Are patents really killing patients? Patents, under an ideal situation, are supposed to help in innovation of new medicines which ultimately benefit patients. But there is a global concern among various leading public health personalities that people, especially those from poor and developing countries who are in dire need of these medicines, cannot access it; even when it is a matter of life and death.

Diseases that kill and maim people in poor and developing countries are not a research priority for many big corporates, operating in Europe and America. They would only be interested in pursuing research on drugs that has a market. For example their priority would be a new Viagra or drug to reduce obesity or a drug that acts against jetlag, which are obviously the needs of business persons.

Major concern

These are not the priorities of poor and developing countries.  A major concern in the public health sector in many of the developing countries would be tuberculosis - a major killer. It kills nearly two million people per year world wide. Resistance to tuberculosis drugs is fast increasing, with 450,000 new cases detected each year, and with HIV it is just adding fuel to the complex situation. The ongoing research on new drugs to treat tuberculosis are hardly worth mentioning also.

Interestingly, Daniel Vasella, the chief of Novartis – a Switzerland based multinational drug company with market outlets all over the world – agrees that “You cannot expect for-profit organisations to do this on a large scale. If you want to establish a system where companies systematically invest in this kind of area, you need a different system”.

How can one discover new drugs that meet the public health demands of the people in poor and developing countries without penalising the patients? One method suggested is the setting up of a prize fund. Through this, it would be possible to reward drug researchers on the basis of the evidence of the impact the new products would have on public health needs. Developers would be rewarded for products that improves treatment options.
This prize fund, set up by the governments, employers or health insurance companies, should conduct research on areas that concern public health interests in that particular country. For example in India, the prize fund could go for research on drugs to treat tuberculosis, malaria, etc.

Right move

A move in this direction has already taken place, when at the last year’s World Health Assembly, under the auspices of the World Health Organisation (WHO), an Intergovernmental Working Group (IGWG) was set up.
It would deliberate and examine as to how new additional mechanisms can be evolved to separate the cost of research and development from the price of drugs. With this it is hoped that health research for new drugs will respond to the genuine health needs of people in poor countries and not to the profit appetites of the big drug companies. The IGWG should target some concrete goal to show it has teeth and develop and support an international strategy for tuberculosis, as a pilot activity.

It is agreed worldwide that there are not enough tools to diagnose and treat tuberculosis, especially when co infected with HIV. WHO members, especially from developing countries, should make binding commitments to support research for both diagnosis and treatment of tuberculosis.

Many multinational drug companies are hostile to this new idea of a prize fund. They strongly feel that their monopoly through patents is the only way out for developing new drugs. But, ultimately it is for the drug companies to decide if they want to explore new ways for the research of new drugs or continue and wrongly persist to protect narrow commercial interest regardless of their devastating side effects.

(The writer is President, Drug Action Forum, Karnataka.)