Ellen 't Hoen: Pool medical patents, save lives

28,358 views ・ 2012-12-10

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Translator: Joseph Geni Reviewer: Morton Bast
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In 2002, a group of treatment activists met
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to discuss the early development of the airplane.
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The Wright Brothers, in the beginning of the last century,
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had for the first time managed
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to make one of those devices fly.
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They also had taken out numerous patents
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on essential parts of the airplane.
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They were not the only ones.
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That was common practice in the industry,
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and those who held patents on airplanes
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were defending them fiercely
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and suing competitors left and right.
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This actually wasn't so great for the development of the aviation industry,
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and this was at a time that in particular the U.S. government
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was interested in ramping up
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the production of military airplanes.
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So there was a bit of a conflict there.
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The U.S. government decided to take action,
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and forced those patent holders
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to make their patents available to share with others
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to enable the production of airplanes.
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So what has this
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got to do with this?
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In 2002, Nelson Otwoma, a Kenyan social scientist,
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discovered he had HIV and needed access to treatment.
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He was told that a cure did not exist.
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AIDS, he heard, was lethal,
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and treatment was not offered. This was at a time
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that treatment actually existed in rich countries.
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AIDS had become a chronic disease.
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People in our countries here in Europe, in North America,
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were living with HIV, healthy lives.
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Not so for Nelson. He wasn't rich enough,
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and not so for his three-year-old son, who he discovered a year later
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also had HIV.
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Nelson decided to become a treatment activist
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and join up with other groups.
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In 2002, they were facing a different battle.
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Prices for ARVs, the drugs needed to treat HIV,
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cost about 12,000 [dollars] per patient per year.
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The patents on those drugs were held
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by a number of Western pharmaceutical companies
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that were not necessarily willing
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to make those patents available.
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When you have a patent, you can exclude
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anyone else from making, from producing or making
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low-cost versions, for example,
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available of those medications.
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Clearly this led to patent wars breaking out
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all over the globe.
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Luckily, those patents did not exist everywhere.
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There were countries that did not recognize
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pharmaceutical product patents, such as India,
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and Indian pharmaceutical companies
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started to produce so-called generic versions,
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low-cost copies of antiretroviral medicines,
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and make them available in the developing world,
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and within a year the price had come down
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from 10,000 dollars per patient per year
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to 350 dollars per patient per year,
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and today that same triple pill cocktail
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is available for 60 dollars per patient per year,
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and of course that started to have an enormous effect
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on the number of people who could afford access
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to those medicines.
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Treatment programs became possible,
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funding became available, and the number of people
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on antiretroviral drugs started to increase very rapidly.
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Today, eight million people
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have access to antiretroviral drugs.
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Thirty-four million are infected with HIV.
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Never has this number been so high,
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but actually this is good news,
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because what it means is people stop dying.
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People who have access to these drugs stop dying.
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And there's something else.
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They also stop passing on the virus.
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This is fairly recent science that has shown that.
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What that means is we have the tools
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to break the back of this epidemic.
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So what's the problem?
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Well, things have changed.
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First of all, the rules have changed.
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Today, all countries are obliged to provide
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patents for pharmaceuticals that last at least 20 years.
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This is as a result of the intellectual property rules
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of the World Trade Organization.
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So what India did is no longer possible.
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Second, the practice of patent-holding companies have changed.
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Here you see the patent practices
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before the World Trade Organization's rules, before '95,
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before antiretroviral drugs.
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This is what you see today,
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and this is in developing countries, so what that means is,
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unless we do something deliberate
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and unless we do something now,
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we will very soon be faced with another drug price crisis,
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because new drugs are developed,
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new drugs go to market, but these medicines are patented
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in a much wider range of countries.
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So unless we act, unless we do something today,
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we will soon be faced [with] what some have termed
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the treatment time bomb.
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It isn't only the number of drugs that are patented.
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There's something else that can really scare
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generic manufacturers away.
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This shows you a patent landscape.
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This is the landscape of one medicine.
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So you can imagine that if you are a generic company
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about to decide whether to invest
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in the development of this product, unless you know
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that the licenses to these patents
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are actually going to be available,
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you will probably choose to do something else.
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Again, deliberate action is needed.
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So surely
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if a patent pool could be established
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to ramp up the production of military airplanes,
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we should be able to do something similar
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to tackle the HIV/AIDS epidemic.
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And we did.
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In 2010, UNITAID established the Medicines Patent Pool
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for HIV.
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And this is how it works:
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Patent holders, inventors
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that develop new medicines
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patent those inventions,
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but make those patents available
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to the Medicines Patent Pool. The Medicines Patent Pool
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then license those out to whoever needs access to those patents.
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That can be generic manufacturers.
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It can also be not-for-profit drug development agencies,
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for example.
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Those manufacturers can then sell those medicines
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at much lower cost to people who need access to them,
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to treatment programs that need access to them.
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They pay royalties over the sales to the patent holders,
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so they are remunerated for sharing their intellectual property.
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There is one key difference
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with the airplane patent pool.
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The Medicines Patent Pool is a voluntary mechanism.
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The airplane patent holders were not left a choice
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whether they'd license their patents or not.
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They were forced to do so.
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That is something that the Medicines Patent Pool cannot do.
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It relies on the willingness of pharmaceutical companies
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to license their patents and make them available
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for others to use.
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Today, Nelson Otwoma is healthy.
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He has access to antiretroviral drugs.
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His son will soon be 14 years old.
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Nelson is a member of the expert advisory group
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of the Medicines Patent Pool,
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and he told me not so long ago,
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"Ellen, we rely in Kenya and in many other countries
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on the Medicines Patent Pool to make sure
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that new medicines also become available to us,
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that new medicines, without delay, become available to us."
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And this is no longer fantasy.
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Already, I'll give you an example.
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In August of this year, the United States drug agency
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approved a new four-in-one AIDS medication.
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The company, Gilead, that holds the patents,
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has licensed the intellectual property to the Medicines Patent Pool.
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The pool is already working today, two months later,
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with generic manufacturers to make sure that this product
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can go to market at low cost
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where and when it is needed. This is unprecedented.
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This has never been done before.
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The rule is about a 10-year delay for a new product
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to go to market in developing countries, if at all.
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This has never been seen before.
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Nelson's expectations are very high,
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and quite rightly so. He and his son will need access
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to the next generation of antiretrovirals
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and the next, throughout their lifetime,
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so that he and many others in Kenya and other countries
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can continue to live healthy, active lives.
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Now we count on the willingness of drug companies
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to make that happen. We count on those companies
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that understand that it is in the interest, not only in the interest
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of the global good, but also in their own interest,
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to move from conflict to collaboration,
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and through the Medicines Patent Pool they can make that happen.
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They can also choose not to do that,
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but those that go down that road may end up
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in a similar situation the Wright brothers ended up with
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early last century, facing forcible measures
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by government. So they'd better jump now.
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Thank you. (Applause)
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