Effect of drug patents in developing countries

Editor—Do drug patents kill? If they do the risk is felt overwhelmingly by the poor. AIDS will soon become the leading cause of death worldwide, and 95% of people infected with HIV worldwide live in the world's poorest countries. Effective treatments are mostly patent protected, with the result that the annual cost to treat a single patient with AIDS is up to 100 times the average gross domestic product per capita in developing countries.¹

These staggering facts have led to a campaign to increase access to essential AIDS medicines in poorer countries, including a loosening of patent protections on medicines.²

Opposition comes mainly from pharmaceutical companies, which argue that without patent protection profits will dry up, eliminating the incentive to conduct research into new drugs. But who really pays for AIDS research? The reality is that taxpayers, not shareholders, have borne most of the cost. Publicly funded research councils have contributed hundreds of millions of taxpayers' dollars to AIDS drug research. Indeed, the Pharmaceutical Research and Manufacturers of America, an industry lobby group, estimates that private industry finances only about 43% of drug development.¹ Five commonly used drugs against AIDS—didanosine, lamivudine, nevirapine, stavudine, and zidovudine—were developed largely as a result of public funds.¹

But beyond this argument lies the question of what a loosening of patent protection means. The access to essential medicines campaign advocates for the right of poorer countries to use completely legal trade measures in a public health emergency.¹ These include compulsory licensing—the legal right to produce patented medicines in exchange for a royalty payment to the patent holder—and parallel imports—the legal right to import patented drugs from another country where they can be obtained more cheaply.

These measures can hardly be considered a threat to drug research, especially since they already exist under the World Trade Organization's rules and would have no impact on patent protections in Western countries. Furthermore, the introduction of generic drugs lowers costs. A study by Médecins Sans Frontières found that the introduction of generic AIDS drugs in Brazil means that it now costs the same to treat 1000 patients there as it does to treat 552 in Thailand, where generic drugs are less available.¹

Patents restrict access to medicines, and poor patients die every day of diseases against which effective treatments exist. Those prepared to defend an unfettered pharmaceutical market must acknowledge that the only freedom it offers these people is the freedom to die without access to essential medicines.