[Ip-health] Op-Ed responses to commentaries by Pharma-connected think tanks

[Sarah Rimmington]

Over the past few months a number of us have noticed several op-ed
commentaries critiquing the WHO IGWG talks and/or the Thai Compulsory
licensing policy. The vast majority of these commentaries were written
by individuals we found to be connected in various ways to the
brand-name pharmaceutical industry. The pharma ties of the authors were
not disclosed to the readers of any of the publications.

Essential Action has submitted responses to most of these commentaries.
I paste the two most recent op-ed responses by Robert Weissman (and the
original commentary he is responding to) below. The first appeared in
The Daily Times (Malawi) on May 7 and the second appeared in the Times
of India today.

I note that we disclose the sources of the funding for Essential
Action's Access to Medicines Project (the Open Society Institute and the
Ford Foundation) to every publication we approach, but that neither the
Daily Times nor the Times of India chose not to publish that
information. I also note that the Times of India removed the sections of
Rob's response where he identifies the industry ties of the author he
was responding to (Tim Wilson of the Institute of Public Affairs,
Melbourne, Australia).


1. The Daily Times (Malawi)
My Point of View -On neo-colonialist NGOs
By Robert Weissman,
07 May 2008

It would be easy to dismiss Temba Nolutshungu's recent opinion --
Neo-colonialist NGOs published in The Daily Times -- if it were not part
of an organised effort to spread confusion about vitally important
policy debates with life-and-death consequences.

The author spins a fantasy story in which public health groups have
wrested control of the World Health Organisation (WHO), and are seeking
to undermine the efficient patent-based pharmaceutical research and
development (R&D) system.

Perhaps readers might have been able to better understand the
motivations for the author=92s arguments if he had revealed his
organisation's financial entanglements with Big Pharma.

The author suggests that Africa has little reason to care about the
price of medicines, because healthcare infrastructure is inadequate.

It is of course true that Africa's healthcare systems are badly depleted
and in need of massive investment. It is also the case that many of the
public health advocacy groups that the author denounces are working to
strengthen African healthcare systems.

But it is not a matter of choosing between improving healthcare systems
and finding ways to lower the price of medicines so they are affordable.

Both are necessary, and both can be achieved.

Remarkably, the author highlights the case of HIV/Aids drugs. Ten years
ago, before generic competition, brand-name companies charged roughly
the same price for lifesaving HIV/Aids drugs in Africa as they did in
rich countries -- $10,000 a year per person, or more. An HIV diagnosis
was a death sentence. Today, the price is as low as $100 per person -- a
price decline that leveraged a huge increase in donor money that
otherwise would not have been made available. The severe problems with
healthcare infrastructure notwithstanding, 2 million people living with
HIV/Aids in Africa are today receiving treatment.

Much more needs to be done -- and improving infrastructure is a top
priority. Only about 30 percent of those in need are receiving
treatment. But without the price reductions brought about by generic
competition, almost all of the 2 million people in Africa now receiving
treatment would be dead or would die soon.

The author also directs attention to important negotiations now underway
at the World Health Organisation. These talks are designed to identify
means to advance both innovation and access to the fruits of innovation.
The idea is to explore reward systems that provide an incentive for the
development of new medicines to meet priority health needs in developing
countries, and to make those products available on an affordable basis.

The need for new arrangements is apparent. The patent monopoly system,
the current means to =91incentivise=92 corporate sector R&D, is not working
for developing countries.

Patents are not worth much if they offer monopolies on sales to a
population that -- no matter how large -- has little buying power.

Developing countries comprise 80 percent of the world=92s population but
amount to only 13 percent of the global market for medical products. As
a result, there is little corporate sector R&D devoted to the needs of
developing countries. A review by Doctors Without Borders found that of
1,556 new drugs put on the market between 1975 and 2004, only 21 were
for "neglected diseases" -- diseases endemic to developing countries.

Pharmaceutical companies commonly price the new drugs that they do
develop, intended for rich country markets, far out of reach of patients
in Africa. Compounding the inequity, most important new drugs are
developed with very substantial government support.

A system that fails to respond to key health needs -- and then prices
what it does develop out of reach -- is not one that recommends itself.

Isn't it worth exploring other ideas, like non-patent prizes to
=91incentivise=92 R&D, with the resulting fruits of the innovation made
available at competitive prices?

Perhaps readers might have been better able to assess the author=92s views
on these matters if he had identified his organisation's ties to the
pharmaceutical industry. A host of multinational drug companies are
among the corporate members of the author=92s Free Market Foundation in
South Africa. These include GlaxoSmithKline, Johnson & Johnson Medical,
Novo Nordisk, Roche and Wyeth.

Ideologues and those would prioritise the narrow commercial interests of
Big Pharma over public health objectives have reason to reflexively
defend a patent monopoly-based R&D system that is not working for the
developing world.

For everyone else, the rising interest in new institutional arrangements
to promote the complementary public health objectives of innovation and
access is something to embrace.

=3D=3D
The author is director of Essential Action, a public health advocacy and
corporate accountability group based in Washington, DC.

--

This op-ed responds to a previously published op-ed by Temba
Nolutshungu. Here is the text of that piece:

The Daily Times (Malawi)
My Point of View- Neo-colonialist NGOs
By Temba Nolutshungu
30 April 2008

Soon after the real colonialists had left Africa, a new breed of Western
colonialists emerged: the statist non-governmental organisations that
want to save us from everything from genetically-modified food to
globalisation--and growth.

These =93consumer=94 and humanitarian groups and =93development=94 charitie=
s are
united in the belief that modern industrial civilisation, profit and
competition are unethical. In their view, people, particularly in
developing countries, would be better served by state control that puts
=93equity=94 and the redistribution of wealth ahead of the economic dynamis=
m
that has enriched the West and such eastern countries as Taiwan, Japan
and South Korea.

But despite their claims to speak for the poor, only a few hundred of
the several thousand NGOs registered at the United Nations come from
developing countries. The vast majority are from the USA, with many from
Britain, France and Germany.

These groups have influence way beyond their size. Many poor countries
do not have the technical capacity to formulate their own policies for
services such as health, so they consult NGOs or bodies such as the
World Health Organisation (WHO), mandated with providing impartial
scientific advice to governments.

The WHO has been colonised by these NGOs, acting as policy consultants
and playing a big part in formulating the WHO=92s technical and policy
advice to members. But the NGO advisors consistently get things wrong.

Take Aids. Because there is no cure, the only way to tackle its spread
is to prioritise prevention, to stop the number of infections increasing
every year. Of course treatment is essential but the NGOs pushed hard
for most public money to be spent on drugs for those already
infected--even though the worst affected countries do not have the
doctors and clinics to administer the drugs. The WHO gave in, so
infections continue to rise and treatment is haphazard.

A similar thing happened with malaria. For years, countries from India
to South Africa successfully controlled malaria by spraying the insides
of houses with DDT.

Environmentalists and NGOs played up scientifically unsound scare
stories from the USA to demonise the pesticide and pushed for a ban: the
WHO stopped recommending it in the 1990s, malaria soared globally and
millions died. Recently, South Africa reintroduced DDT spraying and
cases plummeted but few other countries have dared upset their NGO advisors=
.

Western pressure groups have also scared European consumers away from
buying GM crops grown in Africa: Uganda has been directly threatened by
European Union representatives and Kenya avoids GM.

NGOs operate at national level too, directly feeding governments with
statist policies. In their latest campaign they argue that, because very
few drugs have been developed for a handful of tropical diseases that
occur in the poorest countries, patents prevent this and are inherently
unjust.

They want bureaucrats rather than markets to determine what diseases are
researched and they want subsidies for setting up medicine factories in
Africa, where ingredients, technicians and managers would have to be
imported and where there are very, very few laboratories to test
quality: bad copies are often worse than no medicine at all as they
encourage drug-resistance and virus mutation.

All this in the hope that removing profit will usher us into a magical
new age in which cheap new medicines will become freely available to the
poor =96- never mind the fact that market-led research and development has
produced the vast majority of all treatments available.

The final stupidity is that you could give every African every drug for
free, to no avail: without the infrastructure to monitor and administer
them, many drugs are useless or dangerous.
The NGOs achieved this by lobbying African governments at the WHO: the
similarities between the NGOs=92 campaign literature and the official
position of Kenya, a leading proponent of the R&D Treaty, are too many
to be a coincidence.

Of course, many African governments like these schemes because they help
protect their own pharmaceutical companies or transfer the blame for
their own failures in health care onto foreigners such as multinational
pharmaceutical companies. And these schemes are being aired in Geneva
this week at the WHO=92s Intergovernmental Working Group on Public Health,
Innovation and Intellectual Property (IGWG): member states need to put
the real needs of the poor first and kick out the counter-productive
ideology.

Statist NGOs have enormous influence on public opinion, the UN and
African governments even though their ideologies have been shown not to
work in their own countries: before taking the neo-colonialists=92
medicine, we must carefully read the label or suffer nasty side effects.

2. Times Of India
Keep prices down
By Robert Weissman
8 May 2008

WASHINGTON: In a recent opinion piece ('In defence of patents', Apr 28), Ti=
m Wilson implies that patent monopolies do not drive up drug prices. He mis=
states international patent rules. And he equates patents with innovation, =
confusing a means with an end.

Wilson suggests that public health advocates' concerns that patents "increa=
se the cost of medicines for the world's poor" is misplaced. This is a stra=
nge argument. Patents confer marketing monopolies and are intended to enabl=
e patent holders to raise prices. This the brand-name drug companies do qui=
te well.

India has enjoyed among the lowest prices for medicines in the world, preci=
sely because the country has not, until recently, adopted product patent ru=
les. On a global basis, the case of HIV/AIDS drugs is illustrative of the i=
mpact of patent mono-polies, but not exceptional. Less than 10 years ago, t=
he price of HIV/AIDS medicines in most of the developing world was $10,000 =
a year per person, or more. Today, thanks to generic competition, the price=
 is as low as less than $100 a year. Before the price reductions, an HIV/AI=
DS diagnosis was a death sentence in the developing world. Now three millio=
n people in developing countries are receiving life-saving treatment.

Wilson condemns Thailand for issuing compulsory licences for a heart diseas=
e drug (as well as for cancer and HIV/AIDS drugs). He untruthfully says thi=
s move abused world trade rules, claiming compulsory licences may only be i=
ssued in cases of emergency. The World Trade Organisation says that belief =
that an emergency is required for a compulsory licence "is a common misunde=
rstanding". In fact, the WTO says, "countries are free to determine the gro=
unds for granting compulsory licences".

Thailand's action is a model for the world. The generic version of the hear=
t-disease drug Thailand compulsorily licensed is 1/70th the cost of the bra=
nd-name product, enabling the government to offer the drug in the public he=
alth system. Previously, it was unavailable. Other countries, including Ind=
ia, should follow Thailand's example.

Wilson also bemoans ongoing negotiations at the World Health Organisation (=
WHO), designed to identify means both to develop medicines that meet priori=
ty health needs in developing countries and to make those products availabl=
e on an affordable basis. Underlying the WHO talks is a recognition that pa=
tents are only one mechanism to promote research and development and one th=
at is not working for developing countries. Patents are not worth much if t=
hey offer monopolies on sales to a population that has little buying power.

Developing countries comprise 80 per cent of the world's population but amo=
unt to only 13 per cent of the global market for medical products. As a res=
ult, there is little corporate sector R&D devoted to the needs of developin=
g countries. A review by Doctors Without Borders of new drugs introduced be=
tween 1975 and 2004 found that of 1,556 new drugs put on the market, only 2=
1 were for "neglected diseases" - diseases endemic to developing countries.

The WHO negotiations are looking at an array of innovative proposals to gen=
erate more R&D; direct R&D to respond to health needs, not just market dema=
nd; and ensure that new medicines and health technologies are accessible to=
 people regardless of wealth. Wilson has every right to oppose such laudabl=
e objectives if he desires. But he should not mislead readers with distorte=
d descriptions of policy debates about medical innovation and pharmaceutica=
l affordability.

Those who prioritise the narrow commercial interests of big pharma over pub=
lic health objectives have reason to defend a patent monopoly-based R&D sys=
tem that is not working for the developing world. For everyone else, the ri=
sing interest in new institutional arrangements to promote the complementar=
y public health objectives of innovation and access is something to embrace=
. The robust debate at the WHO - and the experimentation of many developing=
 countries, including India - with diverse mechanisms to promote R&D offers=
 the prospect of dramatic public health benefits in the years ahead.

The writer is director of Essential Action, a public health advocacy group.

--

This op-ed responds to a previously published op-ed by Tim Wilson. Here is =
the text of that piece:

Times of India
In defence of patents
Tim Wilson
28 Apr 2008

Intellectual Property (IP) has always been a niche public policy area under=
stood best by policy wonks and lawyers. Unless there is a major controversy=
, IP tends to escape public consciousness. But that is changing. Over the p=
ast few years campaigns to undermine IP have increased and are now reaching=
 a fever pitch.

IP is essential because it provides the property rights needed for research=
 and development to attract investment with the prospect of a long-term div=
idend. Undermining IP is equivalent to the traditional socialist ethos =97 =
divvy the spoils of today's research and development, rather than focusing =
on expanding it. And a lot is at stake =97 according to the most recent fig=
ures from the United Nations, the Indian patent registry receives more than=
 90,000 applications for patentable inven-tions each year. In spite of this=
 significant contribution, there has been a global campaign to undermine IP=
 rights by a group of anti-market activists, self-interested politicians, v=
ested interests, and more recently, the infiltrated World Health Organisati=
on (WHO).

Innovative medicines have been one of the big targets. These activists have=
 argued that IP rights increase the cost of medicines for the world's poor.=
 Yet they ignore that one of the biggest contributors to increasing costs i=
s actually government-imposed taxes and tariffs that raise the price of lif=
e-saving medicines. For instance, in India the combined taxes and tariffs o=
n imported medicines are 55 per cent; in China, they are 28 per cent.

But this reality has not stopped govern-ments acting to undermine IP. In ea=
rly 2007, the then Thai military government waived the patents of three pat=
ented medicines through a process called "compulsory licensing". Compulsory=
 licensing is an instrument recognised under the World Trade Organisation's=
 Trade-Related Aspects of Intellectual Property Rights (TRIPS) Agreement, a=
nd grants governments the ability to licence the production of patented pro=
ducts "in the case of a national emergency or other circumstances of extrem=
e urgency or in cases of public non-commercial use".

Now the WHO has waded into the debate. Last year, a WHO-designated team ass=
essed the Junta's actions and later issued a brief report legitimising the =
government's actions, which was followed by a how-to guide for countries to=
 waive their international obligations and issue compulsory licences.

This report is feeding into a WHO-initiated Intergovernmental Working Group=
 (IGWG) on Public Health, Innovation and IP formed in 2006. From its incept=
ion the IGWG has been an attempt for health bureaucrats and the activists t=
hat advise them to rewrite =97 and under-mine =97 global IP rules. The acti=
vists are now using their campaign against IP on medicines as a precedent t=
o continue their assault on IP; and global warming has become the new battl=
eground.

In a joint statement at the 2007 G8 summit, the governments of Brazil, Chin=
a, India, Mexico and South Africa called for an agreement to assist in comp=
ulsory licensing the IP related to carbon dioxide emission-mitigating techn=
ology being developed in wealthy countries.

In subsequent media reports the officials argued an agreement is needed "pa=
ralleling the successful agreement on compulsory licensing of pharmaceutica=
ls". Similar themes appeared in a resolution passed by the European Parliam=
ent in November last year recommending a study to assess amending TRIPS "to=
 allow for the compulsory licensing of environmentally necessary technologi=
es".

And the tragedy is that those who are likely to suffer most are the world's=
 poor. Technology transfer is also vital for developing countries to grow t=
heir economies and improve their standards of health and the environment. A=
 2006 World Bank study and a 1998 Inter-national Energy Agency/UNEP study h=
ave identified that strengthening IP rights assists in technology transfer.

The World Intellectual Property Organisation has designated 2008 as the yea=
r for "celebrating innovation and promoting respect for IP". With the IGWG =
convening in Geneva in a few days' time and the assault on IP on climate-fr=
iendly technologies, World IP Day =97 which was on Saturday =97 increasingl=
y seems to be an occasion to reflect on IP's demise.

The writer is director of the IP and Free Trade Unit at the Institute of Pu=
blic Affairs in Melbourne.

--
Sarah Rimmington
Attorney
Essential Action, Access to Medicines Project
Washington, DC
Tel: (202) 387-8030
Cell: (202) 422-2687
www.essentialaction.org/access/