TCS Daily


Faith-Based Activism on Patents?

By Nick Schulz - May 7, 2004 12:00 AM

The international debate over how best to combat deadly diseases in the developing world such as HIV/AIDS just got more interesting courtesy of new research that argues that "poverty, not patents" imposes a greater restriction on access to treatments and medicines.

Amir Attaran, a fellow at the Royal Institute of International Affairs in London finds that patents are largely a non-issue when it comes to treating the world's poor. His findings, out this week, follow earlier research on drug access in poor countries he published in the Journal of the American Medical Association.

The new study, in the journal Health Affairs, concludes that "in sixty-five low and middle income countries, where four billion people live, patenting is rare for the 319 products on the World Health Organization's Model List of Essential Medicines." Attaran points out that "only seventeen essential medicines are patentable, although usually not actually patented, so that overall patent incidence is low."

Attaran suggests the reason patenting is so uncommon is that "in very poor, low-income developing countries, particularly in Africa, annual drug spending may be $2 or less per person. With so little revenue at stake, most drug companies decided to forgo patent protection in these countries."

The significance of these findings becomes obvious when one considers what many global health activists and their friends in the media have been saying for years, arguing that patents are a chief obstacle to fighting disease effectively. Their beef is that the enforcement of drug patent protection in Africa and elsewhere prices the world's poor out of the market. Patents, in short, are killers.

The development organization Oxfam charged in 2001 that "aggressively enforcing... patents in poor countries" results in "pricing life-saving drugs beyond the reach of millions of poor people."

Dr. Chris Ouma of the medical activist group Doctors Without Borders was quoted in the Washington Post asking, "Which is more deadly in Africa? Is it HIV, or is it the businessmen who have briefcases of patent applications?"

The left-wing magazine The Nation editorialized that, "The result in Africa has been murder by patent."

This fight over patents has become increasingly personal and bitter. One prominent activist, Jamie Love of the Consumer Project on Technology, a Naderite group, last year attacked Attaran, prompting Attaran to withdraw from participating in an influential online listserv Love maintains. And in March, Love likened patents to "weapons of mass destruction."

The new Attaran research, however, seems to suggest the most vehement critics of patents such as Love have been practicing a kind of faith-based activism -- taking the "fact" that patents are a large obstacle to global health as given without verifying its veracity.

And if, as Attaran suggests, it's not patents, then how can we explain the limited access to essential medicines in the developing world? Attaran's research concludes that "poverty, not patents, imposes the greater limitation on access."

The "economic data leave no doubt that the failure of billions of people to receive necessary therapies is largely a consequence of economic policies that are in need of study and reform by public health scholars," Attaran says.

First on the list of policies in need of reform is the agricultural price support system in the wealthy West. The recent World Trade Organization decision approving Brazil's case against American cotton subsidies for their distortive effect on global trade -- to the detriment, in particular, of the poor in the developing world -- brings new hope for greater development in the most impoverished parts of the globe. And with more development, opportunity, economic growth, and wealth will come a heightened chance that access to essential medical technologies will no longer be access denied.

Certainly if one thing is clear, the blanket condemnation of all patents as killers for blocking access to medicines by the activists simply doesn't hold water. It's no surprise that advancing global health in the poorest parts of the world is exceedingly complicated. Likewise it's no surprise that sound-bite explanations of the problem don't reflect reality.

This debate is far from over. Love, who has called for junking the traditional intellectual property and patent systems, has already criticized the Attaran study in the Financial Times. We can no doubt expect the debate to heat up in the run up to the global AIDS Summit this July in Bangkok.


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