COLUMN: High drug costs leave human lives out of plan

by Mari Armstrong-Hough

U-Wire

Drugs are expensive. Developing countries need drugs not only to address raging HIV/AIDS epidemics, but also to fight epidemics of malaria, tuberculosis, and various childhood diseases. But, forced by international intellectual property rights agreements to allow major commercial pharmaceutical corporations exclusive production rights, the cost of those drugs can make them unavailable.

Intellectual property and patent law is governed by the Trade Related Intellectual Property Rights Agreement, signed by World Trade Organization member nations in 1994. TRIPS requires member nations to grant 20 years of exclusive production rights to the patent-holding pharmaceutical corporations, preventing generic competitors from alternatives. This is primarily intended to protect the pharmaceutical corporations that incur enormous costs in the research and development of new drugs from direct competition with generic producers that contribute no such research into new drugs. But for poor nations facing multiple public health crises, the cost of commercial pharmaceuticals can make decent health care inaccessible to the people who need it most desperately.

Nations as well as corporations are supposed to be protected under the TRIPS agreement, chiefly by two articles concerning a government's responsibility to public health. Article 8 allows governments to override the TRIPS requirements in the interest of public health, and Article 31 allows government override in the case of a public health crisis. In both cases, nations are permitted to create generic markets by issuing "compulsory licenses." Issuing these licenses can significantly lower drug costs by creating competition and because actual production costs for drugs are generally low.

For many developing governments, this seems the most obvious solution to the exorbitant healthcare costs that prevent huge portions of their populations from living healthily-or continuing to live at all. Generic drugs would bring the cost of treatment closer to the actual cost of production, allowing more people to be treated. Arguably, most developing countries exist in a constant public health crisis meeting the standard set by Article 1 of the TRIPS agreement.

But a variety of pressures on the governments of these countries have prevented them from claiming the protections granted to them under the TRIPS agreement even while the pharmaceutical corporations have engineered their own continued profit. The idea was for these companies to sign agreements with poor governments in which the company agreed to provide select and limited low-cost drugs and the government agreed to essentially give up its rights under TRIPS to override patents and make generic alternatives available. Pharmaceutical companies were supposed to provide discounts on drugs without generic competitors.

Not only has the Accelerating Access initiative not provided the plentitude of cheap medicine a generic market would nearly guarantee, it has almost totally failed to alleviate inaccessibility while preventing governments from exploring generic options. According to ACT UP Paris, in the two-year lifespan of the program, "Accelerating Access has only resulted in getting an additional 0.1 percent of people with AIDS on treatment."

Leaving the burden of increasing access largely in the hands of profit-making corporations is both illogical and unrealistic.