Bitter medicine: why the developing world can't get drugs

So instead of our much vaunted social contract - partial patents in return for global R&D - we’ve signed up instead to global patents in return for partial R&D (in the West only). We’ve given drug companies a global 20-year monopoly and received nothing in return – they would have continued to do R&D in the West anyway, driven by the enormous profits new drugs can generate (in 1999, more than 20 drugs made over US$1 billion in sales each). Worse, we’ve suddenly realised that if anyone is going to cough up millions of dollars for R&D in the developing world, it’s going to be us.

The good news is that it’s not as hopeless as it seems. Practical solutions lie well within our grasp if we can summon up the political will to act.

Western governments, including the Australian Government, must insist that the narrow sectoral interests of the pharmaceutical industry are not allowed to undermine the TRIPS rules – we must support the TRIPS health safeguards and make sure they’re workable. The Australian Government should also take the lead in promoting model TRIPS legislation which developing countries could use without fear of litigation. The price of failure is not only millions of deaths in the developing world, but also the potential collapse of TRIPS and a certain repeat of the Seattle WTO meeting, fuelled by the developing world’s growing belief that international trade agreements are little more than instruments to deliver profits to the West.

Western Governments will have to finance R&D into developing country diseases – unless they can persuade or coerce the drug industry to keep up its end of the social contract. It’s likely the West will also need to finance a global procurement fund, similar to that proposed recently by the UK and Italy, to subsidise or purchase drugs for the poorest countries.

The pharmaceutical industry is part of the solution too. It should agree to recover R&D costs and make its profits in the West, rather than attempting to wring cost mark-ups from the poorest of the poor. Given the almost total absence of drug company R&D for the developing world it is brutal to suggest that developing world consumers should continue to pay price mark-ups that subsidise research for Western diseases. And finally, drug companies should play by the rules. The TRIPS health safeguards were put there in recognition of the right to life. No-one should be allowed to take that away.

If you want to support South Africa’s efforts to access affordable medicines, sign the Drop the Case petition on MSF’s website www.msf.org.