The landmark decision by the Indian Supreme Court in Delhi to uphold India's Patents Act in the face of a seven-year challenge by Swiss pharmaceutical company Novartis is a major victory for patients' access to affordable medicines in developing countries, according to Médecins Sans Frontières (MSF). The court ruling was made on 1 April 2013 in the face of a seven-year legal battle with the pharmaceutical manufacturer. Novartis first took the Indian government to court in 2006 over its 2005 Patents Act because it wanted a more extensive granting of patent protection for its products than what was offered by Indian law. In a first case before the High Court in Chennai, Novartis claimed that the act did not meet rules set down by the World Trade Organisation and was in violation of the Indian constitution. Novartis lost this case in 2007, but launched a subsequent appeal before the Supreme Court in a bid to weaken the interpretation of the law and empty it of substance. Instead of seeking to abuse the patent system by bending the rules and claiming ever-longer patent protection on older medicines, MSF calls on the pharmaceutical industry to focus on real innovation, and governments should develop a framework that allows for medicines to be developed in a way that also allows for affordable access.
Health equity in economic and trade policies
Much has been said in the media about the health innovation and access to medicines impact of the recent decision of the Indian Supreme Court (SC) in the Novartis case. But there are broader implications, argues the author of this article. The ruling is also a revealing tale about the changing role of developing countries in the global intellectual property landscape and the growing influence of the judiciary in these countries in the implementation of international intellectual property rules. The worldwide attention received by the Indian SC ruling and its global implications could represent a turning point, as the Novartis judgment marks the first time that a decision by a judicial authority from a developing country in the area of intellectual property has been so closely scrutinised and so extensively commented upon internationally. The Novartis decision might be spearheading a world where judicial decisions from countries such as China, India and Brazil have an increasing global reach and contribute to shaping global approaches to intellectual property. It is also more generally reflective of the growing assertiveness of developing countries, particularly emerging economies, in the current global intellectual property landscape. However, the author cautions that only the future will tell us is if such a choice is ‘exceptional’ as it touches the highly sensitive issue of drugs affordability – which is of great political and social concern in India – or if it is signalling a broader trend.
The request by least developed countries (LDCs) to push back the date on which they would have to enforce intellectual property rules under the World Trade Organisation (WTO) is the subject of ongoing informal consultations between delegations, as the deadline is fast approaching. Particularly at stake is the time period of the extension, which developed countries would prefer to be limited. Although a large consensus has emerged to grant an extension to LDCs for complying with TRIPS, developed countries voiced their preference for a time-limited extension at the WTO’s March 2013 meeting. Another problem for developing countries is the so-called “no roll-back clause,” which seeks to ensure that if LDCs have granted intellectual property protection to some products, they cannot go back on this decision. LDCs consider this clause as a hindrance to their ability to use policy space. A delegate from an LDC country said that it is important that the extension be awarded as long as a country remains an LDC because many LDCs do not have a technological base. Without that technological base, LDCs would not be able to benefit from intellectual property protection, which might actually hinder their development.
South Africa plans to overhaul its intellectual property laws to improve access to cheaper medicines by making it harder for pharmaceutical firms to register and roll-over patents for drugs, according to the Department of Trade and Industry (DTI). Central to the reforms is closing a loophole known as "ever-greening", whereby drug companies slightly modify an existing drug whose patent is about to expire and then claim it is a new drug, thereby extending its patent protection and their profits. If approved by parliament, the changes should mean cheaper medication for cancer and HIV and AIDS in South Africa. DTI said its policy position was to ensure a strong system that will not grant easy patents, arguing that granting easy patents would open the door for extensions on the original patent. South Africa's position was supported this month by a ruling from India's top court that dismissed an application by Swiss drugmaker Novartis to win patent protection for its Glivec cancer drug. Lobby groups such as Doctors Without Borders (MSF) want South Africa to follow India's example and add a specific clause preventing companies from gaining patents on existing drugs, in a move that would help generic drug manufacturers.
With the support of the Government of South Africa, the World Economic Forum on Africa was held in Cape Town, South Africa, from 8 to 10 May. Over 1,000 participants from more than 80 countries took part. Under the theme ‘Delivering on Africa’s Promise’, the meeting’s agenda integrated three pillars: accelerating economic diversification; boosting strategic infrastructure; and unlocking Africa’s talent. The main message to emerge from the event was the need for investment to consolidate and make more inclusive recent African growth. Participants called for greater regional integration, as well as investments in social entrepreneurship and industry to promote inclusive growth and fight poverty, while others argued that Africa needs to offer better enabling environments for industrialisation to capitalise on opportunities, like the fact that China’s workforce will shed 85 million jobs in the near term. Another participant said that leaders needed to realise that Africa’s true wealth lay in its people, not in its mineral deposits.
What influence, if any, do the BRICS (Brazil, India, Russia, China and South Africa) wield in global health, and, if they do wield influence, how has that influence been conceptualised and recorded in the literature? To answer these questions, researchers conducted a systematic international literature review, finding 887 documents, of which only seven met inclusion criteria and only one provided sustained analysis of the BRICS’ collective influence; the overwhelming tendency was to describe individual BRICS countries’ influence. Although influence was predominantly framed by BRICS countries’ material capability, there were examples of institutional and ideological influence, particularly from Brazil. Individual BRICS countries were primarily ‘opportunity seekers’ and regional mobilisers but with potential to become ‘issue leaders’ and regional organisers. Whilst it may still be too early for newly emerging economies in global health to have matured, the authors argue that there is scope to further develop the concept of influence in global health and to better understand the working of groups of countries such as BRICS. The BRICS have made a number of important commitments towards reforming global health, but they need to start putting those collective commitments into action, the authors conclude.
What can we do collectively to tackle inequality? The author of this article argues that first we need to ensure that governments are providing proper support to the livelihoods of poor men and women. At present, governments are a very long way from knowing if the money that they are spending on economic development is having an impact on poor entrepreneurs. Second, we need to ensure that the rules of the game governing our economies are not stacked against the poorest, resulting in distorted and unfair markets. These issues need to be addressed collectively by governments and included in an international setting. For example, taxing companies that operate across borders requires governments in different tax jurisdictions to cooperate. However, on these difficult, structural issues, promising first steps have been made. George Osborne led the call for a crack-down on tax-dodging multinationals at a G20 meeting last month, while in 2012 governments agreed to rethink investment rules at a United Nations conference in Doha.
According to this article, the BRICS Durban summit in March 2013 marks the point at which the five BRICS powers have carved up the African continent with one common objective: efficient resource extraction through export-oriented infrastructure. The new ‘BRICS Bank’ has cost US$50 billion in start-up capital and comes nine months after $75 billion was wasted by the BRICS powers by bailing out the International Monetary Fund in a manner that shrunk both Africa’s voting share and prospects for world economic recovery. BRICS countries aimed to set up a ‘Bank of the South’. This was dreamt of by the late Hugo Chavez although repeatedly sabotaged by more conservative Brasilia bureaucrats and opposed by Pretoria. the author asks, however, whether this will be any different than Washington’s twin banks? He argues that it will not, if one considers South Africa’s precedent, the Development Bank of Southern Africa (DBSA), which lost R370 million ($41 million) in 2012, promoted privatisation of water and toll roads, and turned a blind eye to construction industry collusion. The author warns that Africa could become an even more violent battleground for conflicts between BRICS firms intent on oil, gas and minerals extraction.
In this article, the author considers why the Economic Partnership Agreement (EPA) negotiations between the European Union (EU) and the African, Caribbean and Pacific (ACP) countries have reached a ‘technical’ stalemate. He proposes three reasons: the configuration of the regions and the great difficulty of states to agree on common interests; the sometimes aggressive nature of European demands; and the evolution of the Europe-Africa partnership in the context of global geopolitical changes. Least-developed countries in Africa already enjoy a number of trade-related flexibilities and advantages and stand nothing to gain from the EPAs, which may explain their reluctance to sign the agreements, the author argues. At the same time, major trading powers are engaged in a low-level trade war aimed at implanting themselves in Africa or consolidating positions they have already acquired. Africa may have understood that such a development could be beneficial provided that it puts into place good policies and strategies, and develops appropriate partnerships. In addition, the emergence of Southern trading powers has widened Africa’s policy space. This could explain the continent’s cautious approach to the trade liberalisation required by the EPAs. The author concludes that the solutions that could unblock the stalemate are no longer technical but political in nature.
In this open letter to the Minister of Justice, Ugandan civil society organisations (CSOs) working in areas of intellectual property (IP) and access to medicines argue that the country’s intellectual property (IP) Bill does not make full and maximum use of the TRIPS flexibilities and therefore poses a threat to public health. Almost 90% of drugs in Uganda are imports, most of which are generic versions that need protection from patent owners who may want to stop their sale in a bid to sell their expensive brand name drugs instead; this would be a disadvantage to Ugandans as they will not be able to access cheap drugs. The CSOs call on government to reaffirm its 2001 Doha commitment to ensure that the TRIPS Agreement does not and should not prevent World Trade Organisation members like Uganda from taking measures to protect public health. The Industrial Properties Bill should take maximum advantage of the flexibilities detailed under the TRIPS Agreement and as provided by the Doha Declaration.