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27 December 2002

Commentary on US policy change on generic drugs

Reports in today's Business Day in South Africa report that the US trade representative to the WTO has 'backed down' on their resistance to the importation and manufacture of generic drugs.

It is clearly early days and we hope to be getting some more information on this apparent change in policy. In the highly charged debate surrounding drug patents and access to drugs, it is essential to be reminded of a few facts first.

  • Patents are not actually blocking access?
    Many drug activists have continuously claimed that drug patents mean that research based drug companies can charge exorbitant prices for drugs and deny millions of poor people access to drugs. Yet, in most of Africa there are hardly any drug patents at all. Research by Amir Attaran and Lee Gillespie White shows that there is no relationship between the degree of drug patents and access to drugs. If drug patents were actually blocking access to drugs, then in those countries with fewer patents we should see greater access and vice versa. Yet this is not the case.
  • The real barriers to access
    As over 99% of the WHO list of essential drugs is off patent, and access remains abysmally low, we should be looking elsewhere for the real barriers to access. In most poor countries, these problems are a lack of health infrastructure, appalling poverty and governments that are not interested in improving healthcare. In many African countries, tax revenues and donor funds are misused by politicians and bureaucrats, almost always to their personal gain.
  • What is up in India
    India has a great and very successful generic drugs industry. This industry has lobbied long and hard for relaxation of drug patent laws so that it can expand its already highly profitable market. Pandering to any special interest group is never a sound basis for policy making. Unfortunately in this case it is being promoted as a positive, life-saving move for poor countries. Yet none of India's huge and very profitable generics drug companies are doing anything to build the essential health infrastructure in Africa - unlike the research based drug companies. Generics play a crucial role in any health system, but these supposed Robin Hoods of the drugs industry simply dump their rip off drugs in Africa with little regard to how they will be stored, distributed and used.
  • And Kenya?
    On a recent trip to Kenya, I learnt that less than half of the available anti-retrovirals are actually patented. Kenya has a successful generic drugs industry, yet none of these companies has shown any interest in producing these unpatented drugs (which they could do quite legally). The reason is that these drugs are expensive to produce and there is no demand for them because of extreme poverty and because Daniel Arap Moi's government (which hopefully will be voted out of power today) has spend the last 30 years robbing the treasure of vital health care funds. It is interesting to note that the anti-retroviral therapies that are being distributed are those produced by Merck and other research based drug companies, and distributed free of charge. So much for profitable western drug companies blocking access to drugs.
  • Why we don't welcome this reported change in policy
    Pressure has been put on the US to change a policy that is not doing harm and that is important for drug companies. Patents are not the major barrier to access, and yet they provide important security to drug companies. We need these companies to continue to do their research and develop new drugs. The worrying decline in the development of new ARV molecules tends to suggest that they are no longer keen to devote the billions of dollars of research funds into this area. Recently many research drug companies have been involved in research for malaria drugs. Will this continue if their intellectual property can be overridden? We need drug companies to see Africa as a positive environment in which to make money, not a basket case worthy of charitable donations. The only long term way to build our health infrastructure is to grow rich. This is not going to happen with intellectual property being undermined, and this policy is especially ill conceived as IPR is not reponsible for denying people access to life saving drugs.

Richard Tren
Director, Africa Fighting Malaria

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