unequal life struggles

Few situations can be more unnerving or harrowing to witness than the death of a child due to entirely preventable circumstances, such as not having access to prohibitively expensive drugs. Viewers were given this unwanted opportunity with the screening of a documentary yesterday afternoon about the nefarious practices of large drug companies in recent years. Unsurprisingly, the tragedy occurred in an African country, remote from the self-regarding concerns of these companies, who continue to push for the closing of loopholes allowing drugs to be manufactured generically in certain parts of the world, from where they're sold or smuggled to places of need. They've been so successful in this push that organizations in India which previously supplied life-saving generic drugs to other parts of the world have now been halted in their activities. The Bush administration has been out of step with the rest of the world, in this as in so much else, in being, it seems, more concerned to protect the profits of pharmaceutical companies than to save lives.

Much of the controversy in this area centres around compulsory licences. The issuing of compulsory licences was validated by a WTO ministerial meeting back in 2001. The idea was to permit countries to issue such licences to secure cheap generic drugs to meet a public emergency. Ever since this decision was made as an option in a Trade Related Intellectual Property Rights (TRIPS) agreement, drug companies have been using their considerable financial muscle to 'discourage' resort to compulsory licences, forcing the resignations of government ministers and senior health officials worldwide.

Furthermore, compulsory licences are only acceptable under TRIPS when used to 'fulfil a local requirement', so that importing generic drugs from other countries is ruled out. Since many poor countries don't have the wherewithal to manufacture their own generics, this would seem to be an absurd, but deadly, technicality. An attempt was made to address this problem by the WTO in their Doha declaration of November 2001, and this declaration was enshrined in law (for European Union nations) by the European Union in May 2006, and by Canada in 2005. Few countries have made use of the provisions of the Doha declaration, though Brazil has used compulsory licensing as a threat to get drug companies to lower their prices.

People power can be used, and sometimes needs to be used, to get drug companies to soften their line. This occurred famously in 2001, when 39 drug companies tried to prosecute the South African government for contravening TRIPS regulations regarding the production and importation of generic drugs. A massive public outcry, a 300,000 strong petition, and other forms of pressure succeeded in getting them to back down, but the situation is still far from satisfactory, and the complex world of compulsory licensing, voluntary licensing, regulation, deregulation, self-regulation, market forces, greed and social conscience makes for plenty of loopholes and anomalies resulting in too many deaths from entirely preventable diseases in poor and sometimes not so poor countries around the world.

There's a useful essay on the issues around TRIPS and generic drugs here.

An analysis of the documentary, Dying for Drugs, and the issues it raises, can be found here