There are fears that India's poorest could lose access to vital medicines if big drug companies succeed in curbing the country's generic medications industry.

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Several pharmaceutical giants are using India's courts in an attempt to block the production of key generic drugs used by cancer sufferers and those with HIV.

Generic Indian drugs cost a fraction of the price of the equivalent products. Essentially, the drugs are local copies of those originally produced by international pharmaceutical companies.

The availability of cheap generic anti-retro viral drugs that prevent HIV being passed from mothers to their children is what has stopped the disease from reaching full-blown epidemic levels in India.

Anjali Gopalan, who heads India's NAZ foundation, which is committed to raising awareness about HIV, says the drugs are the difference between life and death.

"At some level we've been able to arrest the spread of the infection, but suddenly we are seeing high prevalence districts crop up all over the country," she said.

"Without these cheap anti-retro drugs it is sure death for our people. Without them this infection is going to go viral. Without these drugs people are going to die horrible deaths."

As well as HIV, generic drugs are used for most diseases including hepatitis C, tuberculosis and even cancer.

They make up 90 per cent of India's pharmaceuticals market.

But as India's pharmaceutical market grows international companies are seeking a bigger share and the battle is being fought in India's courts.

The most prominent cases involve the pharmaceutical companies Bayer and Novartis.

Bayer wants exclusive rights to sell its anti-cancer treatment Nexavar, while Novartis is seeking a patent for Glivec, a drug used for leukaemia.

Two other European companies, Roche and Gilead, are also in court fighting to patent anti HIV-AIDs drugs in India.

'Maximising profits'

Leena Menghany from Medecins Sans Frontieres in New Delhi says the drug companies are concerned with increasing their profit margins.

"Generic production means that there's competition in the market and that patients come and have a choice to access a more affordable, quality generic," she said.

"And that indeed makes multinational companies very uncomfortable because it's not just about simple profits - it's about maximising profits."

In a statement, Novartis told the ABC that it understands the role of generic medicines in places such as India.

But it say its concern is with the non-recognition of intellectual property rights that help sustain and advance pharmaceutical research and development.

To Ms Gopalan these arguments just do not make sense.

She says it is a clear case of the commercial world butting against the world of the poor and the sick.

"I can understand if the drugs are not there and you don't have anything in your hands to give to people who are suffering," she said.

"But when you have everything and then you are denying it. That to me is criminal."