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Thursday, 19 April, 2001, 15:57 GMT 16:57 UK
Head-to-head: Aids drugs
On the day the world's leading drugs firms dropped their legal challenge to stop South Africa selling cheap versions of patented Aids drugs, BBC News Online talks to organisations on both sides of the argument.

The international aid charity Oxfam welcomes the move, hoping it will facilitate the sale of cheap drugs in poor countries.

But the International Federation of Pharmaceutical Manufacturers says that this view is short-sighted and unlikely to help these countries in the long-term.

Kevin Watkins, Oxfam's senior policy adviser in South Africa

The court case in South Africa was a David and Goliath battle which pitted public health against the corporate wealth of billion-dollar drug companies.

The outcome is a victory for the people of South Africa and for poor people around the world.

Countless thousands of people could have been saved if policies had not been blocked by the drug giants

Kevin Watkins
Anybody claiming victory for the pharmaceuticals industry either has a strong sense of humour, or a weak grasp of reality.

The industry should never have started this case. It has engineered a public relations disaster for itself, and - more importantly - it has delayed by three years the introduction of policies needed to tackle the HIV crisis in South Africa.

Countless thousands of people could have been saved if policies had been implemented in 1997 and not been blocked by the drug giants.

The outcome of this landmark case sends a clear message to other developing countries that the human right of people to affordable medicine takes precedence over the commercial claims of companies, however powerful they may be.

Call for change

The international campaign to provide poor people access to cheap medicines will now be turning its attention to the World Trade Organisation case brought against Brazil's affordable drugs policies by the US.

Ultimately we need to change WTO rules to stop continual repeat performances of the South Africa debacle. Oxfam is calling for a review of the organisation's current treaty on trade-related aspects of intellectual property, the TRIPS agreement.

Firstly, safeguards need to be established to protect the right of governments to provide affordable medicines, and secondly the patent blueprint applied through the WTO needs to be assessed for its appropriateness to the world's poorest countries.

In South Africa, an opportunity now exists for the government, industry and the rest of society to start working together in fighting against the real enemy - namely, a health epidemic that is claiming 250,000 lives each year.

The battle in South Africa has been won, but the war to provide medicines to the world's poorest people continues.

Dr Harvey Bail, director-general of the International Federation of Pharmaceutical Manufacturers Associations

Attaining improved access to healthcare and medicines in developing countries requires a far-sighted vision and a long-term commitment. Oxfam's analysis, however, is myopically focused on the short-term and on prices of drugs.

The reality is that TRIPS will accelerate the introduction of new, patented medicines for HIV/Aids, malaria and other diseases in the developed and developing world

Dr Harvey Bail
Many NGOs, economists and international health experts recognise that the key to improved healthcare, including medicines, is to address poverty, financial resource needs and building infrastructure to permit the use of today's advanced health care technologies.

The cost of medicines is a factor to be considered in the access to care, but many companies in the industry have been addressing this issue, despite the lack of financial resources and infrastructure development.

The reality is that TRIPS will accelerate the introduction of new, patented medicines for HIV/Aids, malaria and other diseases in the developed and developing world.

Drug counterfeiting

The WTO TRIPS agreement will also help address another problem never mentioned by its critics - notably the counterfeiting of drugs, which every day threatens the lives of millions in Africa and other developing country regions.

The number killed by counterfeit drugs has been impossible to measure because of the criminal nature of the activity, but is estimated at tens of thousands every year.

Neither TRIPS nor any other single international agreement provides a complete answer, especially for poorer countries that need assistance to take advantage of the expanded opportunities coming from advances in health care technology.

The pharmaceutical industry has sometimes found it helpful to join with international agencies to develop specially targeted programs in drug research and vaccines.

Less than 5% of the medicines on WHO's essential drugs list are covered by patent protection anywhere in the world

Dr Harvey Bale
Together with the World Health Organisation it founded the Global Alliance for Vaccines and Immunisation, which aims to improve the delivery of vaccines to developing countries.

A number of companies have engaged in long-term programs to deliver - at either low or zero cost - medicines for diseases such as river blindness, trachoma, sleeping sickness, polio, leprosy, malaria, TB, lymphatic filariasis and vitamin-deficiency blindness.

Last year, five pharmaceutical companies joined forces with the UN to launched an initiative to accelerate access to HIV/Aids therapies in developing countries.

Few drugs are patented

The deepening public health crisis in the developing world has nothing to do with patent protection.

Less than 5% of the medicines on WHO's essential drugs list are covered by patent protection anywhere in the world, let alone in developing countries, many of which have no effective intellectual property laws.

Furthermore, "no patents" does not mean "low prices". Even at the lowest prices, many of the world's poorest people cannot afford or obtain low-cost generic treatments for malaria, TB and other common diseases.

A good example is India - no pharmaceutical product patents exist there yet less than 15% of people infected with TB have access to inexpensive treatments.

As the South African health minister recently said: "The problem of access to HIV and Aids-related treatment will not be adequately addressed by simply cutting the prices of anti-retroviral drugs. Care for HIV/Aids-related infections should be addressed in a holistic way ... [and] cover issues of sustainability, accessibility as well as affordability."

Competition not affected

Oxfam has asserted that patents on new products confer a monopoly - allowing patent holders to market a product exclusively at "monopoly prices" for "at least 20 years". This is false on two counts.

First, the 20-year patent term required by TRIPS often implies a marketing exclusivity period of less than 10 years, since it takes 10-12 years of tests and regulatory review for most innovative medicines to reach patients.

Second, patents confer marketing exclusivity, not a monopoly, since there are usually alternative treatments - as an example, there are at least six patented protease inhibitors for the treatment of Aids.

On the contrary, patents create a necessary incentive to increase competitively-supplied innovative drug therapies and products. The presence of a number of treatment options helps ensure price competition for new medicines.

Studies on the effects of countries introducing patent protection often fail to show a significant effect on the price of pharmaceuticals.

The problems of the developing world are severe and the pharmaceutical industry shares society's concerns. But it is not right that we should try to tackle the problems caused by endemic poverty, ill health and lack of infrastructure ourselves.

There is clearly a need for enhanced efforts by all parties to create sustainable solutions and the pharmaceutical industry is ready to play its part.

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See also:

19 Apr 01 | Africa
SA victory in Aids drugs case
19 Apr 01 | Health
SA Aids case: The repercussions
24 Oct 00 | Aids
Aids drugs factfile
19 Apr 01 | Talking Point
Can people power change big business?
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