Patents, prices and patients.

• Author: Hoen, Ellen 't
• Position: Pharmaceuticals

Infectious diseases kill aver 10 million people each year more than 90 per cent of whom are in the developing world. (1) The leading causes of illness and death in Africa Asia and South America--regions which account for four fifths of world population--are HIV/AIDS, respiratory infections, malaria and tuberculosis.

In particular, the magnitude of the AIDS crisis has drawn attention to the fact that millions of people in the developing world do not have access to medicines that are needed to treat disease or alleviate suffering. Over 3 million died of AIDS in 2002, including over 600,000 children, and an estimated 5 million became infected, bringing the total to 42 million.(2) However, 95 per cent of people affected by AIDS are the poor living in developing countries, and only 300,000 of the 6 million people in immediate need of life-sustaining medicines are receiving them.(3)

The reasons for the lack of access to essential medicines are manifold, but in many cases the high prices of drugs are a barrier to needed treatments. Prohibitive prices are often the result of strong intellectual property protection. A producer who has a market monopoly is free from market competition and, unless strong pricing policies are in place, can charge whatever price the market will bear. Patents give their owners a monopoly to use, manufacture, sell and import the patented product and therefore to sell it at the most profitable price, which may not be the most equitable in most developing countries. Generic competition is crucial to ensuring downward pressure on drug prices. Medecins Sans Frontieres (MSF) has witnessed this in many developing countries where we work, particularly in the case of antiretroviral medicines for the treatment of HIV/AIDS.

Just two years ago, the average cost of a triple combination of antiretrovirals was between $10,000 and $15,000 per patient per year; today, it is available for as little as $300. These price reductions were the direct result of international public pressure and generic competition, particularly from Indian and Brazilian manufacturers. Generic competition was possible because of the absence of patent protection in those countries.

The World Trade Organization's (WTO) Trade-Related Aspects of Intellectual Property Rights (TRIPS) Agreement, which sets out the minimum standards for the protection of intellectual property, contains flexibility designed to balance public and private interests. Under the Agreement...