Access to pharmaceuticals in the developing world has long been a bone of contention between Big Pharma companies, the nations in which they are based, and public health agencies in developing countries.
While Americans were appalled at the shenanigans of Martin Shkreli -- the so-called 'Pharma Bro' -- for what many described as cruel price-gouging of lifesaving drugs, the conflict between drug prices and affordability has long festered resentment in poorer countries. A recent article in the Yale Journal of Medicine and Law found that despite global initiatives designed to increase access to pharmaceuticals, such as the 2001 Doha Declaration, their outcomes have actually complicated the distribution of drugs within poorer nations. As a result, nations including South Africa and India have long engaged in legal battles with many of the world’s leading pharmaceutical firms.
Bayer and the Indian government, for example, were entangled in a long legal dispute over the licensing of Nexavar, a cancer-fighting drug that costs over $5,000 a month — almost three times more than per-capita income in India. And while advancements in HIV/AIDS pharmaceutical research means the virus no longer imposes a death sentence, many developing countries are now coping with the costs of new drugs that are more effective in countering high blood pressure and cancer. Some countries have taken it upon themselves to copy drugs, causing a deep rift between the world’s rich and poor nations.
One of the world's largest pharmaceutical companies, GSK (GlaxoSmithKline), just took a bold step in its approach to managing its intellectual property. In an announcement made last week before a meeting with the United Nations’ High Level Panel on Access to Medicines, GSK’s CEO, Andrew Witty (who is a member of the panel), revealed that the company would enact new policies to expand access to its medicines worldwide.
GSK describes its new stance as a “graduated approach to filing and enforcing patents” based on a country’s economic climate. In Least Developed Countries (LDCs) and Low Income Countries (LICs), GSK has pledged that it will not file patents for any of its medicines, in turn giving license to generic drug manufacturers to make copies of those drugs. In Lower Middle Income Countries (LMICs), GSK will apply for patents but let them lapse after 10 years. For wealthier nations, it’s still business as usual. GSK says this policy will apply to all drugs that are on the World Health Organization’s (WHO) List of Essential Medicines.
Will more of Big Pharma companies fall into line? Roche, with almost $50 billion in annual revenues, says it has not filed for pharmaceutical patents in poorer countries for several years, with the result that over 22 million people in 55 countries have access to its HIV/AIDS drugs. Merck shares its intellectual property with the United Nations' Medicine Patent Pool (MPP), but some critics have dismissed that announcement as a public-relations stunt that will have little impact on access to medicines in poverty-stricken regions. The result is a vicious circle that will not stop anytime soon. Drug companies rely on patents as incentive to develop newer and more effective drugs, yet the costs are out of reach for many of the world’s poor in developed and developing nations alike.
But an approach like that of GSK’s could work. In addition to allowing lower prices, the company also funds programs in poorer nations that train health care workers on the ground. While better drugs are part of the good fight, having knowledgeable people who can teach citizens about preventative care and better health habits is a critical public health tactic that should not be dismissed. In turn Big Pharma, often painted as the bad guy in this ongoing controversy, could actually enhance its reputation and trust worldwide.
Image credit: Flickr/GSK
Leon Kaye has written for TriplePundit since 2010, and became its Executive Editor in 2018. He's based in Fresno, CA, from where he happily explores California’s stellar Central Coast and the national parks in the Sierra Nevadas. He's lived in South Korea, the United Arab Emirates and Uruguay, and has traveled to over 70 countries. He's an alum of the University of Maryland, Baltimore County and the University of Southern California.