[Ip-health] MSF Op-ed - Dear Prime Minister Modi: Stand Firm for Affordable Medicines

Judit Rius Judit.Rius at newyork.msf.org
Fri Sep 26 09:11:53 PDT 2014

Dear all,

Please find below op-ed just published in Foreign Policy by Mrs. Meena 
Narula Ahamed and Dr. Unni Karunakara from Medecins Sans 
Frontieres/Doctors Without Borders (MSF) on occasion of Indian Prime 
Minister Modi first visit to the United States. 

Thank you for sharing broadly




Dear Prime Minister Modi: Stand Firm for Affordable Medicines
BYMeena Narula Ahamed, Unni Karunakara 
SEPTEMBER 26, 2014

As Prime Minister Narendra Modi makes his first official visit to the 
United States, one issue at the top of the trade agenda is the strikingly 
different approaches of the Indian and U.S. governments toward 
intellectual property for medicines, particularly when patented 
life-saving medicines are priced out of reach of patients. 

As the ‘pharmacy of the developing world’, India plays an immensely 
important role in supplying affordable medicines to people worldwide. 
These include many patients treated in Doctors Without Borders/Medecins 
Sans Frontieres (MSF) medical projects in more than 60 countries, 
including India. 

But for years, India has faced a barrage of criticism and pressure from 
the United States and the European Union, multinational pharmaceutical 
firms, and their lobbyists over its progressive intellectual property 
policies. In the United States, India is the target of unwarranted and 
purposely misleading claims of unfair intellectual property laws and is 
accused of not “playing by the rules.” The U.S. Trade Representative 
placed India on its Special 301 Trade list, a blacklist of countries whose 
laws and actions do not comport with U.S. interests on intellectual 
property, particularly those of the U.S. pharmaceutical industry. 
Congressional hearings and an International Trade Commission (ITC) 
investigation have also taken aim at India’s policies. 

In actual fact, India’s laws were changed in 2005 to comply with the World 
Trade Organization’s mandates for pharmaceutical patenting, and over the 
past decade India has granted an increasing number of patents on 

So why is the U.S. pharmaceutical industry crying foul over India's 
policies? It stems from the fact that India has a law that limits the 
granting of secondary and unnecessary patents. This means that companies 
are not granted patents for obvious modifications of existing products; 
however, companies are granted patents for truly new medicines. 

In the United States, it is standard practice for pharmaceutical companies 
to file for and obtain multiple patents relating to different aspects of 
the same medicine. It is a way to extend patent protection and block 
generic competition. 

After existing asthma medicines were allowed to be re-patented with 
slightly modified inhalers, generic asthma inhalers disappeared from the 
U.S. market. Protected by extended patent terms, asthma inhaler 
patent-holders in the United States now charge exponentially higher prices 
and have kept generic competitors out of the market long after the patent 
on the original medicine expired. 

For more than seven years, Novartis fought India’s safeguard against 
secondary patenting in court over one of its existing cancer drugs. 
Novartis took the case to the Indian Supreme Court and lost. 

In 2012, for the first time, India issued a so-called ‘compulsory license’ 
– when a government overrides a patent monopoly to make medicines 
available to meet a public health need. This measure is used to jumpstart 
generic production and allows generic manufacturers to enter the market by 
paying a set royalty fee to the patent-holder. India’s compulsory license 
authorized marketing of a more affordable version of a liver and kidney 
cancer medication that Bayer was selling for $6000 per month in India; 
generics are now available for less than $200 per month. 

To understand what is at stake, think back to the 1990s, when first-line 
medicines for HIV/AIDS cost more than $10,000 per patient per year. While 
many AIDS patients in the United States and Europe were coming back to 
life thanks to antiretrovirals, people in developing countries where MSF 
works continued to die simply because they, or their governments, were 
unable to afford the price of treatment. 

The Indian generic industry stepped up, offering to produce the same 
first-line medicines for $1 a day. Today, 11 million people are on HIV 
treatment in developing countries, with around 90% of medicines sourced in 
India. Broad access to affordable HIV medicines has enabled an 
unprecedented global response to a disease that once seemed completely 

India’s patent law and practices are favorable to public health, were put 
in place through a democratic legislative process, and are in line with 
international trade and intellectual property rules. Every country has the 
right to set policies that balance private business interests with public 
health needs. 

India has forged a fair and progressive path in this arena that is 
influencing its BRICS peers and other developing countries. South Africa 
and Brazil are looking to reform their patent systems to encourage public 
health-driven innovation and discourage patent abuse. Prime Minister Modi 
should reject any attempts to turn India back from this path. 

Beyond this, MSF sees the need for a bold new vision for biomedical 
innovation where open access to scientific knowledge is promoted and where 
research and development (R&D) investments are not linked to the price of 
products, thereby making medicines affordable for all who need them. India 
can show even greater leadership by supporting proposals being considered 
at the World Health Organization and other national and regional forums to 
implement new models for medical innovation. Funding for medical R&D, as 
well as vision, leadership and the right policies, are needed to transform 
these proposals into action. 

We urge the prime minister to stand firm in upholding India’s intellectual 
property policies, which are in line with international trade and 
intellectual property rules and which are the foundation of India’s 
vitally important role in global health. 

As a medical humanitarian organization that relies heavily on affordable 
high quality medicines produced in India, we have seen firsthand the 
lifesaving role that Indian laws and policies have played over the past 
decade. We implore Prime Minister Modi to continue India’s leadership in 
global health, innovation and access to medicines, by not only playing by 
the rules but also by challenging them and changing the innovation system 
so it better serves public health needs. 

Meenakshi Narula Ahamed is a trustee of MSF India and is a member of 
MSF-USA’s Board of Advisors. Unni Karunakara is a trustee of MSF India and 
is the former international president of MSF. 

Judit Rius Sanjuan
U.S. Manager & Legal Policy Adviser, Access Campaign
Medecins Sans Frontieres/ Doctors Without Borders (MSF)
333 7th Avenue, 2nd Floor
New York, NY 10001 USA
Office: +1 212 655 3762 // Mobile: +1 917 331 9077
Email: judit.rius at newyork.msf.org // Twitter: juditrius

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