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Doctors Without Borders to India: Protect the “pharmacy of the developing world”

Doctors Without Borders/Médecins Sans Frontières (MSF), governments and treatment providers all over the world rely on generic medicines and vaccines from India. More than 96 percent of the medicines MSF uses in our medical operations to treat more than 200,000 people with HIV are generics from India—not to mention the tens of thousands of people we treat with quality and affordable generic medicines for tuberculosis, malaria and other infectious diseases.

Despite the importance of Indian generics, the ‘pharmacy of the developing world’ is under threat. As Indian Prime Minister Narendra Modi prepares to address a joint session of US Congress this week, Doctors Without Borders is calling on both the Indian and United States governments to protect India’s place as a critical center of generic drug production.

{mosads}India, like the United States, provides patent protection for new medicines and vaccines, which delays low cost generic competition.  Yet unlike the US, low-cost generics are often available much earlier in India.  One critical reason is that the legal regime in India allows for a balanced implementation of the country’s international trade obligations to grant patents on pharmaceutical products. For example, unlike the United States and other countries, India sets the bar higher as to what does and does not deserve a patent. In India, pharmaceutical companies cannot just make a small improvement to an existing medicine and expect to be given 20 years of additional monopoly protection, an abusive practice employed by the pharmaceutical industry known as ‘patent ever-greening.’ India has also refused to introduce a range of other unnecessary measures that would do nothing to advance innovation and would only restrict access to low-cost medicines in India and around the world.

In recent years, MSF has grown increasingly alarmed with the escalating efforts of US industry groups, including BIO and PhRMA, which demand the White House and Congress apply pressure on India to modify its intellectual property law in a manner that would irreversibly damage public health.  We are disappointed that the US government has agreed to these demands and dramatically stepped up its efforts to pressure India into changing its intellectual property laws, rules and policies.

BIO and PhRMA claim its efforts are to increase innovation. Yet stricter intellectual property rules do little to enhance innovation, including for diseases, such as tuberculosis, that particularly affect the countries in which the demands are made.  The challenge today is not only that governments are failing to spend enough on needs-based innovation; it is that they are paying too much into a system that is not working. Nearly 40 percent of research and development is already paid for by the public and philanthropic sectors, and the expenditure on medicines and vaccines exceeds one trillion dollars globally. Drug companies do not spend enough on needs-based innovation, instead spending more on marketing than on research and development and, as recent figures attest, spending more on share buy-backs and dividends, designed to boost executive pay, than on medical innovation. We need a system that ensures not only that all governments pay for innovation, but that innovation is needs-driven and affordable to all.     

The goal of the pharmaceutical industry pressure on India is to remove any balance between the rewards provided to companies for investments in research and development with the need to ensure affordable medicine prices and guard against abuse. India’s patent laws are not only important for India; they are an important model for the US and others on how governments could pay for innovation while establishing limits on how companies abuse the system to charge unaffordable prices and limit competition.

Indeed, by striking a balance between innovation and affordability, India’s laws and policies have saved lives. HIV treatment regimens that used to cost $10,000 15 years ago now cost $100 per person thanks to generic drugs from India. That’s a 99-percent reduction in cost, which means worldwide today almost 16 million people with HIV are getting the treatment they need, including many supported by the financial contributions of the US government to the Global Fund to Fight AIDS, TB and Malaria.

India’s policies are not only fully consistent with global trade rules, but also coherent with public health commitments and needs of both India and the United States. India must unequivocally reject the intellectual property laws and practices of the United States that have led to an unprecedented global health crisis: spiralling medicine prices held hostage to lengthy and multiple monopolies, including new cures for hepatitis being prices at the absurd price tag of 1,000 USD per pill.   

Judit Rius Sanjuan, US Manager & Legal Policy Advisor for MSF’s Access Campaign. MSF is a medical humanitarian organization that relies on both innovation and affordable access to medicines and other medical technologies to perform its medical operations.


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