[Ip-health] Science: WHO Panel Weighs Radical Ideas

Sun Dec 3 11:45:02 2006

<SNIP>

One such framework, which the IGWG may consider, is a hotly debated
proposal for an international treaty to open up drug discovery,
championed since 2002 by James Love, director of the Consumer Project
on Technology in Washington, D.C. Under Love=92s =93R&D Treaty,=94 countrie=
s
would agree to spend a minimum percentage of gross domestic product on
medical research, including a portion for neglected diseases. In
addition, the treaty would promote open access to research findings and
possibly add R&D incentives. For instance, governments could award big
monetary prizes for those who invent important new medicines.
Manufacturers would then be free to produce and market them cheaply.

<SNIP>

But others point out that health PPPs have a narrow base: 60% of their
funding comes from a single source, the Bill and Melinda Gates
Foundation; governments contribute very little. Moreover, industry
tends to help PPPs that work on diseases that affect both the poor and
people from rich countries, such as malaria and TB, says Els Torreele,
project manager at the Drugs for Neglected Diseases Initiative. Given
the scope of the problem, something more radical is needed, she says.

<SNIP>

But Love thinks the world may be ready for a change. He notes that,
although the U.S. government has generally aligned itself with the
pharmaceutical industry, it strongly supported increased access to HIV
drugs in Africa. It also unexpectedly voted for the resolution
introduced by Kenya and Brazil that called the IGWG into existence.
(The drug companies and the European Commission opposed the plan.) Love
is hoping for another surprise.

-------------------------------

www.sciencemag.org

SCIENCE
VOL 314
1 DECEMBER 2006

Lifesaving antiretroviral drugs have been available for a decade in
wealthy countries, yet millions of HIV-infected people south of the
equator still can=92t get them. The medicine cupboard is equally bare for
people afflicted by tropical illnesses such as visceral leishmaniasis,
sleeping sickness, and Chagas disease, for which there are no truly
good therapies. Western medical science has not done well by the
world=92s poor, and some critics blame this on its reverence for
intellectual property (IP). Is it time to overhaul the IP protection
system? A new working group hosted by the World Health Organization
(WHO) will consider that question in a series of meetings beginning
next week in Geneva, Switzerland.

Critics of the current IP protection system hope that WHO=92s
Intergovernmental Working Group (IGWG) on Public Health, Innovation and
Intellectual Property will reform=97or even hack down=97the stillexpanding
worldwide patent system. They say it puts lifesaving new drugs beyond
the reach of poor patients and hampers development of new medicines for
tropical diseases. But others, including the pharmaceutical industry,
argue that the IP protection system isn=92t the real problem and that the
talks in Geneva risk distracting people from practical solutions. The
IGWG=97whose members will include representatives of governments as well
as nongovernmental organizations=97 appears =93motivated by anticapitalism
rather than logical thinking about how to get drugs to patients,=94 says
Trevor Jones, a former director of research and development at the
Wellcome Foundation.

Patents are designed to spur the invention of new products. But they
also allow companies to charge high prices, putting people without
purchasing power at a disadvantage. Many critics say it is not enough
to help the poor get access to drugs; the system=92s incentives must be
changed. To produce new drugs for neglected diseases, they say, the
world needs a new R&D system that rewards not market sales but the
potential to save lives and improve health.

One such framework, which the IGWG may consider, is a hotly debated
proposal for an international treaty to open up drug discovery,
championed since 2002 by James Love, director of the Consumer Project
on Technology in Washington, D.C. Under Love=92s =93R&D Treaty,=94 countrie=
s
would agree to spend a minimum percentage of gross domestic product on
medical research, including a portion for neglected diseases. In
addition, the treaty would promote open access to research findings and
possibly add R&D incentives. For instance, governments could award big
monetary prizes for those who invent important new medicines.
Manufacturers would then be free to produce and market them cheaply.

The treaty, recommended in a letter to the World Health Assembly by 162
scientists, health experts, and others last year, =93is widely seen as
the end of the pharmaceutical industry as we know it,=94 says Anne-Laure
Ropars, a researcher at the George Institute for International Health
in London.

No wonder the industry is vehemently opposed. The treaty would create
an =93extremely complicated international bureaucracy,=94 says Eric
Noehrenberg of the International Federation of Pharmaceutical
Manufacturers and Associations in Geneva, adding that the award system
would never work. Instead, Noehrenberg offers a different idea: The
world should create markets where they currently don=92t exist. For
instance, companies could be enticed with research grants from a
=93Global Tropical Disease Fund=94 or the promise of guaranteed sales
should they develop an effective new drug.

The industry also contributes through a model called the public-private
partnership (PPP). Over the past 10 years, more than two dozen PPPs
have sprung up to tackle diseases of the poor. Enlisting industry,
academia, governments, and foundations, these partnerships, such as the
TB Alliance and the Medicines for Malaria Venture (MMV), have produced
many new candidate drugs (Science, 13 January, p. 167). And the IP
protection regime has not been an obstacle, says MMV president Chris
Hentschel: =93If people spent less time thinking about IP and more about
other things, we would make more progress.=94

But others point out that health PPPs have a narrow base: 60% of their
funding comes from a single source, the Bill and Melinda Gates
Foundation; governments contribute very little. Moreover, industry
tends to help PPPs that work on diseases that affect both the poor and
people from rich countries, such as malaria and TB, says Els Torreele,
project manager at the Drugs for Neglected Diseases Initiative. Given
the scope of the problem, something more radical is needed, she says.

Whether the IGWG can deliver a solution remains to be seen. The group=92s
predecessor at WHO, the Commission on Public Health, Innovation, and
Intellectual Property Rights, issued a raft of recommendations in
April=97such as increasing contributions to PPPs and building clinical
trial capacity=97but could not agree on some key patent issues. Some
predict that when the IGWG issues its final report to the World Health
Assembly in May 2008, it may propose ways to implement the less
controversial parts from the April review rather than a radical reform.

But Love thinks the world may be ready for a change. He notes that,
although the U.S. government has generally aligned itself with the
pharmaceutical industry, it strongly supported increased access to HIV
drugs in Africa. It also unexpectedly voted for the resolution
introduced by Kenya and Brazil that called the IGWG into existence.
(The drug companies and the European Commission opposed the plan.) Love
is hoping for another surprise.  =96MARTIN ENSERINK

------------
Thiru Balasubramaniam
Geneva Representative
CPTech
voice +41.22.791.6727
fax +41.22.723.2988
mobile +41 76 508 0997
thiru@cptech.org