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One of the issues that concern every human being is health. The charter of the World Health Organization and the signatory to that has to ensure health for all. This effectively means that the countries are duty bound to ensure health systems adequately reach the population.
Sadly the commercial issues have throughout clouded the real objective of the ideal principles originally intended for. With the advent of the World Trade Organization and the rapid pace of globalization the governments throughout have been railroaded into shifting priorities from the basic issues of governance. More and more money is being spent in defense and arms procurement. Health sector and education has been given a go by.
In this backdrop with the looming health crisis and the epidemic of AIDS and resurgent diseases, health assumes a paramount importance. For effective delivery of health care, affordable medicines are important. To understand the pricing of the drug the drug development is not out of place:
Once a new molecule is identified, it is called a generic drug. To safeguard the molecule the drug companies patent the molecule. This means that they have the right over the molecule including the delivery systems and marketing. To protect the discovery and ensure that no one else copies the molecule there is an international agreement which is defined by TRIPS (Trade Related Intellectual Property Rights).
What has been the scene in India and other developing countries so far?
Up until now the Indian patents act 1970 had been in force. This was unique in the fact that it patented the process but not the product. So we had a large number of manufacturers who had cheap copies of the generic drugs being manufactured abroad. Any new drug had copies out within a span of 6 months.
It meant that the Indian drug company was thriving on cheap labor and inadequate patent protection laws. It also meant that the drug prices in India were the lowest in the world. A comparative price structure across the world would reveal the disparity in prices. In this backdrop the decision of the Indian drug maker Cipla sparked row of protests among the international drug manufactures after it decided to provide cheap anti AIDS drugs in AIDS hit Africa.
All along the line one thing stands clear. Is it having vast sums of money gives one the right to play God? Why is it that these drug manufacturers blatantly misuse the position of advantage they have themselves placed into?
The drug corporations claim that they spend large amounts of money on research and development.
Actually an analysis of spending of the companies shows that a small percentage is spent on the research and development. Most of the money is spent on advertising and marketing, in a classic case of some people feeding over the lives of many. That’s worse these companies have "gifted” away large amount of stock options to the top echelons. Is there no end to greed of some at the cost of disadvantage to the majority?
Over and above the WTO has also not helped the matters. The natural cost advantage of Indian drug manufacturers is also at stake. While in narrow terms this is no excuse to spend on research and development but the larger issue at stake is that disadvantaged people are going to be put at even more disadvantage. Over a period of time the cost of medicines is going to skyrocket. How can people earning less than a dollar per day afford the health care? This sounds frightening.
What are the practical issues at stake? A patient suffering from say tuberculosis is not able to afford the recurring costs of the expensive medicines. He is forced to leave in between. The disease returns with increased ferocity and what’s worse compounds the problem in multi drug resistant tuberculosis. This strains the limited health care budget of the developing nations, a recurring problem with no solution in sight.
Another problem is that of neglected diseases. There has been no research for the diseases like malaria. Currently most of the companies are involved in the manufacture of "designer drugs". Off and on the market remains, the developed countries which can afford to pay for the astronomical costs through their almost universal health insurance. How many people have access to the same in the developing countries?
A recent report in JAMA says that infectious diseases that continue to be the leading cause of death in poor countries do not affect industrialized countries. The drug development has ground to a virtual standstill; only 1% of the 1393 new drugs approved between 1975 and 1999 are for tropical diseases, which account for almost 10% of the global disease burden. There is no global liability or any moral obligation on part of the drug companies to innovate or produce drugs for the developing countries.
All along the line the governments backing the companies also have a lot to say in the matters of policy. It is no secret that corporations donate a lot of money for the campaigns. A case in the point is the censure of Thailand when it decided to stick out its neck and place the priorities of its population in place. Repeatedly it was threatened with trade sanctions by the United States. The lives of people have no meaning in the "global village."
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Abhishek
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