The 59-year-old will tomorrow be surrounded by family and friends as he celebrates his freedom at home in Libya.
This is despite being given just three months to live when the Scottish authorities released him on compassionate grounds because of his prostate cancer on August 20th 2009.
Surviving family of the 270 people who died because of the bombing of Pan Am flight 103 over Lockerbie in 1988 are among those who have expressed outrage at the debacle.
And now further anger is expected after a medic in Tripoli confirmed that Al-Megrahi was receiving Abiraterone, the hugely expensive hormone-based therapy drug.
Abiraterone was discovered by British scientists at the Institute of Cancer Research in London, and has been extremely successful in clinical trials.
A study at the Royal Marsden Hospital in London in 2007 found it dramatically improved the condition of up to 70 per of prostate cancer patients.
But, despite pharmaceuticals giant Johnson and Johnson preparing to market the drug under the name Zytiga, its cost – estimated at some £3000 a month – could make it unobtainable for the majority of sufferers in the UK when it eventually goes on sale.
“Brother Al-Megrahi has received the very best treatment, including Abiraterone,” said a source connected to the Tripoli Medical Center, which has been looking after Al-Megrahi since his release.
“Medics have used it to prolong his life. He remains extremely ill, and very weak, but believes that the blessing of his survival will help him to clear his name.”
“Mr Al-Megrahi will have some of the best therapists and medical healthcare at his disposal so he will almost certainly be using this drug alongside other advanced treatment options,” said Professor Roger Kirby, founder and director of The Prostate Centre in London.
“He has long outlived the speculative three-month prognosis, and it appears he may continue to do so for a while yet. I strongly suspect that this drug has been central to that,” he said.
It is currently Ramadan, the holy Muslim month, and the source said Al-Megrahi and his family were ‘particularly pleased’ that he was spending his second as a free man.
Al-Megrahi has always pleaded his innocence, and has received unqualified support from Colonel Gaddafi, who has bankrolled all of his medical treatment, as well as the legal fight to prove his innocence.
Abiraterone has been deemed safe by the European Medicines Agency and by the US authorities. But it must be approved for sale across the EU by the European Commission, after which the National Institute for Clinical Excellence, England’s drug rationing body, will rule whether it is effective enough to merit its cost for supply on the NHS.
In trials it was found to extend the average life span of a late-stage cancer sufferer by up to five months. Patients without the drug are expected to live eighteen months.
Professor Kirby is now lobbying for the drug to be given fast-track approval.
“In clinical trials Abiraterone was proven to prolong lifespan by almost a third for late-stage cancer patients,” he said.
“It is inconceivable to think that the European Commission would opt against its use in Europe. Put bluntly: it would deny prostate cancer sufferers a chance to extend their lives.”
There were widespread celebrations across Libya when Al-Megrahi returned to a hero’s welcome from a Glasgow prison two years ago, but tomorrow’s marking of the anniversary will be extremely low key.
Tripoli remains under nightly attack from British and French bombers, while rebels threatening to end Gaddafi’s 42 years in power are just 30 miles from the city.
“Under these circumstances there will be no celebrations of Brother Al-Megrahi’s release,” said the same medical source. ‘Instead he will spend the day in a safe house well away from the fighting.
“There will be no triumphalism – Brother Al-Megrahi will spend a quiet day with his family,” the source added.
Al-Megrahi was filmed last month by Libya’s state-run television service at a rally of his tribe, which remains loyal to Colonel Gaddafi.
Despite looking extremely ill as he sat in a wheelchair, Al-Megrahi’s surprise appearance was a huge propaganda coup for the dictator’s beleaguered regime.
But, a few weeks earlier, a mission to capture the freed bomber and return him to face justice in the United States was revealed.
Under a secret deal between Barack Obama and Libyan rebel leaders, Al Megrahi would have been detained by opposition troops and then handed over to US Special Forces.
The Scottish government has insisted the decision to release Al-Megrahi was taken in good faith, and based on medical evidence from Dr Andrew Fraser, the director of health and care of the Scottish Prison Service.
But William Hague, Britain’s Foreign Secretary, said Al-Megrahi’s release was a “great mistake”, adding: “This was absolutely the wrong thing to do. It shows the medical advice it was based on was pretty much worthless.”