E-DRUG: Medicine is just for those who can afford it: why don't
pharmaceutical companies develop drugs for the poor?
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[This contribution to Al Jazeera by MSF Campaign Director Manica
Balasegaram is worth a read. Crossposted from IP-Health with thanks. WB]
Al Jazeera Opinion
Medicine is just for those who can afford it: Why don't pharmaceutical
companies develop drugs for the poor?
Last updated: 14 Mar 2014 09:08
Manica Balasegaram
Dr Manica Balasegaram is the Executive Director of Medecins Sans Frontieres'
Access Campaign.
http://www.aljazeera.com/indepth/opinion/2014/03/medicine-just-those-who-can
-aff-201431181911299288.html
Medicine is expensive, sure, but have you ever asked yourself why? The
pharmaceutical industry will have you believe that without high prices, we
don't get new drugs. The reality is, with high prices we don't always get
new drugs we need either. If a new drug is developed and nobody can afford
it, where is the benefit from it?
Limiting access to the products of pharmaceutical innovation is nothing new
to me. I've seen it for the last 15 years as a doctor with Medecins Sans
Frontieres. In one of my first field missions in Uganda, I watched young
children with malaria die because the best treatment to give them -
artemisinin - was not available and I was forced to use less effective
drugs. It was tragic to witness.
I was outraged at remarks made in December, but widely reported only in late
January, by the CEO of German pharmaceutical company Bayer, on one of the
company's cancer drugs. CEO Marijn Dekkers said that Bayer "didn't develop
this product for the Indian market; we developed it for Western patients who
could afford it." I was shocked at his candour: Dekkers'
comments sum up everything that is wrong with the pharmaceutical research
and development (R&D) industry today.
As it currently stands, patents create long monopolies, which allow
pharmaceutical companies to charge the maximum price they can without fear
of competition. Patients and health providers are put in a near-impossible
predicament: Either they pay the market rate, or they wait until the maximum
profits have been squeezed out of a drug and its patent expires.
Waiting in many cases means dying.
The current system also means some drugs just don't get developed at all;
there are some diseases for which there have been no new drugs developed for
half a century or more. It's because - while the need is there - these drugs
just aren't profitable for the pharmaceutical companies to do research on
them.
The reality of this was painfully illustrated in January, when British
pharmaceutical company AstraZeneca announced it was pulling out of R&D for
malaria, tuberculosis and neglected tropical diseases. They're all diseases
that occur, for the most part, in poor countries. Instead, they'll be
concentrating on drugs for typically rich country diseases: cancer,
diabetes, and high blood pressure.
But this lack of R&D into areas of need is beginning to hurt the developed
world, too. Just as we're facing superbugs that can't be killed with
existing antibiotics, there are no new ones in the development pipeline.
We're seeing people die of infections we can no longer treat with the
antibiotics we have. But the pharmaceutical companies don't want to pour
their R&D into a drug that people only take for a couple of weeks; they want
to develop drugs you need to take for a lifetime.
As taxpayers, we are in essence paying for drugs twice. First, a lot of the
R&D behind successful new drugs is heavily subsidised by the tax payer:
Globally, at least 40 percent of all R&D is paid for from the public purse
and by philanthropic organisations; for some diseases, such as tuberculosis,
it's over 80 percent. Then we have to pay again the high prices for the
patented medicines when they are produced. The only people satisfied by this
current system are the shareholders of pharmaceutical companies.
It is critical that innovation is rewarded. But there are alternative models
than high drug prices and long monopolies for supporting useful medical R&D.
What we should have at the end of the R&D process, is medicine which is
effective, safe and - most critically - affordable for everyone who needs
it. The current system not only fails patients in India, it fails the
uninsured and underinsured worldwide.
We need to find new ways of paying for research that do not force a choice
between developing a drug and making it widely available. This idea is
nothing extraordinary; there are already alternative ideas out there -
models such as prize funds - that reward new discoveries through substantial
financial payouts, paid on the condition that the drug is immediately open
to price-lowering market competition.
There comes a time when we need to collectively look at a system and realise
that it is no longer fit for purpose. Current R&D models for new medicines
are not working; not for the world's poor, nor for you and I. It is time to
get angry, to demand change. The poor are no longer far away, passive and
prepared to die slowly of an illness we can cure. They demand change and so
should everyone.
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Dr Manica Balasegaram is the Executive Director of Medecins Sans Frontieres'
Access Campaign; based in Geneva, he helps campaign for better tools and
access to medicines, particularly for the developing world. He has worked as
a doctor in MSF field projects in Uganda, Sudan, Republic of Congo,
Ethiopia, India and Bangladesh.
Joanna Keenan
Press Officer
Médecins Sans Frontières - Access Campaign
P: +41 22 849 87 45
M: +41 79 203 13 02
E: joanna.keenan[at]geneva.msf.org