India’s Intellectual Property Appellate Board has upheld the country’s first compulsory licence on a pharmaceutical product. The much-awaited verdict upholds the compulsory licence issued to Hyderabad-based Natco Pharma Ltd, an Indian generic drug manufacturer, which sells a much cheaper version of German pharmaceutical company Bayer AG’s kidney and liver cancer drug Nexavar in the market. The judge cited affordability and product access as the reasons for the decision to dismiss Bayer’s appeal against the compulsory licence (CL). The decision means that the way has been paved for compulsory licences to be issued on other drugs, now patented in India and priced out of affordable reach, to be produced by generic companies and sold at a fraction of the price. In response to the decision, Médecins Sans Frontières expressed hope that, in the near future, compulsory licences will be issued for the newest drugs to treat HIV and affordable generic versions will be available not only in India, but in the rest of the developing world. Bayer has announced it will appeal the decision.
Health equity in economic and trade policies
The focus of this book is on advancing innovation in medical and health technologies and ensuring that the people who need these technologies can access them, arguing that policies on these issues have to be viewed together in order to make real progress. The book describes the options available for policies involving health, intellectual property and trade, and reviews the latest developments in the three organisations that co-produced the book, seeking new ways for the three organisations to reinforce each other, ultimately to meet objectives such as the right to health and the Millennium Development Goals. It looks at ways to tailor systems so that innovation is encouraged, yielding new treatments for the diseases of the poor, and how to ensure sustainable and equitable access to these innovations. The book argues that private sector-led competition policy is the way forward on the basis that it can promote innovation, and improve access to medicines, provided that transparent and non-discriminatory procurement procedures are followed.
In this article, the author argues that the global intellectual property (IP) system cannot be seen as blind to basic concepts of social justice, proportionality and common humanity or it will lose legitimacy. This is why it is wrong to force less-developed countries (LDCs) to implement TRIPS fully based upon a timetable that disregards their public health needs. If they are forced to do this, the world’s poorest will end up paying the richest for medicine and other essential technologies, which will cast an unethical shadow over IP rights. IP is already abused by that kind of rent-seeking in some sectors – and has been for some time – and the actions of a relative few have damaged the interests of the rest. But the author believes this is an opportunity for this unspoken majority to make clear that the actions of a relative few aren’t the norm, but the exception. The LDCs’ proposal is an opportunity for all concerned with IP to recapture legitimacy. For companies that take their corporate social responsibility (CSR) seriously and have active CSR programmes, the author urges them to support the LDC extension as not only the ethical thing to do but also as a way for them to gain good publicity at no cost.
In recent years, several innovators in high-tech sectors have complained that the large volume of vague patents has become a major barrier to innovation. When start-ups attempt to unveil a new product, they risk violating a broad, obscure patent. In this paper, the authors argue to abolish the American patent system on the basis that there is no evidence patents improve productivity and that they have a negative effect on innovation. The paper's authors point out that problems with patents in fact run much deeper than many critics of the recent system have emphasised. The historical and international evidence suggests that the initial eruption of innovations leading to the creation of a new industry is seldom, if ever, born out of patent protection and is instead the fruit of a competitive environment. They also argue that the patent system is endangering public health by raising the cost of prescription drugs, while failing to generate enough innovative new treatments for life-saving diseases. The aim of policy, in general, should be that of slowly but surely decreasing the strength of intellectual property interventions with the final goal of abolition.
In this article, the author argues that migration has a role to play in inclusive development and addressing the Millennium Development Goals (MDGs) for poverty, gender equity and health. Remittances sent to family back home usually help to cover the daily consumption needs, which helps to reduce poverty and hunger. Remittances are, in addition, often invested in health, education and accommodation. Such investments often come with important impacts on the MDGs linked to education and health, particularly where women decide on the use of remittances. Sectors with critical skills shortages can benefit from the transfer of skills through circular migration and return (so-called ‘brain gain’ and ‘brain circulation’). The migration experience can empower women, both as individuals and as a group, by helping them to enter the labour market and earn higher incomes. The transfer of values and ideas brought about by migration (so-called ‘social remittances’) may also facilitate the gender equity goals of the MDGs.
On 26 February 2013, the World Health Organisation (WHO), the World Trade Organisation (WTO) and the World Intellectual Property Organisation (WIPO) presented their trilateral publication ‘Promoting Access to Medical Technologies and Innovation’ to the WIPO Standing Committee on the Law of Patents (included in last month’s newsletter). Promoted by the three organisations as ‘neutral’ and ‘informative’, the report came in for criticism from delegates from developing countries. On behalf of the Africa Group, Algeria said that while the study recognises that there are some limitations to the use of patent flexibilities, it does not look at the constraints developing countries encounter when using the flexibilities. Furthermore, many African countries lacked resources to meet all the formal requirements needed to implement flexibilities. Algeria highlighted the African and Developing Agenda Group (DAG) joint proposal on a patents and health work programme, which calls for further research, information exchange and technical assistance for least-developed countries (LDCs). Delegates from India and Brazil also called for further research into TRIPS flexibilities, arguing that the report had not done enough in this regard.
An estimated 0.5 to 1.5 million informal miners, of whom 30-50% are women, rely on artisanal mining for their livelihood in Tanzania, and are exposed daily to mercury and arsenic. The primary objective of this study was to assess community risk knowledge and perception of potential mercury and arsenic toxicity in Rwamagasa in northwestern Tanzania, an area with a long history of artisanal gold mining. A total of 160 individuals over 18 years of age completed a structured interview. These interviews revealed wide variations in knowledge and risk perceptions concerning mercury and arsenic exposure, with 40.6% and 89.4% not aware of the health effects of mercury and arsenic exposure respectively. Males were significantly more knowledgeable (36.9%) than females (22.5%) with regard to mercury poisoning. An individual’s occupation category was associated with level of knowledge, and individuals involved in mining (73.2%) were more knowledgeable about the negative health effects of mercury than individuals in other occupations. Of the few individuals (10.6%) who knew about arsenic toxicity, most (58.8%) were miners. Overall lack of knowledge, combined with minimal environmental monitoring and controlled waste management practices, highlights the need for health education, surveillance, and policy changes, the authors conclude.
The African Union (AU) has announced it will proceed with the establishment of a Pan-African Intellectual Property Office (PAIPO), despite misgivings from civil society and development economists about the potential impact on local economies. There is currently no intellectual property (IP) office for Africa. The AU has requested a meeting of all stakeholders dealing with intellectual property before the May 2013 AU Summit. According to the author of this article, public information is difficult to obtain from the African Union, and nothing further is known at this time. He argues that signing up to the global IP system, in which nearly all of the IP rights are owned by non-African entities, clashes with the development objectives of the African Union, which are to promote African sovereignty and equitable development.
Low fruit and vegetable consumption is an important contributor to the global burden of disease. In the wake of the United Nations High-level Meeting on Non-Communicable Diseases (NCDs), held in September 2011, a rise in the consumption of fruits and vegetables is foreseeable and this increased demand will have to be met through improved supply. The World Health Organisation, the Food and Agriculture Organisation and the World Bank have highlighted the potential for developing countries to benefit nutritionally and economically from the increased production and export of fruit and vegetables. Aid for Trade, launched in 2005 as an initiative designed to link development aid and trade holistically, offers an opportunity for the health and trade sectors to work jointly to enhance health and development. It is one of the few sources of aid for development that is stable and experiencing growth, according to this paper. At present the health sector has very little input into how Aid for Trade funds are allocated. This is an opportune moment to investigate opportunities for collaboration, since more than half of the reporting external funders are planning to revise their Aid for Trade strategies in 2013. Health departments should make central planning and finance departments aware of the potential health and economic benefits, for both developed and developing countries, of directing Aid for Trade to fresh produce markets.
The 2012/13 edition of the Global Wage Report looks at the macroeconomic effects of wages, and in particular at how current trends are linked to equitable growth. Among the major findings of the report are that the gap between wage growth and labour productivity growth is widening, the difference between the top and bottom earners is increasing, and the labour income share is declining. Workers are receiving a smaller slice of the economic pie than before. These worrying changes affect the key components of aggregate demand – particularly consumption, investment and net exports – that are necessary for recovery and growth. The report looks at the reasons for these trends, which range from the increasing financial and trade globalization to advances in technology and the decline in the power of trade unions and reduced union density. Raising average labour productivity remains a key challenge which must involve efforts to raise the level of education and the capabilities that are required for productive transformation and economic development. The development of well-designed social protection systems would allow workers and their families to reduce the amounts of precautionary savings, to invest in the education of their children, and to contribute towards stronger domestic consumption demand and raise living standards. The report calls for internal and external “rebalancing” to achieve more socially and economically sustainable outcomes within and across countries, proposing policy actions beyond labour markets and national borders.