Current negotiations on a free trade agreement (FTA) between the European Union and India are causing serious concern in many quarters over future access to cheap generic medicines used to treat some of the world's great public health threats: HIV, tuberculosis and malaria, and also cancer. Those fears are well founded: if the EU and India agree on stringent patent and border measures, India's role as the "pharmacy of the south" could well come to an end.

The result could see patients in poor countries facing stock-outs, price increases and even having to pay the full cost of their treatment – meaning that only the richest among them will get treated. And we have to remember that a young African diagnosed with HIV today will have to stay on treatment for the next 50 years, not only to keep alive but to avoid transmitting the virus.

In the midst of the outcry, mostly based on the crucial issue of human rights, what has not been said is that there is a responsibility for both India and the European Union to be pragmatic and reasonable. The EU has invested hundreds of millions of euros in procuring medicines to the developing world and the development of a generic industry. This has enabled the EU to reap the largest value for the money it has invested in global public health. Now that fewer funds are available to reach treatment goals, the last thing the union should do is undermine the very instruments that have made its global health funding strategies successful.

India has responsibilities too: it should acknowledge that several of its generic manufacturers have built their fame and experience on making quality medicines available to poor countries at the lowest possible prices. They have played a pivotal role in improving access for the poor, but they now have the responsibility to continue serving the patients who have indirectly facilitated their expansion and subsequent entry into more lucrative international markets.

The medicines-related issues discussed in the FTA are not only a question of public health, but of ethics, justice and reason. The result will either be a win-win situation that will also benefit the poor or a lose-lose proposition that may kill the poor. It would be unthinkable that private interest pressure from European pharmaceutical companies to preserve an obsolete business model could prevail over common sense, common interest and the health of millions of people.

• Philippe Douste-Blazy is UN special adviser on innovative financing for development and chair of Unitaid.

• Denis Broun is executive director of Unitaid.