[Ip-health] VICE: Surprise! Big Pharma Don't Want Developing Countries Having Access to Cheap Medicine

Joanna Keenan-Siciliano joanna.l.keenan at gmail.com
Fri Oct 25 06:00:19 PDT 2013

Surprise! Big Pharma Don't Want Developing Countries Having Access to Cheap
By Joseph Cox

Compared to a number of other nations, India has done an incredible job of
keeping medicine cheap enough that its citizens can afford to buy whatever
it is that they need. Most importantly, it avoids handing out patents for
drugs unless they're completely new or have some sort of therapeutic
advantage over already-available treatments, meaning that the vast majority
of life-saving medicines are free to be replicated and sold by any company
that wishes to do so.

For example, in 2012, German Big Pharma company Bayer were charging $4,500
(£2,780) per month for a kidney and liver cancer medicine. Deeming that a
little too pricey in a country where the average yearly wage is around a
quarter of that number, the Indian government granted a license to
manufacturer Natco to produce a generic alternative to the branded
medicine, as long as they paid some royalties to Bayer. As a result, the
price of the medicine decreased by a massive 97 percent.

However, aggressive lobbying from US pharmaceutical companies is set to
change all that. America's pharmaceutical plutocrats are attempting to
revise intellectual property laws in India, meaning that many people
seeking treatment will be forced to buy expensive US imports instead of
domestically produced replicas. Which obviously isn't great news for the
96.9 percent of citizens living with less than $5 (£3) a day.

In most drug-producing countries that aren't India, once a drug has been
developed and a first patent filed and granted, pharmaceutical companies
then engage in a practice called "evergreening". That practice basically
involves undermining access to affordable medicines by using a variety of
tactics to extend the company's monopoly on the drug past its initial
20-year patent period. By obtaining multiple secondary patents, often for
trivial modifications to the original, companies are able to protect their
product for decades, preventing production of cheaper generic replicas.

Because Indian patent law forbids evergreening, the country's generic
pharmaceutical companies have been able to produce affordable versions of
foreign medicines to suit their nation's income. But it's that law that's
coming under pressure from the US government and international drug
companies, with both institutions wanting India to allow evergreening,
therefore further tightening the companies' grasp on drug monopolies. That,
of course, means that low-cost generic medicines will simply disappear,
leaving India's sick the choice of whether to submit to severe poverty in
order to raise the cash for US imports, or forego treatment altogether.
Either way, India loses.

And it's just not those needing medical treatment in India who should be
worried about the lobbying. India has been referred to as "the pharmacy of
the developing world", exporting more than half of its generic medicine to
the world's poorest countries every year. And the exports include more than
just paracetamol and basic painkillers; the Indian pharmaceutical industry
produces treatments for life-threatening diseases, like hepatitis C and HIV
– treatments that the countries importing them don't have the resources to
make themselves.

In fact, speaking to Rohit Malpani from Médecins Sans Frontières (an
organisation that relies heavily on affordable generic drugs), he stressed
that even a tiny alteration in the law "would have enormous impacts on
public health systems in sub-Saharan Africa, Latin America and Southeast

The crushing irony of the whole thing is that the vast majority of
medicines taken in the US – and those distributed by US aid programmes –
are of the generic variety, many of which are developed by Indian
manufacturers. So that's Indians, US aid agencies, Médecins Sans
Frontières, the world's poor and vulnerable and US citizens that US
pharmaceutical companies could be screwing over with the proposed change in

According to the letter sent to President Obama that outlines the proposals
to force India into buying American-made medicine, Representatives Erik
Paulsen, John Larson and 170 other members of Congress are "deeply
concerned about the growing trade imbalance between the United States and
India". The lobbyists claim that India is "harming" US industry by
"jeopardising jobs and innovation here at home" and having "a negative
impact on […] investment in the United States".

You'd been forgiven for thinking that these were the words of a right-wing
venture capitalist with no ability to value human life over the prospect of
making a little more money. But Rohit pointed out that the support is
"decidedly non-partisan", saying that "we don't see any empathy or
understanding of the measures that the Indian government or other
governments are taking to ensure affordable medicine prices. In some ways,
we often see very little space between the approaches of either political

Paulsen and his patriotic friends are also worried that other countries may
take up India's abhorrent stance on producing medicine domestically for the
benefit of its own people and join the attack on America's economy, because
"[India] is a thought leader among emerging countries".

The justification the lobbyists have provided for their attack is that the
Indian government's attitude towards producing affordable alternatives is
illegal – that they're breaking intellectual property laws by replicating
branded drugs. However, Rohit told me that "every sort of impartial legal
expert has validated India's measures as being consistent with global trade

Rather than just take Rohit’s word for it, I consulted a report from the
World Health Organisation (WHO). The report explained that member states
should "consider, whenever necessary, adapting national legislation in
order to use to the full the flexibilities contained in the Agreement on
Trade-Related Aspects of Intellectual Property Rights". These flexibilities
in the law include compulsory licenses, just like the one awarded to Natco
to produce a cheaper alternative to the kidney and liver cancer medication
that Bayer were trying to peddle for almost 100 times more.

After approaching Pfizer – one of the main pharmaceutical companies behind
the lobbying – and being bounced between multiple media departments, I
wasn't provided any comment. Instead, I was forwarded testimony that Chief
Intellectual Property Counsel Roy Waldron delivered to the House of
Representatives back in June. He stated that India's actions lower their
ability to "provide faster access to life-saving medicines", and that the
country was a "hostile innovation and investment environment".

Which basically translates to: "Because Indians have made their own
medicine that people there can actually afford, nobody wants to waste
thousands of dollars on the stuff we make that does exactly the same thing.
Which is a mean and selfish thing to do to America's billionaire
pharmaceutical bosses."

After reading through Waldron's novel take on how India looking after their
sick is a direct attack on the US economy, I was kindly directed to some of
the many think-tank websites that have been set up to push the anti-India
initiative. The "Alliance for Fair Trade with India", for example – which
isn't just concerned with the pharmaceutical industry, but also technology
and other sectors – is full of incisive information detailing how India is
being "unfair" and is practising "discrimination" against US traders.

When I asked Rohit how the Indian government should go about countering all
this political pressure and PR hot air, he said they should continue doing
what they've always done, which is to "very carefully and continually
defend these measures they have taken as legal".

Continuing, Rohit said that the Indian government should collaborate with
other pressured countries to fight back, and emphasised how crucial it is
that the government spreads "knowledge and understanding amongst people in
the country, [so they] understand how these very technical changes to the
patent law will have an impact on their lives, as well as the lives of

If Paulsen and the other Congressmen get their way, it would undoubtedly
sound the death knell for the generic medicine trade in general. Which
wouldn't only affect those in India and the rest of the developing world,
but countless others around the globe; as Dr Margaret Chan, Director
General of the World Health Organisation, said earlier this year: "The
costs of many new medical products are becoming unsustainable for even the
wealthiest countries in the world. [Of the 12 cancer drugs approved last
year], 11 were priced above the $100,000 per patient per year. This price
is unaffordable, for most patients, most health budgets and most insurance
companies. These are problems for all countries, not just the developing

Joanna Keenan
Press Officer
Médecins Sans Frontières - Access Campaign
P: +41 22 849 87 45
M: +41 79 203 13 02
E: joanna.keenan[at]geneva.msf.org
T: twitter.com/joanna_keenan


More information about the Ip-health mailing list