OPINION: UN is barking up the wrong tree when it comes to access to drugs

20 July 2016
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ACCESS to medicines for HIV/AIDS, tuberculosis (TB), diabetes and other related diseases will dominate discussions when stakeholders convene at the International AIDS Conference in Durban next week.

At issue will be the considerations of a special UN High-Level Panel on Access to Medicines (UNHLP), convened last November by Secretary-General Ban Ki-Moon.

We must not expect fresh thinking from this panel. It is merely the latest iteration of a decades-long campaign to skew the debate as the UN continues to presume patents are a major barrier to access to medicines and, therefore, a major obstacle to health and development.

The reality is far different, and to adopt the UN’s recommendations could do more harm than good.

The high-level panel was convened “to review and assess proposals and recommend solutions for remedying the policy incoherence between the justifiable rights of inventors, international human rights law, trade rules and public health in the context of health technologies”.

That sounds very admirable. However, as Joseph Allen says: “Despite its name, the high-level panel isn’t tasked with expanding the availability of medical treatments. Instead, it’s only addressing ‘the policy incoherence between intellectual property laws and access to medicines’. This unusually specific mandate lays bare an unfortunate bias on the issue. It assumes the world doesn’t have an essential-medicines problem; it has an ‘incoherent’ patent system.”

Indeed, the panel overlooks the fact that 95% of the World Health Organisation’s (WHO’s) essential medicines list — the medicines that experts consider most important to improving global health for the world’s poorest — are already off-patent. Most of the remaining 5% of medicines with patent protection are for HIV/AIDS treatment, but the patent owners either do not register or do not enforce their patents in the poorest countries.

Where is the wisdom in spending vast sums of money to convene yet another international panel to discuss access to drugs, when those funds could be put towards actually providing drugs to those so desperately in need?

Examining SA’s struggle to increase access to healthcare is instructive. This country’s leading killers — TB, influenza, pneumonia and intestinal infectious diseases — could readily be treated with off-patent medicines at little or no cost, yet the obsession with drug patents as a major barrier to access diverts attention from far more important obstacles to healthcare.

For instance, the country’s public hospitals and clinics are plagued by pervasive stock-outs of basic, nonpatented, medicines. To improve logistics and management should be the first answer to any question about increased access to medicines.

If the South African government truly wants to make medicines more easily accessible, it should concentrate on implementing some simple reforms. For instance, it should remove value-added tax on pharmaceutical products; to tax the sick and most vulnerable members of society is counterintuitive.

An urgent reform would be the overhaul of the process of registering medicines and devices. SA’s drug regulator, the Medicines Control Council (MCC), can take more than five years to approve a drug that typically has already been approved by US or European regulators. Not only do these delays reduce revenue and increase costs to drug makers, they deny people timely access to the medicines.

Instead, the approval process could be greatly improved by simply recognising the work performed by other rigorous regulatory authorities. One member of the UN panel, Malebona Precious Matsoso, is a former head of SA’s MCC and has presided over lengthy delays in drug approvals. Self-reflection can be difficult, but Matsoso’s experience as a regulator should give her some insights into how to reform and improve the drug registration process.

Access to healthcare, along with life expectancy, has been steadily improving globally. Members of the panel should not ignore this. More people now have access to HIV/AIDS treatment than ever before, and preventable diseases, such as malaria, have been on the decline for years.

More must be done to improve global health and access to medicines.

But to blame the drug companies ignores the reality that patents are hardly ever the real barrier to access for the world’s poor.

Let us hope that at the International AIDS Conference, governments and the UN look to fix their own problems before tearing down an intellectual property rights system that, over many years, has successfully delivered life-saving medicines.

Urbach is a director of the Free Market Foundation

This article was first published in Business Day on 15 July 2016

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