Accessing the Essentials: The Betrayal of Pharmaceuticals in the Developing World
by Nicola Feldman
Millions of children are unnecessarily dying from preventable and treatable diseases because they cannot obtain essential medicines. Meanwhile pharmaceutical companies are boasting $35 billion dollar profits. One-third of the world's population currently lacks access to life saving medicine, often because adequate drugs are not available and when they are, their price tag is far too expensive. As pharmaceutical companies are producing and profiting from luxury drugs that range from increasing sex drive, to preventing depression, to enhancing hair growth, the impoverished world watches its children die by the millions from diseases that could be cured.
Generally, many of the diseases that plague the extreme poor do not lead to death in industrialised countries; but in the developing world they threaten lives. Young children are especially vulnerable to untreated diseases as their underdeveloped immune, digestive, reproductive and cental nervous systems put them at higher risk. Consequently, over two million children are dying from deadly diseases such as malaria, tuberculosis and HIV/AIDS. Every 30 seconds, malaria kills a child somewhere in the world, while tuberculosis is to blame for 400,000 child deaths per year. Add HIV/AIDS into the mix, and an additional 380,000 young lives are lost annually.
A major problem in developing regions is the lack of access to essential medicines. Difficult diagnosis, accurate prescribing, distributing and monitoring as well as inadequate health systems, infrastructures and budgets all prevent children from receiving sufficient treatment. But what is perhaps the easiest problem to fix is the biggest factor preventing children from receiving medicine - the price tag. Drugs often remain too expensive due to patents and monopolies secured by pharmaceutical giants who prevent generic drugs and price competition from reducing prices. Individuals that live in extreme poverty, struggling on less than $1 a day, cannot afford to purchase medicines for themselves or their children, and public funding does not come close to solving the problem. To combat malaria with branded drugs in sub-Saharan Africa alone carries a hefty $2-3 billion price tag, while public funding supplies only $400 million in malaria medications.
When price competition and generic drugs do exist, there are substantial improvements in drug prices. The injection of generic competition into the global Antiretroviral (ARV) market catalyzed a dramatic drop in drug prices. In the US and Europe, ARVs cost up to $15,000 per patient per year, but generic drug producers have offered to sell the equivalent medicines for as low $130 in developing countries. An enormous step forward for impoverished children's battle against the HIV/AIDS epidemic.
The international community has taken steps to assist in this sort of generic drug implementation in situations of public health and necessity. In 2001, the Doha Declaration was signed by members of the WTO to accompany their TRIPS (Trade-Related Aspects of Intellectual Property Rights) agreement enforcing patents' 20 year monopolies. The declaration stated that rules on patents should not prevent poor countries' ability to "protect public health, and, in particular, to promote access to medicines for all." It gave developing countries the explicit right to produce, export, and import affordable copies of expensive patented drugs through various safeguards. A promising prospect for the millions of sick children whose lives depend on the availability of cheaper generic drugs.
Sound like an encouraging start? Don't get too excited. Since the declaration was signed, little has changed. Wealthy countries and their powerful drug giants do their best to ensure that monopolies and profits persist despite the devastating effects this has on children's access to medical treatments. The biggest culprit? The United States.
Under the influence of the pharmaceutical industry, the US has been forcing developing countries to accept stricter intellectual property protection via threats of trade sanctions as well as Free Trade Agreements known as 'TRIPS-plus' rules which weaken or eliminate the public health safeguards allowed by the Doha Declaration. Consequently, patented medicines have even higher levels of intellectual property protection than required under TRIPS, delaying the availability of affordable generics to countries in need. Pfizer Pharmaceutical is one recent bully to make headlines. In the Philippines where HIV/AIDS epidemic is growing, Pfizer is challenging the government's rights to use the TRIPS safeguards in order to provide cheaper HIV drugs. A similar situation involving Swiss pharmaceutical company Novartis has stirred considerable global controversy regarding its legal battle with Indian patent laws. India is the leading supplier of generic drugs to the developing world, and if Novartis is successful more medicines are likely to be patented in India, making it very difficult for generic producers to make affordable versions of them. This could affect millions of children around the world who currently depend on the Indian produced drugs. Both cases illustrate the betrayal of the third world by drug companies that wish to rob them of their Doha rights.
The pharmaceutical industry claims that without stringent intellectual property and patent rules there would be no research and development incentive for new solutions to diseases, including those devastating the developing world. Patent protection fundamentally underpins continued R&D investments. While this may be true, research has shown that these drug companies spend as little as 10% of their budget researching developing world concerns. Medecins Sans Frontieres (also known as Doctors Without Borders) explains,
"In the private sector R&D has long neglected the major killers of the developing world. It has been over 30 years since the last major new TB drug was developed. And, for lack of a market, drugs are simply not developed for the most neglected diseases."
This lack of R&D is a significant factor to why the developing world is not receiving the treatments they need. Desperately needed newer treatments for diseases such as malaria and Tuberculosis are not being created, leaving outdated medicines that are increasingly ineffective. Growing resistance to existing drug combinations and complicated treatment processes are causing treatments to fail. A large portion of poor children who do receive malaria treatment are still given drugs such chloroquine and sulfadoxine-pyrimethamine, to which malaria has become resistant. A similar situation has occurred with multi-drug resistant strains of tuberculosis (MDR-TB) causing the regular treatment, DOTS, to cure only 50% of MDR TB. DOTS treatment can also last over six months long and is extremely intensive, requiring on-going commitment and responsibility which can be difficult for children. Updated versions of treatments are in dire need but the pharmaceutical industry continues to spend the majority of its resources creating the next profit-making medicine, leaving underprivileged children to suffer from inadequate medicines. Obviously, pharmaceutical companies are not responsible for causing or solving the developing world's health crisis. However, they are vital players that have the ability to improve the future for millions of impoverished sick children. Therefore, drug companies have the responsibility to assist global access to essential drugs by encouraging Doha rights and equitably priced drugs, as well as researching and developing cures for neglected and unprofitable diseases. But instead, they are creating Viagra and taking the third world to court to help secure their medical monopoly.
Medecins Sans Frontieres is currently circulating a global petition against Novartis and its legal battle with Indian patent laws. Sign their "Drop the Case" petition today! http://www.msf.org/petition_india/international.html