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RECENTLY, Jeremy Corbyn, leader of the British Labour Party, caused ripples when he stressed that publicly funded research should not be farmed out to the pharmaceutical industry. Corbyn’s intervention flagged an important issue about research and development expenditures in the production of new drugs, vaccines and diagnostics. R&D is instrumental to the development and growth of new medicine and vaccines. As new diseases and infections arise at a greater pace than ever before, the need for new medicines and vaccines to overcome them has grown.
Yet, the way the current R&D regime is structured does not inspire confidence that new, effective and affordable drugs and vaccines will be developed to meet the growing public health needs of poor countries. This is why the current R&D regime has been criticised by health right activists worldwide for its obsessive concern with profit generation and exclusive patent protection rights.
High prices and exclusive patent protection rights are advanced as the rationale for recovering huge investments poured into the production of new drugs. But high R&D expenditure figures, as quoted by the pharma industry, have been challenged by health rights activists and industry insiders according to a Médecins Sans Frontières report, Lives on the Edge.
In contrast to the high cost of producing new medicines by pharma, the non-profit research initiative, Drugs for Neglected Diseases, has shown that investments in developing new treatments can be as little as $113-169 million — as opposed to the industry-supplied cost, ranging between $800m to $2.6 billion. Of the high R&D cost cited by pharma, a large chunk goes into marketing.
The state and pharma industry must invest in R&D.
The existing R&D regime is heavily geared towards producing medicines for the developed world, where high-priced medicines for long-term chronic conditions such as diabetes and hypertension can generate huge profits. In contrast, there is little investment for producing new antibiotics that are not sufficiently lucrative or for short-term use. In essence, the market for expensive cancer drugs is far more lucrative than antibiotics.
This profit-driven R&D regime has put developing countries beyond the pale of the much-hyped benefits of pharma R&D. One downside of this is apparent in the minute allocation of funds given to treatments of tropical diseases which largely affect the developing world, ie non-lucrative market. This leads to the conclusion that the current R&D model is centred more on profit than public health needs of developing countries. This is illustrated in the lack of investment for treatments of neglected diseases.
The other important issue is that of patent rights protection. Most pharmaceuticals are keen on extracting as much profit as possible from drugs produced long ago. This sustained profit stream is ensured through patent protection, which leads to monopolistic prices. Even after the current patent protection right expires, these companies go to great lengths to hold on to patent rights by demanding extensions, claiming to have made some modification to the original patent. This practice, called ‘ever-greening’, discourages not only innovation in medicine but also prohibits the production of patent-free, cheap and affordable generic medicines. The newest way to ensure lengthy patent protection is to incorporate it in new trade and investment treaties. These are being pushed through with missionary zeal by the US and Europe, prolonging patent life beyond the current 20 years’ limit. The Asia-Pacific Trade Agreement is an example.
Pakistan is doubly disadvantaged here. Not only is the country deprived of affordable generic medicines, there is very little R&D investment in new medicines and vaccines. It lacks any data on pharmaceutical R&D; in fact, Pakistan is one of only a few countries that has not shared R&D data with WHO. The government and pharma combined pour scant investment into R&D coffers. Pharmaceutical companies blame the government for not taking the lead. Yet, with extremely low health spending, expecting the government to do so is a pipe dream. Currently, funds allocated for R&D are either left unspent or diverted for other uses. There is no information on how this money is used.
On the other hand, with pharma addicted to making quick bucks from finished products or licensed drugs, there is an utter lack of institutional or collective industry vision for developing indigenous pro-people R&D strategies to develop new medicines and vaccines. Rather than utilising some part of the inflated profit windfall, the industry is constantly lobbying for official drug price increases — despite unofficial price hikes having been serially engineered over the years. For new cheap vaccines and medicine to become available to people, Pakistan’s pharma industry and the government need to devise a pro-people, pro-poor R&D regime.
The writer is a development consultant and policy analyst.
Twitter: arifazad5
Published in Dawn, August 16th, 2016
