E-DRUG: Nine questions for Roger Bate
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Dear Roger Bate:
Since 2001, you have been shopping the notion, with Amir Attaran, that
patents are not important in terms of access to medicines. In the 2001
version of this work, which was first presented by Amir in a June
conference in London that you helped fund, he presented updated data
(from a Lee Gillespie-White's Merck funded project at IIPI) on patents
on ARVs. Even though Attaran and White found more patents on ARVs than
anyone had found earlier (key patents on the 3tc-d4t-NVP combo in more
than 30 African countries), and even though generic were still are far
cheaper, and even though there are obviously links between patents in
countries with big markets (like RSA or Brazil) and prices in countries
with no patents, it was presented a "evidence" that patents don't
matter. Most recently Attaran has updated Tom Bombelles's September
2001 PHA presentation on patents on drugs in WHO Essential Drugs list
(which only includes 19 patented products), as more "evidence" that
patents don't matter. What Attaran's recent paper really shows is few
patented drugs are on the WHO essential drugs list -- hardly a surprise
to anyone who knows anything about this topic.
The latest (among several) attack on WHO is over the Mozambique CL on a
particular ARV combination. This was a license that foreign investors
and donors for Mozambique wanted, to ensure that they did not run into
problems with those who are attacking the uses of generics as
infringements of IPR. It might end up applying to the CIPLA patent on
this combination product, some process patents we don't know about, or
maybe nothing. But it was certainly useful for Mozabique to take some
initial steps to implement compulsory licensing, which will become more
important over time as various IPR agreements and obligations (AGOA) are
implemented. The Mozambique license also was necessary to attract
foreign direct investment in the generic pharma sector in Mozambique,
who are not as confident as you about future IPR disputes on these drugs.
In Africa, it is well known by people on the ground, that dozens of
countries are overriding the patents identified in the Attaran/White
Jama article. Few are doing this in a manner consistent with the TRIPS
agreement. Many are simply not enforcing existing patents 3TC, NVP,
AZT+3TC or d4T+3TC+NVP.
Some countries have reporedly issued CL's, but not made this public, to
avoid attacks from people like you or Attaran, or variou PhRMA lobbyists.
My questions to you (and Attaran) are the following:
1. Do you acknowledge that GSK's verisons of 3TC, AZT and AZT+3TC are
more expensive than generic alternatives?
2. Do you acknowledge that the BI versions of NVP are more expensive
than generic alternatives?
3. Do you acknowledge that you cannot buy 3-in-1 d4T+3TC+NVP from
patent owners?
4. Do you acknowledge that resources for treatment in Africa are scarce?
5. Do you accept the logic (that everyone else seems to get) that
cheaper prices on ARVs free up resources and expands treatment opportunies?
6. Do you think that it is better for African countries to override
patents informally, by not enforcing laws, or more formally, with TRIPS
consistent measures?
7. Do you think that the WHO Essential Drugs list should include more
than 19 patented products?
8. Do you recognize any connection between patent protection in middle
income countries and the ability of generic suppliers to produce cheap
generics for low income countries (think economies of scale).
9. Why do you continue to present these issues as matters of ideology?
Is there something "left wing" about wanting the poor to have access
to medicines? Is there something "right wing" about patents that I
don't know about?
Jamie Love
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James Love, Director, Consumer Project on Technology
http://www.cptech.org, mailto:james.love@cptech.org
tel. +1.202.387.8030, mobile +1.202.361.3040
[A copy was sent to Roger Bate at rbate@cei.org]
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