Medicinal Patents Complicate Sustainable Global Health

The fact that there is gross inequality in the world is well understood, but one fact in particular can still jar those who have become accustomed to this situation: millions of people are dying every year from diseases for which treatment has already been discovered. How does such a situation persist? There are many components to the health inequity that leads to this devastating result, but one in particular has attracted much focus among health-care activists in the past decade: intellectual property.

Patents are central to the economics of health care today. The theory of patents as applied to medicine is as follows: research and development of new medicines is an expensive process. If companies are willing to undertake new research, which is so critical for health care, they need an incentive to do so. Patents give them this incentive by ensuring them a monopoly over the production and distribution of the medicine for a period of twenty years after the granting of the patent.

In many ways, this theory makes logical sense, and many say that a strong intellectual-property regime is centrally important for economies to function. Indeed, since 1995, the World Trade Organization has mandated through its Trade-Related Aspects of Intellectual Property Rights agreement that all its member countries respect intellectual property. And yet, the fact stated above best represents how this theory does not work perfectly: millions of people are dying because of lack of access to medicines already in production. There is clearly a problem in the production and distribution of medicines.

Due to lack of competition, monopolies allow for the setting of high prices, which would be much lower in a competitive environment of generic production. For instance, when d4t (stavudine), an antiretroviral developed at Yale, was made available to generic competition, the price became available at less than $40 per patient per year. While this is clearly a victory for global health, high prices remain the company’s compensation for its investment in research and development. Yet it is clear that millions of people across the world are too poor to pay the current prices for the treatment of their sicknesses. Patents, although they help encourage greater research, also act as barriers to accessing the fruits of that research. It is for this reason that intellectual property has become such a focus for those who concern themselves with health inequality.

How does one resolve this problem? There are those who argue for removing patents altogether in order to remove the access barrier, but they are countered by those who argue that this would also create a vacuum in incentives for research. Economists such as Unversity Professor Joseph Stiglitz have envisioned new ways to create incentives by using a theory of prize funds. Some have argued for relaxing the enforcement of patents only in countries where the access barrier would be particularly acute. In 2001, the WTO recognized the barrier to public health that patents presented, and signed the Doha Declaration, which gave its member countries more flexibility in the enforcement of patents. It authorized the use of compulsory licenses, in which countries can declare the right to produce a specific drug generically if they deem it necessary in the interests of public health. Although the ultimate solution has not been found, there is a growing atmosphere of innovation in patent theory in order to account for public health.

This is countered, however, by unwavering defense of patent theory as it stands. Large companies that are able to use patents to their monetary advantage defend patent theory vigorously and influence government policy via extremely powerful pharmaceutical lobbies. Thus, the United States government is influenced to undermine the Doha Declaration by demanding stronger intellectual-property adherence through bilateral trade agreements. This ideology seems to de-emphasize the importance of public health and the lives of millions.

It seems clear, based on many different principles established through many points of entry, that lives should take priority. If the death of millions is not simply to be seen as a regrettable loss, then factors contributing to those deaths must be open to critical examination, and solutions that most benefit health must be prioritized. The growing atmosphere of critical innovation in patent theory is of the utmost importance, and must not be hedged in upon by the prevailing conservative atmosphere on this issue.

If you are interested in the issue, Global Justice and Universities Allied for Essential Medicines would like to invite you to a talk tonight at 8 p.m. in Earl Hall. Assistant professor Bhaven Sampat from the Mailman School of Public Health will be talking about the general issue of intellectual property and access to medicines, as well as discussing his own innovative research into the issue. Food will be served.