian companies, have been crucial to the fight against AIDS in the poorest countries. Generic competition has brought prices down and allowed aid agencies and government programs to treat more people for a host of other diseases.

If the Indian law is overturned, Chan Park says there will be a huge ripple effect.

PARK: Whether it be mental health or diabetes or Malaria or tuberculosis, Novartis's challenge would threaten the ability of Indian generic pharmaceutical companies to produce affordable versions for much of the developing world.

Decisions on hundreds, maybe thousands of drug patent applications in India now rest on the outcome of this case. And the court's decision could well reshape how countries comply with international trade law.

In Delhi, India, I'm Shia Levitt for Marketplace.