November 6, 2007, from the Wall Street JournalThe World Health Organization will discuss this week the problems facing the world’s poor. Many of the technocrats gathering in Geneva for the Intergovernmental Working Group on public health, innovation and property rights believe that eliminating drug patents will usher in a new era of global health and prosperity.
They blame intellectual property laws for high drug prices and limited research and development into cures for the "diseases of poverty" — illnesses that disproportionally affect the poor, such as AIDS, tuberculosis and malaria.
Unfortunately for us in the poorest nations, these health activists are missing the forest for the trees. Inadequate infrastructure, not price, is the chief obstacle blocking access of high-quality medicine to poor countries.
Imported drugs often sit for months in Africa ‘s dirty, non-air-conditioned storage facilities — either losing quality or expiring before reaching patients. Hospitals lack doctors, nurses, equipment and sometimes even electricity to effectively administer available medication. Roads are often in disrepair, making it particularly difficult to reach rural populations, where disease rates are the highest.
Malaria is a perfect example. In the 1990s, this infectious disease surged in sub-Saharan Africa as the parasites causing the illness became resistant to the most effective medications at that time. In 2001, the Swiss drug maker Novartis signed a contract with WHO to provide African patients with Coartem, its blockbuster antimalarial combination therapy, at production cost.
But demand was low because most African countries said they simply did not have the money to purchase the drug even at production cost. Consequently, Novartis was forced to close a production facility and destroy expired stock, incurring substantial financial losses in the process.
Even when pharmaceutical companies offered drugs for free, as Pfizer and GlaxoSmithKline have done in the past with drugs to treat trachoma and malaria, respectively, African countries still had severe problems in storing the drugs and distributing them. Poor roads, dilapidated health centers and inadequate medical personnel to administer the right prescriptions all stood in the way of helping patients. The tools to cure malaria were ready — we in Africa were not.
If the West is any guide, better health systems come with economic development and higher standards of living. Both are frequently stifled in poor countries by destructive policies and home-grown corruption. Import taxes and tariffs on lifesaving drugs, for example, can be severe. Brazil , currently leading the global crusade to break patents, levies a 30% tariff on all imported medicines. Kenya and Ghana slap tariffs of 37.8% and 33%, respectively, on all imported medicine, ultimately doubling drug prices under their national health schemes when retail costs are factored in. The paradox here is that Kenya is the main African advocate for breaking patents of essential drugs.
Many health activists, however, ignore these realities and instead focus their attention (and ire) on Western pharmaceutical firms, applauding nations that issue patent suspensions on drugs.
Last year, the Thai military government declared that it could not afford branded drugs to treat its citizens. So it issued compulsory licenses, or patent suspensions, for two AIDS medications and one heart drug and began producing copies locally. Though the quality of the drugs was unknown, the move was hailed by activists as a victory for "patients over patents."
But the generals weren’t really worried about patients. If public-health concerns had been the prime motivation, the Thai government wouldn’t have refused the massive price reductions the patent holders had offered. Even more tellingly, the government rejected the opportunity to use money from the U.N.-sponsored Global Fund to Fight AIDS, Tuberculosis and Malaria to purchase WHO-certified generics.
Far from a noble act, Thailand ‘s compulsory licensing was a bald power play to beef up local manufacturing and generate revenues for a corrupt state. Unfortunately for Thai AIDS patients, producing the drugs locally has proved prohibitively expensive and has sharply limited their supply.
What’s more, few generics and locally produced copycat drugs are tested and certified by respected regulatory authorities. Low-quality pharmaceuticals can expose viruses, bacteria and parasites to substandard doses of an active ingredient, breeding the bug’s resistance in the process. This can doom an entire class of drugs. The poor quality of Thailand ‘s copycat antiretroviral drug caused a rise in resistant AIDS viruses two years ago.
Another cautionary tale comes from India . Under pressure from antipatent activists, the WHO in 2004 green-lighted without testing an antiretroviral generic produced by Ranbaxy, an Indian company. The Geneva-based organization then had to quickly withdraw its approval again when Ranbaxy failed to provide adequate safety data.
By most estimates, it costs Western pharmaceutical companies around $800 million to develop a new drug and bring it to the market. The risk of losing a product through compulsory licensing will only discourage investment in future research.
Yet antipatent activists, with their myopic fixation on price, are relentlessly bullying bureaucrats to follow their advice. Let’s hope the WHO won’t succumb to the misconception that compulsory license can cure Africa ‘s health problems. Instead, economic development remains the continent’s best hope for eradicating the diseases of poverty.
Africa faces a lot of challenges in the various sectors of its economy: health, agriculture, finance etc.
Looking at the health sector, so many people are unable to buy drugs for treatment of disease. Africa being so unfortunate has the highest records of HIV/AIDS and malaria. I agree that some drugs that are imported into Africa expires before reaching the final consumer i. e. the patient. We lack proper storage facilities. You put a tablet of paracetamol in your mouth and before you bite into it it spreads. We also lack equipment and personnels needed for for proper health care delivery.
It is sad to note that most African countries are agriculturally gifted. But yet still what our farmers produce is only hand to muth. We still use hoe and cutlass for farming. With this status, the farmer can never become rich. Ghana most importantly is a rice growing country but yet we import over millions worth of rice annually. Go to the forests and you’ll marvel at the bamboo plantations we’ve got and yet we import tooyh picks.
When it comes to the issue of finance, it is heartbreaking and thought provoking. We have selfish leaders who think about themselves only forgeting about the ordinary man who voted them into leadership. African economy today is only making the rich richer and the poor poorer. Ghana has signed up for seveal foreign aids including the MILLENNIUM DEVELOPMENT CHALLENGE ACCOUNT, POVERTY REDUCTION STRATEGY etc. Of what percentage of all these money does the ordinary Ghanaian enjoy. The money goes into the pockets of heartless politicians who award contracts to families and friends in oder to enjoy KICK BACKS.
POVERTY is actually a disease that can and must be cured. The antidote to African poverty relies on we Africans.
First, people must be taught and trained from childhood to have an entrepreneurial mindset, so that they are able to create jobs themselves and don’t have to wait for MNCs to come and set up businesses expolit them to make large profits and pay less for their labour. It is time Africans learn to be their own boss.
Africans must also learnto take risk. The fear of making mistakes and being ridiculed has made us stagnant. ‘there are no mistakes, no coincidences.All events are blessing given to us to learn from’- ELIZABETH KUBLER-ROSS in Yoga journal, November 1, 1976.
To cure the disease of poverty, big companies like the MNCs should be task with the obligation tha each year they go into tertiary institutions, select final year students train them and absorb them into the system.
We have good businessmen and women, young energetic and talented people who need employment. People retire and are re-employed with the excuse that they have the experience and the technical knowhow. Human resource is being wasted in Africa because each year there are fresh people gaduating from schools who have to feel thos vacancies and inject new ideas.
I don’t blame health workes especially doctors who are migrating to seek greener pastures abroad. I also do not think the government of Ghana places any high value on education and health. If not so you wn’t visit a hospital only to find a seventy year old doctor who should be restig after several years of service with over hundreds of patients to attend to. He is so slow that before it gets to the turn of some patients they die.
‘The old order changeth giving place to new’ so if people retire, they should be allowed to enjoy their pension sothat young peolpe are emloyed to bring in new ideas to improve our economies.
We also need selfless leaders who’ll put themselves in the shoes of the poor i society and help improve their standards of living. If we continue to wait for the whiteman to come and tell us what to do we’ll forever remain POOR.