Friday, June 20, 2008

By Franklin Cudjoe

Franklin Cudjoe Last month, the World Health Organization’s governing body, the World Health Assembly (WHA), formally adopted a set of public policy recommendations for poor governments struggling with disease.

Key among these recommendations was a call to weaken pharmaceutical patents through more liberal use of compulsory licenses, which allow governments to produce generic knock-offs of patent-protected drugs. Behind this call is a belief that patents prevent poor patients from accessing drugs.

But patents aren’t pushing up drug prices. Bureaucrats are. Consider the huge tariffs put on imported medicines in the developing world, going as high as 30 percent in some African countries.

What more, prices aren’t the reason so many poor patients can’t get healthy. Even if you gave them unlimited to access to top-notch pharmaceuticals, most would still be facing substantial health risks every day. They’d still be drinking from polluted rivers. They’d still be relying on defunct medical equipment. They’d still be risking respiratory infections from heating systems run on animal dung. They’d still be living near open sewage systems.

Most poor countries simply don’t have the healthcare infrastructure needed to deliver medical services safely and effectively. Hospitals in Africa are notorious for letting newly born babies lie bare on the floor after delivery. Doctors routinely misdiagnose illnesses. And there’s a tremendous shortage of qualified medical staff.

The situation only gets worse when you consider that the health insurance systems in the developing world are thoroughly corrupt. One Ghanaian insurance administrator was recently caught making personal purchases with money from clients’ accounts.

Compulsory licenses would likely exacerbate the problem of substandard pharmaceuticals in Third World drug markets. Locally produced pharmaceuticals often don’t met basic quality and safety standards.

Consider a recent study (which I assisted with) from Africa Fighting Malaria (AFM), a non-profit health advocacy group, published in PLoS ONE, the U.S. Public Library of Science peer-reviewed medical journal.

In a representative sample of anti-malarial drugs sold in six African nations, researchers with AFM found that almost half of the drugs manufactured in Africa failed basic quality tests. The study also found that a third of the drugs sold in Africa were "artemisinin monotherapies," which are single dose malaria treatments that are often ineffective and cause the creation of drug-resistant strains of the disease.

With this trend, Ghana’s estimated annual malaria burden of $762 million will only be exacerbated.

The irony is that the WHA is also encouraging Western pharmaceutical firms to increase investment into medicines for diseases unique to the Third World. How do you convince shareholders to invest in R&D when the resulting drug formula can just be stolen by the local government — with international sanction, no less?

What the WHA should be doing is encouraging poor countries to adopt prudent economic policies that will enable investment in healthcare infrastructure, and ultimately encourage citizens to buy reliable health insurance.

Franklin Cudjoe is editor of www.AfricanLiberty.org and executive director of IMANI Center for Policy and Education, a think-tank located in Accra, Ghana. His email is franklin.cudjoe@gmail.com