E-DRUG: Guardian: MSF response to GSK - This prescription for change needs to go much further
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http://www.guardian.co.uk/commentisfree/2009/feb/24/pharmaceuticals-international-aid
This prescription for change needs to go much further
Drug giants need to back Unitaid's patent pool rather than dish out
discounts, says Tido von Schoen-Angerer
GlaxoSmithKline chief executive Andrew Witty promises to "slash prices on
all medicines in the poorest countries" and to "share knowledge about
potential drugs that are currently protected by patents", a move reported
as a "radical" shift in the UK drug manufacturer's attitude to "providing
cheap drugs to ... the developing world" (Drug giant pledges cheap
medicine for world's poor, 14 February).
Witty's seriousness in seeking to boost access to drugs in developing
countries is welcome. But we fail to see any radical departure from
standard fare. His prescription for change needs to go much further.
GSK will reduce drug costs "to no more than 25% of the levels in the UK
and US, and less if possible". But such a pricing policy would leave GSK
drugs more expensive than the tried-and-tested way to drive prices down:
competition with multiple generic manufacturers, thanks to which the first
generation of Aids treatments has seen a price drop close to 99% in the
past decade.
This also has an air of deja vu: eight years ago, I was treating people
living with HIV in a Médecins Sans Frontières project in Thailand when
Glaxo slashed the price of the Aids drug zidovudine/lamivudine by 90% to
$730. Generic competition has since driven that price down to one-seventh
of this amount.
Further, Witty's price-cut pledge is restricted to "the 50 least developed
countries", excluding those nations where burgeoning middle classes live
side by side with millions who cannot afford medicines. Witty suggests
"making drugs more affordable in middle-income countries". But GSK needs
to do more than give ill-defined promises. In China, GSK's patent allows
the company to charge prohibitive costs for the Aids drug lamivudine. This
problem is not one that can be wished away: as patients across the world
start to develop resistance to existing drugs, they will need access to
newer, more expensive medicines. The price of Aids treatment is set to
skyrocket.
I welcome GlaxoSmithKline's attempts to encourage research through a
"patent pool" for neglected diseases - which would allow others to develop
and produce GSK's drugs. But a pool should not be restricted to so few
diseases, and we need concrete changes to boost innovation and access for
HIV/Aids too. Such a scheme is already being established by the
international drugs agency Unitaid.
Witty claims there is sufficient innovation for Aids drugs. He is wrong.
We need new drugs that can be used in the countries where we work. We need
heat-stable drugs for places with no refrigeration. We need new fixed-dose
combination drugs that simplify treatment regimens and boost outcomes. And
we need more child-friendly drug formulations.
Patent barriers can stop this innovation happening - until GSK pools its
rights on lamivudine, patients in China can't benefit from the
three-in-one pills that have revolutionised treatment elsewhere. For GSK
to back the Unitaid patent pool would be the "radical" shift to address
innovation and access problems - not Witty's proposals for price
discounts.
Dr Tido von Schoen-Angerer is director of Médecins Sans Frontières'
Campaign for Access to Essential Medicines
tido.von.schoenangerer@geneva.msf.org