Oxfam claimed this week that the high cost of medicines is caused by tough intellectual property rules and that this is why most people in the poorest countries have no access to drugs. The facts are wrong and divert attention from the bigger truth: In most countries there simply aren't enough nurses, doctors and clinics to administer to the sick.
It is not surprising, however, that the price of medicines should become the focus of debate. After all, who wants to hand over large sums of hard-earned cash to pay for expensive drugs when, in theory, they only cost a few cents to make in a factory? Surely by weakening patents the government would reduce drug prices, thereby increasing access to medicines for all?
Taken at face value, the answer would seem to be yes. But look a little deeper and you will find that intellectual property and the price of medicines is largely irrelevant in the face of the other major factors that affect a nation's health.
Take the example of India. Since 1975, it has weakened intellectual property laws in the belief that it would drive down the price of medicines. It certainly did that for some drugs, but did it make the Indian people any healthier?
The answer is no.
Access to even basic medicines in India remains unacceptably low. Children go without routine vaccinations. Simple off-patent anti-infectives are out of reach of the majority of the rural poor. Despite pumping out cheap generic AIDS drugs for years, a paltry 12,000 of India's 5 million AIDS sufferers were receiving the drugs at the end of last year.
For the Indian poor, the price of drugs is not the issue. The real issue is the state of their healthcare infrastructure.
The government-run system is a shambles, riddled with inefficiency and corruption and beset by a lack of resources. The transport network is so bad that rural people struggle to get to a clinic, even if one exists within 1,500km of their home. Meanwhile, dirty water and cooking fuels exact a terrible toll of disease on the poor.
So, when the Indian government decided last year to strengthen its intellectual property laws in order to accelerate India's economic development, it was able to do so because the people did not see a connection between arcane patent laws and the reality of their lives.
What they want are hospitals, clinics, doctors and nurses. Without these things, you can give drugs away for free and they still won't get to the most needy.
The Indian voters understood this -- and the prices of medicines have not shot up, despite activists' forecasts.
There are similarities with many other countries. In the Philippines, 40 percent of people will never see a doctor in their entire lives. Clinics and hospitals are rare. PhilHealth, the government-run social insurance scheme, provides very basic cover for only around half of the population.
The exodus of healthcare workers to better opportunities overseas has reached such high levels that last year the Filipino Alliance of Healthcare Workers warned that the healthcare system faces "imminent collapse."
This is compounded by counterproductive policies. Last year, the Philippines increased VAT on medicines from 10 to 12 percent and -- incredibly -- made previously exempt things like doctors' fees subject to VAT. This amounts to little more than a tax on the sick and dying.
The Philippines is not unique. Most countries in Africa, and many in Asia and Latin America have dysfunctional health systems, a lack of health insurance and regressive taxes on medical goods and services.
As a result of these failures of governance, less than 50 percent of people have regular access to essential medicines in some parts of Africa and Asia.
In the end, it is the patients who are suffering from the current fixation with patents and prices. It is taking energy and discussion away from the things that reall?y matter, such as infrastructure, doctors and nurses. Unless these things are made more widely available, people will go on dying from easily preventable diseases.
As for prices, out of 18 comparable AIDS drugs named by Doctors Without Borders in an attack on patents, 14 patented drugs sell below or around the cost of generics.
Last July, the head of the WHO's AIDS division said: "It is very obvious ... that the elephant in the room is not the current price of drugs. The real obstacle is the fragility of the health systems. You have health infrastructure that is dilapidated, a health workforce that is demoralized, labs that don't work, supply chains that don't exist and diagnostics that are missing."
Improving provision is not easy. But it would help if debate focused on these life-saving factors. In the face of widespread health crises, diverting energy and attention toward patents is a disservice to patients.
Philip Stevens is director of the health program at International Policy Network, a London-based development think tank.
Concerns that the US might abandon Taiwan are often overstated. While US President Donald Trump’s handling of Ukraine raised unease in Taiwan, it is crucial to recognize that Taiwan is not Ukraine. Under Trump, the US views Ukraine largely as a European problem, whereas the Indo-Pacific region remains its primary geopolitical focus. Taipei holds immense strategic value for Washington and is unlikely to be treated as a bargaining chip in US-China relations. Trump’s vision of “making America great again” would be directly undermined by any move to abandon Taiwan. Despite the rhetoric of “America First,” the Trump administration understands the necessity of
In an article published on this page on Tuesday, Kaohsiung-based journalist Julien Oeuillet wrote that “legions of people worldwide would care if a disaster occurred in South Korea or Japan, but the same people would not bat an eyelid if Taiwan disappeared.” That is quite a statement. We are constantly reading about the importance of Taiwan Semiconductor Manufacturing Co (TSMC), hailed in Taiwan as the nation’s “silicon shield” protecting it from hostile foreign forces such as the Chinese Communist Party (CCP), and so crucial to the global supply chain for semiconductors that its loss would cost the global economy US$1
US President Donald Trump’s challenge to domestic American economic-political priorities, and abroad to the global balance of power, are not a threat to the security of Taiwan. Trump’s success can go far to contain the real threat — the Chinese Communist Party’s (CCP) surge to hegemony — while offering expanded defensive opportunities for Taiwan. In a stunning affirmation of the CCP policy of “forceful reunification,” an obscene euphemism for the invasion of Taiwan and the destruction of its democracy, on March 13, 2024, the People’s Liberation Army’s (PLA) used Chinese social media platforms to show the first-time linkage of three new
Sasha B. Chhabra’s column (“Michelle Yeoh should no longer be welcome,” March 26, page 8) lamented an Instagram post by renowned actress Michelle Yeoh (楊紫瓊) about her recent visit to “Taipei, China.” It is Chhabra’s opinion that, in response to parroting Beijing’s propaganda about the status of Taiwan, Yeoh should be banned from entering this nation and her films cut off from funding by government-backed agencies, as well as disqualified from competing in the Golden Horse Awards. She and other celebrities, he wrote, must be made to understand “that there are consequences for their actions if they become political pawns of
RSS