I write the article World disease not rooted in patents in The Providence Journal of 7 May 2008.
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Last week, some of the best and brightest minds in international public health gathered in Geneva to draw up formal policy recommendations for how Third-World governments should deal with disease. The event was sponsored by the World Health Organization (WHO), and at issue was the role of intellectual-property rights in pharmaceutical innovation and distribution.
The attendees pushed the WHO to support greater use of compulsory licenses, a legal measure that lets developing nations make patent-protected drugs in the event of a public-heath crisis. Proponents of this idea pointed to Thailand to bolster their case.
In March, Thai Health Minister Chaiya Sasomsap announced that he would be continuing the country’s compulsory license program, breaking the patents on four popular cancer drugs and producing generic knock-offs through Thailand’s state-run pharmaceutical firm.
Last year, the minister’s predecessor in the military government filed the original compulsory licenses for the cancer treatments, as well as for the heart-disease medication Plavix and two HIV/AIDS antiretrovirals.
International health activists and politicians, such as Carl Schlyter, Swedish member of the European Parliament, supported both moves. After all, is it not good to give poor patients access to pharmaceuticals by locally producing cheaper copies? Don’t patents just let pharmaceutical companies make money?
Unfortunately, the facts tell a different story. And the recent developments actually prove detrimental to the poor.
Thailand started production of generic AIDS medications under the auspices of the WHO in 2000, but the WHO eventually pulled the project and its funding because the Thai government’s factories were not able to uphold the quality of the medications, actually increasing the number of drug-resistant strains of the virus. The Thai government then turned down the WHO’s offer to get free medications from India.
The Thai government spends a very small amount on health care, just 3.3 percent of gross domestic product, even compared with its poorer neighbors. With a $600 billion economy — the 21st largest — it seems strange that the Thai government just wants to save costs estimated to a total of $24 million on compulsory licenses.
Together with issues of corruption, like the ones surrounding the rapid controversy and resignation of Chatree Banchuen, head of Thailand’s Food and Drug Administration, the Thai government’s priorities can indeed be questioned.
Thanks to last week’s conference, we now can expect middle-income countries like Brazil and Mexico to seize patents. If that happens, the steep discounts offered by patent holders to poor countries could disappear, as the patent-holding firms seek to recoup new losses.
What’s more, it could also lead to fewer life-saving drugs. It costs around $800 million and a decade of research and testing to bring a single new medicine to market. Developers’ investments are protected through patents, which grant them the exclusive right to sell the drug for a limited period. Take away the one way drug firms have to compensate a risky investment, and research into future treatments will wither away.
Rather than seizing intellectual property and trying to shoulder the manufacturing burden alone, developing nations should take full advantage of the drugs being given away or discounted by the patent holders themselves.
Burkina Faso, one of the poorest countries, shows a better way. The health ministry there is treating its citizens for such diseases as elephantiasis, river blindness and intestinal worms. It’s doing so with $450 million worth of medicines donated by Pfizer, Merck and GlaxoSmithKline and assistance from the U.S. Agency for International Development.
Such partnerships with industry are not new. In 1987, Merck announced it would donate Mectizan, a treatment for river blindness, to anyone who needed it for as long as necessary. It has since administered more than 452 million pills. And in recent years, GlaxoSmithKline has given away 67 million treatments of Albendazole, which prevents the transmission of elephantiasis.
The problems surrounding public health in poorer countries are not about patents, but poverty and poor medical infrastructure. These efforts free up government resources to address the far bigger public-health challenge of developing the infrastructure and trained personnel needed to deliver medicines.
Governments should work with patent holders to get safe, cheap drugs for their people. The WHO should help them to take this more productive way to health and development.