Opinion in the Hamilton Spectator
February 3, 2011
Generic-drug ‘solution’ for Africa not needed
Prices and patents are not the issue in getting medicines to people in developing countries
Although it is commendable that Canadian Parliamentarians wish to do their part in saving lives around the world, private member’s Bill C-393, being debated in the House of Commons, is not the route to follow.
Bill C-393 seeks to amend Canada’s Access to Medicines Regime (CAMR) passed in 2004 that allows generic drug manufacturers to be granted a “compulsory licence” to manufacture and export a generic version of a brand-name drug to a developing country facing an emergency public health situation. The proposed amendment would grant the generic companies a “one-licence solution” that would allow a generic manufacturer, once licensed under this regime, to export any patented drug to any country already on the respective CAMR lists.
But a “solution” to what? Almost all of the essential medicines, as defined by the World Health Organization, are off-patent already. The ones remaining on patent are often supplied by the patent-holding company at little or no cost to poor countries — usually well below generic prices.
CAMR has been used only once, by Rwanda, to treat 21,000 AIDS patients. The federal government has stated the shipments to Rwanda took longer than expected because the generic manufacturer seeking a compulsory licence needed time to find an interested importing country, as well as on account of Rwanda’s procurement procedures.
In October of this year, The Cameron Institute released its 200-page, fact-based report, Pharmaceutical Access in Least Developed Countries: on-the-ground barriers and industry successes. It concluded the research-based pharmaceutical industry — through 150 different public-private partnerships that focus on “voluntary licensing” of drugs and sustainable capacity building — has invested $8.5 billion US to provide 9.5 billion doses and drug treatments to almost one billion patients in 50 least developed countries. They have also trained and supported 350,000 doctors, nurses and other health professionals in those countries.
The report also concluded the major barriers to access to medicines in the least developed world are neither prices nor patents. Instead, the on-the-ground obstacles include market failure, corruption, insufficient health personnel, lack of infrastructure such as potable water and roads and the lack of political will to bring change to these desperate countries. Even Uganda’s president, Yoweri Museveni, who presided over the world’s largest reduction in HIV/AIDS prevalence, has declared the whole argument against patents is a red herring perpetrated by vested interests.
Last fall, a lobby group called the Grandmothers to Grandmothers Campaign issued a two-page document to MPs that supports the proposed changes to CAMR. Now, the Hamilton-Burlington area’s Grandmothers of Steel are in the picture also supporting the NDP’s desire for a “one-licence solution.”
They claim the failure of the world to use CAMR means Canada has not fulfilled its pledge to the world. But it has been the world that has decided not to use CAMR.
The Canadian government and Canada’s research-based pharmaceutical industry have been leaders in improving access to needed medicines around the world without CAMR. In the past decade alone, research-based pharmaceutical firms operating in Canada have discovered four generations of medicines to treat HIV/AIDS and have worked in partnership with more than 25 international aid programs to build clinics, train health professionals, improve women’s and children’s health and donate medicines and vaccines throughout the developing world.
Today, Canada is focusing more on bilateral aid for countries that have demonstrated they can use it effectively and get positive results. The same approach needs to be taken when improving access to medicines to make sure the drugs get to where they need to be, rather than detoured into black markets.
By targeting its scarce resources, Canada, along with its partners, has reduced the percentage of the world’s population living in extreme poverty from 33 per cent to 19 per cent. Infant mortality has been reduced by 20 per cent in 11 West African countries, largely due to immunizations supplied by research-based pharmaceutical companies. Over the past decade, there has been a 12-fold increase in those receiving treatment for HIV/AIDS. All without CAMR.
Innovation doesn’t come free. If you take away the incentive for companies to invest billions in research, there will be fewer new products developed to fight malaria, tuberculosis and dengue fever that can save millions of lives in developing countries. Generic drug companies do not research and develop new drugs; their revenues only go to themselves.
The research-based pharmaceutical industry invests more than any other industry and many countries in innovation — innovation that saves lives both here and in the poorest of countries because they partner with others to make it so.
D. Wayne Taylor is a professor of health services management in the DeGroote School of Business at McMaster University. In 1986, he was appointed the first director of the health services management program at McMaster and served in that position until a year ago. He is also executive director of The Cameron Institute, an alternative, not-for-profit, public policy think-tank specializing in the independent study of current health, social and economic issues in Canada and internationally.
(Source: The Hamilton Spectator)