E-DRUG: Does Colombia really have to choose between peace and public health?
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http://politicsofpoverty.oxfamamerica.org/2016/05/does-colombia-really-have-
to-choose-between-peace-and-public-health/
How the pharmaceutical industry has captured US trade and foreign policy.
Supporting a peace deal in Colombia is one of the Obama Administrations top
foreign policy priorities this year.
The Colombian government is on the verge of concluding peace negotiations with
the Fuerzas Armadas Revolucionarias de Colombia (FARC) guerillas, raising hopes
that this hemispheres longest lasting and only remaining internal armed conflict may
soon come to an end after more than 50 years.
In February, President Obama requested over $450 million from US Congress to support effective implementation of a peace deal.
<http://www.reuters.com/article/us-usa-colombia-idUSKCN0VD2XM>
So it came as a surprise to find out recently that some in the
Administration and US Congress have indicated that US aid for Peace Colombia
may be at risk due to actions by Colombias Health Ministry to use a public health
policy to promote generic competition in order to lower the cost of an expensive leukemia drug.
<https://www.washingtonpost.com/business/economy/dispute-with-swiss-drugmake
r-has-colombian-officials-worried-about-us-peace-funding/2016/05/18/6f1903ee
-1c5e-11e6-8c7b-6931e66333e7_story.html>
<http://www.huffingtonpost.com/entry/colombia-gleevec_us_5733d4ece4b077d4d6f
224ee>
The Huffington Post reported that two letters were sent in late April by
the Colombian Embassy in Washington to their Foreign Ministry describing
perceived pressure from US Congress as well as the US Trade Representative
(USTR) regarding Colombias preparation to issue a compulsory license on the
cancer drug, Imatinib, that is marketed in Colombia as Glivec.
<https://www.wto.org/english/tratop_e/trips_e/public_health_faq_e.htm>
A compulsory license is a mechanism recognized by the
World Trade Organization (and commonly employed by the US for a range of
technologies) that authorizes a government to introduce generic competition
for a patented product in exchange for royalty payments to the patent
holder.
<http://keionline.org/node/2505>
Embassy staff referred in particular to a meeting with Senate Finance Committee
majority staff, who they said denied that Colombia had the right to issue the compulsory license, and expressed concern that doing so could threaten approval of US aid for Colombias peace process.
Oxfam joined over 120 others to send a letter to Colombias President Juan Manuel
Santos in support of his governments initiative to declare access to the cancer drug
to be a matter of public interest, thus paving the way for the government to grant a
compulsory license on the patent for Glivec, which is held by the Swiss
pharmaceutical company Novartis.
<http://www.citizen.org/documents/letter-to-colombia-santos-imatinib-license.pdf>
Such public expressions of support in Colombia for this legitimate and legal public
health measure help reinforce the governments will to defend its right to health in the face of bullying by the pharmaceutical industry and some US officials.
Colombias Minister of Health, Alejandro Gaviria, referred to the compulsory
license as a question of survival
<http://www.usnews.com/news/business/articles/2016-05-18/colombia-battles-wo
rlds-biggest-drugmaker-over-cancer-drug>
and explained that the countrys health care system guarantees patients access
to all approved drugs, but the budget is strained due to the high price of
medicines. The Ministry estimates the government would pay an additional
$15 million annually for Glivec without generic competition enabled through a
compulsory license.
<http://www.usnews.com/news/business/articles/2016-05-18/colombia-battles-wo
rlds-biggest-drugmaker-over-cancer-drug>
Why is this happening now?
Glevic (marketed in the US as Gleevec) is the top-selling drug of Novartis,
<http://www.fiercepharma.com/sales-and-marketing/novartis-braces-for-multibi
llion-dollar-generics-hit-as-gleevec-copies-launch>
bringing in $4.65 billion revenue in 2015 and helping to make Novartis the
worlds top pharmaceutical company in 2014 in terms of global sales.
<http://www.pmlive.com/top_pharma_list/global_revenues>
But the patent expires in the US this year, when generic competition will kick in and
thus reduce Novartis revenues from the drug. Yet the patent will continue in
effect for another two years in Colombia. So essentially, Novartis wants
patients in Colombia to pay more for the drug than patients in the US.
While that may be good business for Novartis, it is deplorable public
policy. And given all of the public funding and incentives that
pharmaceutical companies receive from governments, they should not be able
to put profits above patients health.
It is also worth noting that Novartis just announced a restructuring in which it will split
its pharmaceuticals division into two business units, one focused just on cancer
drugs. As Novartis positions itself to reap the greatest profits from cancer
therapies, it probably sees Colombias action as an obstacle to expanding
its revenue stream.
<http://www.reuters.com/article/us-novartis-restructuring-idUSKCN0Y81ZB>
But there is no legitimate excuse for USTR or Members of Congress to subvert
broader foreign policy as well as public health interests by further
protecting the pharmaceutical companys monopoly power to keep prices high.
While USTR has denied it has tied funding for Peace Colombia to whether or not
a compulsory license for the cancer drug is issued, it is very clear that this threat
was implicit. It was understood that it was understood.
<http://www.usnews.com/news/business/articles/2016-05-18/colombia-battles-wo
rlds-biggest-drugmaker-over-cancer-drug>
Oxfam joined Public Citizen, KEI and Health GAP to send a letter to Finance
Committee Chairman Senator Hatch to request public clarification of this
matter following the meeting that his Committee Staff held with Colombian
Embassy representatives. But no public clarification has been forthcoming.
<http://big.assets.huffingtonpost.com/NGOHatchLetter.pdf>
<http://www.huffingtonpost.com/entry/colombia-drugs-orrin-hatch_us_573e2b96e
4b00e09e89e86aa>
This is not the first time that the US Trade Representative and Senator
Hatch have sought to use all available mechanisms to bully countries so that
they refrain from using legitimate public health flexibilities, such as
compulsory licensing, to spur generic competition in order to lower the cost
of medicines. But its a galling example of bad US policy and illustrates US
policy incoherence.
The US-Colombia bilateral free trade agreement does not limit Colombias
right to issue a compulsory license, and there should be no link, either
explicitly or implicitly, between US aid for Peace Colombia and Colombias
decision to prioritize public health. Colombia must not be forced to choose
between funding the peace process or addressing public health needs!
Johann CASTAÑEDA
France
Johann CASTAÑEDA <johann.castaneda@inserm.fr>