Public Health?
how pharmaceutical companies can make us less healthy
PrintA woman sits with a doctor in his office. He is explaining to her how she should take her medicine. He shows her a pillbox. “I’ve drawn a moon on one side, and a sun on the other. You take all of the pills on the sun side in the morning, and all of the pills on the moon side at night, understand?” He pauses as she nods. “Okay. Now let’s practice opening and closing the tops of the box, because sometimes the pills can pop out.”
He hands her the pillbox, and she takes it in her hands to practice, holding it as if it were gold.
This medicine is gold. This woman is living with AIDS in sub-Saharan Africa, and she is receiving donated anti-viral drugs.
In 2004, the biggest killer in the world was not cancer or heart disease, the common culprits for death in the West; instead, the majority of the world’s population died from various upper respiratory infections, like pneumonia and bronchitis. The next four deadliest illnesses were AIDS, diarrhea, tuberculosis and malaria. How can so many people be dying of a list of illnesses in which four out of the included five are almost completely eradicated in North America and Europe? Because they live in the poorest places in the world, places where necessary medical drugs are simply too expensive.
On Friday night, in honor of National Public Health Week, the Barnard-Columbia Public Health Society held a screening of Health for Sale, a documentary by Michele Mellara and Alessandro Rossi. The film explores the political and economic problems caused by big pharmaceutical companies, particularly the process of drug-patenting. “These large pharmaceutical companies should be taking social action against deadly diseases and be real contributors to solving the world’s largest health problems,” says Amy Huang, the public relations chair of the student-run CPHS.
All of the big pharmaceutical companies are based in Geneva, Switzerland, as is the World Trade Organization, which oversees pharmaceutical patenting laws. According to the WTO, a patent can be granted if a product represents a significant innovation, thereby guaranteeing it as intellectual property. For a certain period of time, no other company can produce the same product.
On April 15, 1994, the WTO initiated the Trade Related Aspects of International Property Rights agreement, known as TRIPS. The TRIPS agreement allows the WTO to regulate trade of patented products. When patents are applied to pharmaceutical drugs, this ensures that rival companies cannot sell generic alternatives to the drugs, which are much cheaper.
Patents can be applied to anything, even genetically modified organisms like plants and animals, but the biggest problem for the developing world is caused when patents are applied to pharmaceutical drugs. The issue, critics argue, is that because they ensure that no other company can sell the drug, they create a virtual monopoly. During the allotted period of time, the company that holds the patent can sell the drug for as much money as they want without any fear of competition. This means that desperately needed medicines, such as those for AIDS and malaria, are not available to most of the developing world because they are too expensive.
Articles 6 and 30 of the TRIPS agreement stipulate that it’s possible to import drugs from the cheapest source, without asking for patent permission, if it’s in the best economic interest of the country. Furthermore, if the country is experiencing a health emergency, they can also ask for patent rights to be suspended. However, various humanitarian organizations argue that the qualifications and steps for enacting these exceptions are complicated and unpractical.
In South Africa, one case in particular highlights the tension between poorer governments and pharmaceutical companies. The country enacted a law that allowed them to import cheap, generic AIDS drugs. In 2001, 40 of the world’s largest pharmaceutical companies sued the South African government, but lost. In the ruling, called the Doha declaration, the courts found that South Africa was within their rights to import generic AIDS drugs, and that they were not in violation of patenting laws.
Even the United States has run into problems with TRIPS. During the period of anthrax scares in 2001, the United States demanded that Bayer, the patent holder of an antidote to anthrax called Cipro, supply the drug at less than the $5 per pill cost. When the German company refused, the United States threatened to ignore TRIPS and use a generic form of the drug. Bayer ended up agreeing to supply Cipro at 95 cents per pill. Despite the anthrax scare, however, in the end there were only 3 deaths in the US, and two-dozen cases of infection. An article in the New York Times criticized these events as being another form of American exceptionalism.
Critics also maintain that it is not true that patents act as an incentive for investment by guaranteeing protection of property rights. “The point of a global economy is that people in developing countries can also participate,” says Dr. Y.K. Hamied, Chairman of Cipra Ltd, a company based in India that counts itself as one of the world’s biggest producers of generic drugs. “I have never been against patents...I am against monopolies. In India, with the number of AIDS sufferers at 10 million, and likely to go to 35 million by 2015, we simply cannot afford a monopoly.”
Dr. Hamied argues that large companies take advantage of the convoluted patenting process. “How many patents should a drug have? Three? ... But If I have a good product, how do I extend its lifespan? And so, some of these drugs have 240 patents on them.” Dr. Hamied charges these companies with “neglecting the poor man on the street in India. They are virtually committing selective genocide.”
In the United States alone, health care costs increased 7 percent over the last year, while GNP only increased by 2 percent. It’s questionable how long even wealthy countries such as the United States will be able to afford basic pharmaceuticals, much less those in the third world. “It is our mission to raise awareness for public health issues by holding events like these,” says Huang. “Soon, we are all going to be affected by this.”
16 April 2009
vol. 6, issue 10
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