While African governments, such as Zambia, are often singled out as grossly corrupt, not enough is said about corporate tax ‘avoidance’ on the part of mining companies, which costs the nation billions of US dollars annually, according to this article. And the much-lauded Extractive Industry Transparency Initiative (EITI) is not helping, the author argues. The EITI standard is meant to ‘facilitate transparency’ by assessing net discrepancies between resource rents - royalties and taxes remitted by multinationals and received by governments. In 2010, Zambia published its EITI report, disclosing payments from mining companies for the year 2008. It revealed that mining companies remitted US$463 million in payments to the government in 2008, with ‘significant discrepancies’, noting a net total of ‘unresolved discrepancies’ of $66 million. Tax havens such as Switzerland are essential to resource-seeking corporations operating in Africa, the author of this article argues, and she estimates more than 85% of asset portfolios for sub-Saharan Africa passes through tax havens. She concludes that EITI’s figures for revenue leakage are underestimated by billions because it does not consider what multinationals ought to have paid Zambia, and it never investigates the means through which corporations were able to circumvent taxation.
Public-Private Mix
Multinational companies may be engaged in high-risk activity which is eroding the tax base and warrants a tax audit in their respective countries, say senior tax officials of South Africa, Mozambique, Ghana, Tanzania and Zambia. They met at the offices of the African Tax Administration Forum in South Africa on 23 June 2011. Logan Wort, executive secretary of the forum, said that tax authorities in Africa agreed that they would begin work on a multilateral agreement to exchange information on taxpayers, such as multinational companies, for tax purposes. Wort argues that multinationals should not enter into high-risk transactions, such as transfer pricing arrangements, which pose a risk to the tax base. Unfortunately, there is no legal instrument to take collective action against such companies, he said.
Product development partnerships, non-profit research institutes and private sector groups have come together over the past years to conduct research and development (R&D) in the areas of the development of drugs, vaccines and diagnostics for neglected diseases, including tropical diseases and other major infectious diseases like HIV and AIDS, tuberculosis and malaria. However, arguments have been put forward that their efforts are disjointed and that funding flows inefficiently to individual research projects resulting in insufficient resources, funding volatility, poor resource allocation, and duplicated and unnecessary efforts. In response, several pooled funding mechanisms have been proposed to address what proponents see as the key problem(s) in the current system: the Industry R&D Facilitation Fund (IRFF) originally proposed by the George Institute; the Fund for Research in Neglected Diseases (FRIND) proposed by Novartis; and the Product Development Partnership Financing Facility (PDP-FF) proposed by the International AIDS Vaccine Initiative (IAVI). The goal of this paper is to provide insight into the extent to which these three proposed mechanisms would have a positive effect on accelerating R&D for neglected diseases. It considers how these proposals are likely to perform against two criteria: their capacity to raise additional money for neglected disease R&D and their capacity to improve the efficient allocation of those funds. The authors of the paper use a literature review, interviews with key stakeholders and illustrative modelling to assess the proposals against these two criteria. Most interviewees expressed doubts that common ground could be found with regard to the metrics on resource allocation if the fund were covering a large and diverse part of the R&D space. However, stakeholders overwhelmingly agreed that a pooled fund focused on late stage work only would be a more feasible and useful proposition.
Kenyan pharmacists are taking advantage of government-subsidised anti-malarial medications to maximise their profits, according to this article. Media reports from different parts of the country, including rural areas, revealed that retail prices of the subsidised anti-malarial drugs varied from 80 KES (US$1) to 240 KES ($3). Some private pharmacists claimed that they inflated the price to cover distribution costs and other inputs, while many do not stock the subsidised drugs, as profits from subsidised medications were considered too marginal. In order to reduce instances where pharmacists are inflating the cost of the subsidised drugs, the Kenyan government has embarked on awareness campaigns through the media to inform Kenyans of the availability of the drugs, and the recommended prices per dose. Technically, the government of Kenya does not have control over drugs sold in pharmacies in the private sector because the pharmaceutical market in the country is based on ‘a willing seller, willing buyer’ concept, but the author argues that this does not appear to be working for poor consumers.
On 30 May 2011, the Drugs for Neglected Diseases initiative (DNDi) signed an agreement with pharmaceutical manufacturer Sanofi for a three-year research project on nine neglected tropical diseases. Sanofi will bring molecules from its libraries into the partnership, and DNDi and Sanofi will collaborate on the research. According to the agreement, the intellectual property (IP) rights resulting from the partnership will be co-owned by DNDi and Sanofi. Publication of results is hoped to benefit the wider research community and the partnership has commited to improving access to health interventions for patients in all endemic countries, irrespective of their level of economic development. The agreement will cover nine diseases: leishmaniasis, Chagas disease, human African trypanosomiasis (sleeping sickness), lymphatic filariasis (elephantiasis), onchocerciasis (river blindness), helminthiasis, dracunculiasis (Guinea-worm disease), fasciolosis, and schistosomiasis.
This case study describes how a public-private partnership initiated to develop a new anti-malarial combination has evolved over time to address issues posed by its effective deployment in the field. In 2002, the Drugs for Neglected Diseases Initiative (DNDi) created the FACT project to develop two fixed-dose combinations, artesunate-amodiaquine and artesunate-mefloquine, to meet the WHO anti-malarial treatment recommendations and international regulatory agencies approval standards. In co-operation with private drug manufacturers, the partners developed the product and embarked on additional partnerships to ensure the adoption of this new medicine by malaria-endemic countries. The speed at which the drug was adopted in the field is argued to show the power of partnerships that combine different sets of strengths and skills, and that evolve to include additional actors.
This paper reports on the initial phases of the pharmaceutical development of an artesunate-amodiaquine (ASAQ) bilayer co-formulation tablet, undertaken following pre-formulation studies by a network of scientists and industrials from institutions of both industrialised and low income countries. University researchers, private companies specialised in pharmaceutical development and clinical batch manufacturing, as well as the World Health Organisation and Medecins Sans Frontieres collaborated on the project within a larger public-private partnership (the FACT project). The main pharmaceutical goal was to combine in a solid oral form two incompatible active principles while preventing artesunate degradation under tropical conditions. Collaborations between research and industrial groups greatly accelerated the process of development of the bi-layered ASAQ tablet. No intellectual property right was claimed. Lack of public funding was the main obstacle hampering the development process.
In this briefing, the authors consider the responsibilities of pharmaceutical companies for enhancing access to medicines in the context of sexual and reproductive health. They first examine the issue of access to medicine in the context of both HIV/AIDS and the human papilloma virus (HPV), highlighting the intersection with the fundamental rights to sexual and reproductive health. Having provided this context, the authors outline the responsibilities of States to ensure that medicines are available, accessible, culturally acceptable, and of good quality. However, they stress that the pharmaceutical sector has an indispensable role to play in relation to the right to health and access to medicines. The responsibility should be shared between the pharmaceutical industry and global and national governing bodies.
Product development partnerships, non-profit research institutes and private sector groups have come together over the past years to conduct research and development (R&D) in the areas of the development of drugs, vaccines and diagnostics for neglected diseases, including tropical diseases and other major infectious diseases like HIV and AIDS, tuberculosis and malaria. However, arguments have been put forward that their efforts are disjointed and that funding flows inefficiently to individual research projects resulting in insufficient resources, funding volatility, poor resource allocation, and duplicated and unnecessary efforts. In response, several pooled funding mechanisms have been proposed to address what proponents see as the key problem(s) in the current system: the Industry R&D Facilitation Fund (IRFF) originally proposed by the George Institute; the Fund for Research in Neglected Diseases (FRIND) proposed by Novartis; and the Product Development Partnership Financing Facility (PDP-FF) proposed by the International AIDS Vaccine Initiative (IAVI). The goal of this paper is to provide insight into the extent to which these three proposed mechanisms would have a positive effect on accelerating R&D for neglected diseases. It considers how these proposals are likely to perform against two criteria: their capacity to raise additional money for neglected disease R&D and their capacity to improve the efficient allocation of those funds. The authors of the paper use a literature review, interviews with key stakeholders and illustrative modelling to assess the proposals against these two criteria. Most interviewees expressed doubts that common ground could be found with regard to the metrics on resource allocation if the fund were covering a large and diverse part of the R&D space. However, stakeholders overwhelmingly agreed that a pooled fund focused on late stage work only would be a more feasible and useful proposition.
In this study, the authors examined how economic reforms, like structural adjustment programmes that were developed and implemented in the 1990s, have affected the health sector. They report that these policies facilitated reforms in the health sector that facilitated the entry of multinational financial (insurance) and pharmaceutical capital. This redefined both the health-ill-care model and converted patients into consumers being pressured to buy products, largely via the media and the advertising industry.