ALISON LAWTON and JAMES TANSEY
Globe and Mail Published on Monday, Mar. 09, 2009 12:00AM EDT Last updated on Friday, Apr. 10, 2009 12:34AM EDT
Nobody would expect a multinational company to give away its assets in the midst of the worst recession in decades. Yet, recently GlaxoSmithKline announced it would dramatically reduce prices on its patented drugs in developing countries and would begin to share intellectual property, the most cherished asset of a pharmaceutical company.
GSK plans to cap the price of medicines in 50 of the poorest developing countries at no more than 25 per cent of the cost they are sold in developed countries. While pharmaceutical companies have funded similar initiatives on a limited basis - Merck has just helped 100 million people access a treatment for river blindness - this is the first systematic policy change by a big pharma company on this scale. It sets a powerful precedent.
For years, shareholders have demanded returns that made the sector one of the highest performers over the past three decades. At the same time, governmental and non-governmental groups have pressured these firms to make vaccines and treatments available to developing countries at affordable prices. GSK's initiative and commitment to sharing data on drugs through patent pools breaks the impasse. Eventually, it will increase the pace at which new treatments are created. It is unclear why GSK chose to make this move now, but it comes after significant pressure by companies to open up innovation in this area.
The patents that companies hold are their most valuable assets. Ideally, a single patent translates into a single commercial treatment. Unfortunately, each small slice of an intellectual property, a treatment or an incremental improvement is held by a competing company. If any single company tries to commercialize a treatment, it has to get permission and rights from all the other companies. If one player chooses to hold out for a better price, the process stalls.
Author Michael Heller calls this the "gridlock economy," with too much focus on private property and too little on common or open-source data.
Patent pools allow companies to share intellectual property with other researchers who may be able to improve on the treatment, while protecting some of the value in the patent.
Part of the reason for this shift is lobbying by the NGO community. Since 2000, research on neglected diseases has increased significantly, largely through partnerships with philanthropic organizations such as the Bill and Melinda Gates Foundation, the Clinton-Giustra initiative and Médecins sans frontières. The Gates Foundation has provided 18 per cent of the funding, trumped only by the U.S. government.
About 80 per cent of these funds are spent on the "Big Three" diseases - malaria, tuberculosis and HIV/AIDS - while diseases such dengue fever and bacterial pneumonia are more neglected, despite their impact on health.
An independent report in 2008 by the Access to Medicine Initiative that examined the role companies play in making drugs more available ranked GSK as the No. 1 company worldwide, followed by Novo Nordisk and Merck. The ranking is intended to help shareholders identify which companies have the strongest commitment to tackling the burden of disease globally.
But it still isn't enough - globally or locally.
Even discounted medicines are expensive in many parts of the world; many of the poorest countries lack the most basic health-care infrastructure to support distribution. Designing drugs that are stable in tropical conditions and delivering drugs to remote locations represents another big logistical challenge. To date, the Canadian government's contribution has been small. A recent report by the George Institute, led by London School of Economics researcher Mary Moran, reports that investment in neglected diseases by Canada was just $0.57 per capita, per annum, compared to $4.09 per capita by the United States and $5.37 by Ireland (just in case we thought it was a "big country" phenomenon). The Canadian government should follow the lead of GSK and Ireland and make the kind of long-term investment in building a health-care infrastructure in developing countries and in solving the problems of affordability and distribution that stand between drugs and neglected diseases.
Alison Lawton is chair of Unicef Canada's Unite for Children Campaign. James Tansey is an associate professor with the Sauder School of Business at the University of British Columbia.
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