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The pipeline
R&DBetter treatment outcomes
Market failure
Lack of financing
Monopoly pricing of medicines & tech
Infrastructure inadequacy
Social support & Adherence difficulties
World Pharmaceutical Market
Source: IMS Health, 2002
Region % of market
North America 41.80%
EU 24.8
Japan 11.3
L. America/Caribbean 7.5
SE Asia 5.0
Middle East 2.6
E. Europe 1.8
India 1.8
Africa 1.3
Rhetoric v. Reality
• TRIPs & the WTO
• Parallel importation – cross-border trade of patented goods
• Compulsory licensing – generic production, primarily for domestic
market
• Special 301
The Doha Declaration
“We recognize that WTO members with insufficient or no manufacturing capacities in the pharmaceutical sector could face difficulties in making effective use of compulsory licensing under the TRIPS Agreement.”
Information onslaught...
• PhRMA budget: $150 million/year• $1 million for an "intellectual echo chamber of
economists”• $2.5 million in payments to research and policy
organizations "to build intellectual capital”• $17.5 million to fight price controls and protect
patent rights in foreign countries and in trade negotiations
• $9.4 million for public relations
Source: NYTimes, 1 June 2003
Intellectual echo chamber...• Attaran and “off-patent essential medicines”• Roger Bate and “Africa Fighting Malaria”• DiMasi’s “$800 million” R&D figure• Data exclusivity, diversion
Source: Public Citizen, 2001
Post-Doha:
• USTR (originally with EU and Japanese support) broke initial deadline for negotiations
• 17-page decision
• Possible implementation by Canada?
The new USTR proposals:
• Chile – CAFTA – ARTA – FTAA – PPP
• Singapore – Indonesia/Thailand – ASEAN
• SACU
Positive trends...
• New infrastructure being built in southern Africa by Brazil
• March-ins through Bayh-Dole: Norvir
• Expansion beyond AIDS and into the United States: Xalatan glaucoma case
• Pooled R&D approach (www.essentialinventions.org)
• New non-market approaches: DNDi
More information…www.essentialmedicines.org
www.accessmed-msf.org
www.cptech.org/ip/health
Dying for Growth: Global Inequality and the Health of the Poor (Kim et al., 2000)
Pathologies of Power: Health, Human Rights and the New War on the Poor (Farmer, 2003)
The Political Economy of Social Inequalities: Consequences for Health & Quality of Life (Navarro, 2002)
Global Intellectual Property Rights: Knowledge, Access and Development (Drahos & Mayne, 2002)