TCS Daily

Patent Nonsense

By Roger Bate - January 2, 2001 12:00 AM

Those concerned about the global fight against HIV/AIDS can find a prescription for victory by looking at a recent fight against another disease: malaria.

Shortly before World AIDS Day last month, the South African Department of Health held its annual Malaria Control Conference. Sadly, there was little media fanfare surrounding the event. Despite the low level of public attention to malaria, conferees were able to celebrate phenomenal successes, especially in KwaZulu Natal where malaria rates are down by around 80% compared with last year.

The success in the malaria fight is due in large part to two things: the reintroduction of insecticide spraying with DDT (produced only in India and China); and a change in drug therapy to a new, highly effective Novartis drug based on a Chinese herb.

Another factor was the strong political will to control the disease. By increasing funding to the malaria control programs, standing up to the anti-DDT environmentalists and committing itself to providing effective therapies, the government of South Africa seems to have the disease under control.

This political will does not, however, seem to be reflected in the South African government's fight against HIV/AIDS. The government continues to turn its nose up even at drugs, such as Nevirapine, that could reduce mother-to-child transmission of the virus, even though German drug company Boehringer-Ingelheim has offered to provide it for free.

Worse, the lack of leadership in South Africa provides cover for other governments, allowing many of them to remain in denial about the disease and its consequences. This denial continues despite the fact that AIDS is poised to ravage much of Asia and Eastern Europe.

Patent Nonsense

Several governments reluctant to confront the deadly disease have sought political cover for their inaction by shifting blame to alleged "profiteering" by the drug companies. And they've received help from the front lines of the fight, as AIDS activists have been only too willing to parrot that complaint. When drug companies develop a new cancer treatment, they are lauded as heroes, but when they devote millions to HIV research, they are accused by activists of having "blood on their hands."

The central gripe of the AIDS activists -- that drug patents block access to drugs -- is false. In most of Africa, for example, there are no patents on AIDS drugs, so this cannot be so. Poverty and political will are the real problems.

But the activists have managed to convince governments that their cause is just. At the recent WTO meeting in Doha, negotiators spent much valuable time on a declaration that enables them legally to weaken patent protection for pharmaceuticals. The result is that drug companies now have less incentive to invest in drugs for the developing world as a whole.

And this sustained attack on the pharmaceutical industry has already hindered efforts at disease control. While research into other diseases is increasing, investments in HIV research are being cut. According to Pharmaprojects, an independent research group, the number of anti-retrovirals in development rose steadily from 1990 to 1998. Since then, however, development has fallen back to 1990 levels.

The simple fact remains that the development of drugs is enormously costly. A new study by the Tufts Center for the Study of Drug Development estimates that a drug company typically spends over $800 million to bring a new medicine to market. In 1987, the figure stood at around $231 million and the increase has been around 5 times greater than inflation. Most of the increase in cost is attributed to the increasing cost of clinical trials, according to the study's author, Dr. Joseph DiMasi.

Encouraging Signs

Some recent encouraging signs, however, suggest that all is not lost in the near future. In mid-December, the Pretoria High Court ruled in favour of a campaign to force the South African government to provide Nevirapine to HIV positive pregnant mothers throughout the country. Will this encourage Asian countries to provide the drug? Let's hope so. According to Harvard University demographer, Nicholas Eberstadt, AIDS rates are about to explode in India and China. If the South African court's ruling is upheld, it will be harder for these countries to sit on their hands.

Tellingly, speakers at the South African Malaria Conference didn't bash the drug companies. Instead, they stressed the urgent need for the development of new drugs. Why? Several of them shared fears that resistance might develop to the new Novartis drug; and should resistance develop, there will be no drugs to treat malaria patients effectively. In other words, the best hope for fighting disease rests in continued (and expensive) scientific research.

It is time that governments and activists do more to encourage new drug development. There's one sure way to do that. Assure the drug companies that their colossal investment and intellectual property rights will be protected. If not, then the AIDS disaster that is visiting Southern Africa could well spill over into Asia, with devastating and tragic consequences.

Richard Tren is a director of the South African based NGO Africa Fighting Malaria. Bate is a director of the London based think tank, International Policy Network.

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