Recently our friends over at Afro-IP brought to light an article by Alec van Gelder in the WSJ on the problem of access to medicines in Africa. While the article is specific to the problems in Africa, its points about lack of infrastructure and diversion of money being major barriers to access are true across almost all developing countries. [Unfortunately the article is only fully available to subscribers.]
The article goes on to state that Big Pharma has been made a scapegoat of in these problems with activists constantly attacking their patent rights, and states that ‘this misguided battle against pharmaceutical companies’ patent rights will only make Africa’s health crisis worse’. Without getting into the specifics, in short, the article criticises activists – comparing them to scratched record players repeating the same thing about prices and patents being the main problem, while according to the author the main focus should be on the problem of lack of health infrastructure.
No doubt that the author raises certain very valid points in his article, however there are some crucial issues that seem to be mixed up to me.
Firstly and most strikingly, is what he says about Compulsory Licensing. He rightly mentions that too much CL-ing will lead to discouragement to produce these medicines. However, in what seems to be a shot in the dark, he states that the reason CL haven’t been used much is an increasing supply of medicines. While the TRIPS allows CLs, the main reason that they haven’t been used often is political pressure against using them. Using a variety of what can be termed as backhanded moves, certain countries such as the US “push” developing countries not to use the Compulsory Licensing provisions of the TRIPS Agreement. Taking my own shot in the dark, I’d go as far as to say that they would be perhaps too common if there were complete political free-will in deciding on this matter.
While I agree with him in that Pharmaceuticals are being made scapegoats in the whole process, I believe this is more because of the role they’ve been assigned in the system. They are profit making bodies, like any other corporations, who happen to make medicines. They are not charitable bodies out to save the world. In fact, on the face of it at least, certain companies are doing much more than is required by them to promote access to medicines. However, where I deviate from the article is that the author still insists that patents are the best hope for promoting access. He seems to see these issues as one. There is one issue of low access to medicines due to price barriers and another larger issue of the health sector being one in which the market does not determine the requirements of the people. For eg: another issue of access to no access to medicines due to the medicines for those diseases not being created at all.
He doesn’t give cognizance to the fact that the patent system essentially caters to a market that can afford the heavy investment and profits thereof from it. This is not limited to 1st line and 2nd line ARV treatments, (which receive the most publicity) but also to the several diseases which don’t receive publicity and which affect the developing world, and especially those that aren’t (usually) present in the developed world.
I simply cannot see how one can press a normative argument for the current patent system using exceptions and ‘charitable actions”, and even compulsory licenses (which had essentially be introduced to ensure that there is at least some level of access), as a best case scenario for promoting accessible medicines. If the drug innovation system is such that it requires ‘charity’ by one party to the other, then it is certainly one which requires improvement.
Finally on the point of insufficient healthcare infrastructure, he is certainly right. The common example displaying the necessity of this is that of the DOTS formulation for TB treatment which works in the developed world but not in the developing world due to its rigourous infra-structural requirements over the prescription period of 6 months. Thus even the presence of a medicine for a disease that affects millions in the developing world is ineffective regardless of the price of the medicine. Unfortunately however, he seems to see the problems in some sort of hierarchal structure, when it reality, the problem of drug innovation and access to medicines is very nuanced and multi-faceted. As such, these issues ought to be looked at holistically rather than one by one.
Just off the top of my head, a hypothetical (and hence very unlikely) example of a holistic solution would be a vaccine for African sleeping sickness, funded by a prize system put together by several governments, (and hence free / cheap to the patients) that is spread like a virus through the air. While I readily admit this is far from any actual solution, my point is that the most effective solutions will be those that look to address all the problems, and not simply one over the other. Again, admittedly this is very difficult, but simply ignoring or undermining one portion of the problem certainly does nothing for it.
Dear Spicy IP,
I am a representative of Fisheye Analytics, a media monitoring and analytics company. We are passionate about showcasing the importance of social media in business and personal communications. Part of our study involves identifying the readership numbers of blogs of various profiles. We have selected your blog to be part of this pilot study and would like to request for the readership number for your blog, or an estimate of it. A daily average would be most appreciated but any unit would be great. Please also let us know if you are basing the given figure on visitor numbers or any other indicator. If you would like to know more about what we do, please visit http://www.fisheyeanalytics.com. Please also feel free to contact me at [email protected].
Thank you for your assistance in making social media mainstream.
Sincerely,
Rachel