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November 18, 2019

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Guest Column:

U.N. taking foolish approach to improving delivery of medicines to developing countries

In developing countries, roughly 1 in 3 people lack dependable access to “essential” medicines — a category that includes a range of things from ibuprofen to HIV/AIDS treatments.

The United Nations hopes to address this global crisis through its High-Level Panel on Access to Medicines, which is expected to issue recommendations in the coming weeks. Unfortunately, the panel seems on track to do more harm than good.

The reason? Secretary-General Ban Ki-moon has instructed the panel to ignore fundamental causes of drug shortages in the developing world — inadequate transportation infrastructure, flawed government policies, a lack of trained medical workers, etc. — and instead focus on patent rights as the culprit.

Attacking the inventions of biopharmaceutical researchers will do little to improve access to medicines in the developing world. Instead, it will undermine the incentives for medical innovation, leaving patients here and abroad worse off.

Despite its name, the High-Level Panel isn’t tasked with expanding the availability of medical treatments. Instead, it’s only addressing “the policy incoherence between intellectual property laws and access to medicines.” This unusually specific mandate lays bare an unfortunate bias on the issue. It assumes the world doesn’t have an essential-medicines problem; it has an “incoherent” patent system. And rather than argue for this misguided view, it’s baked it into the mission of the UN panel.

Luckily, those with a genuine interest in improving access to medicines have rejected the panel’s misguided assumptions. In a comment to the UN, the State Department’s Ann Blackwood made the United States’ reservations clear, writing that, “(w)e question the premise that the rights of inventors ... and public health are ‘misaligned.’” She adds the panel’s narrow focus “suggests predetermined outcomes” and strongly recommends a revised approach.

Such skepticism is more than justified. Consider that the majority of drugs deemed “essential” by the World Health Organization aren’t under patent.

Far from being a threat to public health, patents are indispensable to promoting life-saving medical research. If companies couldn’t protect their inventions through intellectual property laws, they’d have little reason to take the enormous risks involved in drug discovery. It’s not a coincidence that drugs are only created in a few countries with strong patent systems.

There are easier ways to make money than drug development. On average, developing a new drug takes more than 12 years and costs well over $2 billion. Of the handful that reach the market, only about 20 percent will turn a profit. Without patent protection, no company can assume this risk. Unfortunately, the panel ignores this reality.

At a recent meeting, one participant argued for another way to pay for research and development. Her solution: putting governments in charge so there are “no monopolies on medicines that are financed with public money.” It would be hard to think of a worse approach than putting governments in charge of drug development — unless it’s putting the UN in charge.

An honest examination of the problem would acknowledge that governments — and not private research firms — are often the biggest barriers to expanding the availability of medicines.

According to the World Health Organization, the main reasons the developing world lacks access to basic medicines are an inability to select and use those medicines rationally, unaffordable drug prices, inadequate financing, and unreliable health and supply systems.

Many of these problems have to do with education, local and national institutions, and the infrastructure used to deliver medicines. As for the matter of affordability, the WHO points out that taxes, tariffs and other government policies play a significant role in keeping drug prices so high in the developing world.

The UN should have looked at all of these factors. It chose, instead, to reinforce a counterproductive narrative in which patents are the enemy of medical access. This approach doesn’t just distract from the problem at hand; it will make it worse. That’s something none of us can afford.

Joseph Allen consults on intellectual property and technology transfer policies. For 12 years he headed the National Technology Transfer Center.

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