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© Sebastien Le Clezio

Access once again under threat
Over six years after the Doha Declaration clarified countries’ sovereign right to take measures to protect public health, access to medicines remains under threat.   

The scale of the retaliation against Thailand’s recent attempts to secure access to life-saving treatments for its population, the legal disputes over patents in India, and the pressure put upon countries to agree to more restrictive patenting measures than necessary under international law all bear witness to that threat.  Many of the questions raised in the way intellectual property and health interact remain unresolved and the progress made by bringing prices down through generic competition remains vulnerable.  

Now that TRIPS is implemented in all the major drug producing countries of the world, strong political will from developing countries to issue compulsory licences, to enact patent laws with a pro-public health perspective, and to refuse TRIPS plus provisions in free trade agreements, is more important than ever.

Finding sustainable solutions
The battle for access to medicines will not be won on a drug-by-drug or a country-by-country basis.  What we need are long-term solutions that answer the problem in a sustainable way.

In today’s model, the cost of researching and developing medicines is paid for through high drug prices.  This means that research is steered towards areas where the profit rewards are the greatest, so diseases which predominantly affect the developing world are neglected.   

Any attempt to address the twin problems due to today’s paradigm for drug development – high prices on the one hand, and the lack of research and development (R&D) into diseases of the developing world on the other - will therefore need to look at both access to medicines, and medical innovation at the same time.

We need a system that delivers adapted and affordable drugs that respond to patients’ needs.  Mechanisms need to be established - such as those included in the WHO's Global Strategy to address access and innovation, like patent pools, or prize funds - that allow for any new medicines, diagnostics and vaccines that are developed to be priced affordably from day one.  And when patents are a barrier, countries need to be able to use, freely and without risk of retaliation, legal flexibilities such as compulsory licences in order to ensure access to medicines for their populations. 

Patients cannot afford to wait twenty years for patents to expire and generic competition to kick in, in order to access life-saving medicines.  And now that India, the pharmacy of the developing world, will grant patents on newer medicines, we cannot expect generics to come to the rescue for newer drugs.

Isn’t it time therefore to stop tinkering in the margins of the drug development and pricing system, and actually rewrite the rules?

Last updated: January 2009