[Ip-health] The Guardian: Profits before the poor? Drugs giant offers an answer to the toxic question facing a 'heartless' industry

[Thiru Balasubramaniam]

http://www.guardian.co.uk/business/2009/feb/14/gsk-big-pharma-drugs

Profits before the poor? Drugs giant offers an answer to the toxic
question facing a 'heartless' industry

     * Sarah Boseley
     * The Guardian, Saturday 14 February 2009
     * Article history

For Andrew Witty, it's a question of redefining the unwritten contract
that major drug companies have with society. For critics of big
pharma, it's about addressing widely felt concerns about an industry
that has often seemed heartless. Either way, the changes proposed by
the chief executive of GlaxoSmithKline goes to the core of one of the
most toxic debates of our time.

The most serious charge against such firms is that they put profits
ahead of poor people's lives. It's an allegation GSK has not escaped,
even though it has cut the prices of its Aids drugs in developing
countries and has promised efforts to develop a malaria vaccine.

The low point came in 2001, when GSK was among 39 multinational
companies that took legal action against the South African government
to try to prevent it importing cheap drugs. Amid an international
outcry, the drug companies backed down. "I don't think anybody can
claim that was handled well," said chief executive Andrew Witty.

He admits the industry could have done more in the past, but claims
the problem was a fixed mindset. "I would say people tried really hard
within a set of rules which haven't really been challenged very
hard ... I guess what I'm just challenging a little bit is like why
can't those rules be flexed a bit?"

Witty says drug companies have an obligation to respond to society's
needs and demands. "It's been obvious for a while, I think, that
efforts have to be made to really reassert and strengthen that
contract with society."

That goes to the very core of the business. Drug companies are
criticised for failing to deliver for the rich world as well as the
poor - for the UK and US as well as Tanzania or Ethiopia. They stand
accused of focusing their efforts on making "me-too" blockbusters -
barely altered copies of other companies' billion dollar sellers for
indigestion or heart disease - rather than working on diseases where
there are few treatments, such as Alzheimer's.

Transparency is a major issue. Witty has pledged to publish all
clinical trial data, whether positive or negative - and be open about
GSK's payments to doctors.

He has also signalled his willingness to negotiate on price, in a
climate where value for money is increasingly discussed and other
countries are contemplating setting up a version of Nice, the National
Institute for Healthcare and Clinical Excellence, which decides
whether drugs are cost-effective for the NHS.

Another part of the social contract is ending practices that cause
public anxiety, he said. About eight weeks ago, GSK announced without
fanfare that it would commit never again to experiment on great apes.

"People said that's a mistake, because you might one day have to go
back and do those experiments," he said. "Society will accept a degree
of experimentation with animals provided it has a purpose, provided
there are no alternatives and provided it is done compassionately and
humanely, but they trust us to shut the door behind us when we don't
need to do it any more."

He likens this to the risk he admits he is taking that dropping prices
in the poorest countries will result in cheap drugs being shipped
clandestinely back for sale in the rich world.

"It's not a reason not to do it. Of course it creates risk but now
it's our job to work with the Europeans and the Americans and whoever
else is involved to try and get them to understand why it is important
it doesn't all get reimported, why it's important that you don't
benchmark the price in New York to the price in Ethiopia, because it's
just wrong to do that. It's almost as wrong to do that as it would be
not to do it in the first place."

GSK would love to undermine the Indian and Chinese generics companies,
which sell copies of their drugs at rock-bottom prices in Africa and
Asian countries where patents do not apply, because - since nobody had
the money to buy their drugs - pharma companies did not take them out.

But mostly this is about diseases for which there are no drugs. There
has been mounting pressure from the World Health Organisation and non-
governmental organisations for action, especially on patents. Witty
said he had spent many years in Africa and Asia and seen "the
consequences of these diseases at a kind of personal level ... and
also the damage it does to a society - the way entire populations
become hollowed out and almost inevitably are consigned to not being
able to progress properly."

He is trying, he said, to start a different kind of discussion with
the various stakeholders. "If we can just make one piece of progress
on one disease which hasn't had any progress for 40 years it has to be
worth it."

Critics of the drug companies acknowledged yesterday that GSK was
making strides, but said it could go further, for instance, on the
point of giving away 20% of profits in the 60 least developed
countries - GSK currently has operations in only 18 of them and earns
around =A330 million a year from them.

"I recognise the fact that GSK is seeking to meet concerns," said
Michelle Childs, director of policy and advocacy at M=E9decins sans
Fronti=E8res, who welcomed the move to open to pool patents on chemical
compounds that could help the development of treatments for neglected
diseases. But, she said, she would challenge GSK to go further. "He is
saying there is no need for a patent pool for HIV. Our position is
that there is an urgent need for a patent pool for HIV because of the
rising prices of new first and second line drugs for patients who
develop resistance." Buying cut-price drugs from GSK would not
necessarily be the best move for the poorest countries, she added.

Generic companies were capable of producing drugs at lower prices than
big pharma could manage, because of the lower costs of manufacture.
GSK's combination HIV drug Combivir had been reduced from $730 (=A3506)
in 2001 per patient per year and now sells at $197 in the least
developed countries.


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Thiru Balasubramaniam
Geneva Representative
Knowledge Ecology International (KEI)
thiru@keionline.org


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