Drug discovery and production is a business; its purpose is profit. However, the goods produced through this business carry much more value than the price assigned to them. They save human lives. Examining the pharmaceutical industry to ensure that access to medicine is a right afforded to all human beings, not a luxury reserved for those able to pay, is crucial.
Dr. Bradley Stoner, an associate professor of Anthropology in the School of Arts and Sciences and Infectious Diseases at the Washington University Medical School, was able to offer both an anthropological and medical perspective on the current model of drug research, discovery, and production.
“Since the drug discovery is embedded in the private sector, drug company’s primary responsibility is to their shareholders. It’s very expensive to bring a drug to market, and so the companies must take a big risk with the reward of being paid back in the end. However, when you have a disease like HIV that is so devastating, and the drugs are priced out of reach, you develop a two-tiered healthcare system. It’s very disheartening to those of us on the public health side.”
Dr. Stoner referred to the fact that access to treatment for HIV in the form of anti-retroviral drugs (ARVs) is limited, especially for those in Sub-Saharan Africa, as many are patented and expensive.
“In the early 2000’s, concern by international AIDS activists lowered restrictions on local production of drugs. Countries like Brazil and India were able to produce their own drugs. The problem was that these countries were not allowed to sell the drugs. There are a host of countries in Sub-Saharan Africa that have the need for the drug but not the ability or infrastructure to produce it. We rely on donor countries and international organizations to provide drugs to these countries.”
Access to HIV treatment has improved: the cost of first line HIV treatment for one person for one year has fallen from $15,000 in 1996 to $115 in 2013, and by the end of 2013, 11.7 million people of the 35 million infected were receiving treatment for HIV.
However, a potential international trade deal, the Trans-Pacific Partnership (TPP), now exists that could even more severely decrease access to medicines for those without the money to pay for patented drugs. A leak revealed that the United States is pushing for terms that would help pharmaceutical companies profit by restricting production of generic drugs. These terms include lowering the bar on what can be patented; slowing generic production by not allowing the generic producer access to the clinical trials performed by the pharmaceutical company; and extending patents, now 20 years, to at least 25 years.
While HIV/AIDS is not the only disease for which this agreement would have repercussions, the global health community should be informed of its potential negative repercussions. “Right now,” Dr. Stoner said, “what’s getting manufactured are drugs for people who can pay for them; that’s why we’re seeing so many new drugs for type two diabetes and hypertension. The ugly underbelly to privatization of pharmaceuticals is this two-tiered healthcare system, where there’s a 30 year lag until it’s cheap enough for people in developing countries to afford drugs.”
The implementation of the TPP will only widen the gap between the two tiers of health care. Those with the money to pay for drugs would receive an even higher level of care than those without the money to pay for patented drugs.
Looking towards the future, Dr. Stoner suggested that, “a solution would be for the United States government and other OECD countries to invest more heavily in drug discovery. They could pool their resources and fund an institute for discovering drugs and bringing them to market.”
Any solution to this problem must balance profit for pharmaceutical companies and access to affordable medicine for those in need. If the TPP is approved, it will favor profit for pharmaceutical companies, and decrease health equity for patients in developing countries. If access to health care is a basic human right, medicines cannot be priced at astronomically high prices that are out of reach to all but the affluent.