Cancer, dementia, diabetes, tuberculosis, and heart and lung disease, accounted for 31 million of the 56 million deaths worldwide in 2016. Eighty percent of these deaths occurred in developing and low income countries; the truth is many people died because the drugs they needed were too expensive to buy. The good news is—Third World Network (TWN) Malaysia are showing there is something we can do.
Developing and low income countries share a bigger burden of these deaths because their public health systems are often under-funded and unable to make the imported drugs available at an affordable price. This is partly because of the exorbitant costs and the long-term nature of the treatments required. As a consequence, sick patients go untreated leading to their debilitation and death. Both government and patients do not see a way out of the problem because the drugs produced by big pharmaceutical companies, usually based overseas, are bound by patents that are locked into trade deals.
‘Companies often extend their product patents by tweaking the chemical make-up of the drugs to maintain their monopoly of production and sale’
Pharmaceutical companies fix the prices of drugs they produce and also license these drugs to ensure that no one else can use the same combination of chemicals. These licenses can run for as long as 20 years, during which time the companies have a monopoly of production and sale. Pharmaceutical companies argue that the protection afforded them by the licence is necessary to recoup research and development costs, but profits have been shown to far outstrip these. Moreover, companies often extend their product patents by tweaking the chemical make-up of the drugs to maintain their monopoly of production and sale.
It is customary for countries to sign trade agreements to improve trading flows and boost the economy. The benefits of trade agreements can be widespread but some clauses can close the door on the possibility of countries making essential drugs themselves, while ensuring overseas companies continue to monopolise supply. These agreements substantially reduce the ability of countries to make laws that promote the local production of essential drugs, while government officials in different ministries often do not appear to know or fully understand the technical implications of some of the agreements that former or current governments have signed.
‘It is estimated that over 450,000 Malaysians are infected with Hepatitis C, and that the new treatment plan will make it possible for Malaysia to eliminate the disease by 2025’
However, special agreements made at the World Trade Organisation (WTO) give governments the legal right to prioritise the health of their citizens and so produce drugs in their own countries—even if they have subsisting trade agreements that might otherwise prevent them from doing so. Nonetheless, government awareness of the WTO agreements remains low, and those that are aware often do not know how to activate its provisions, nor do they have the required drug manufacturing capabilities and resources for research and development.
TWN Malaysia is implementing a project to tackle these factors, with support from the Commonwealth Foundation and the cooperation of the Malaysian Government. In particular, TWN Malaysia has worked with other civil society partners to provide technical and legal input to overcome the license barrier for Sofosbuvira—a drug used for treating Hepatitis C. Due to these efforts, the price of a three-month supply has now dropped from US$10,000 to US$100. This has allowed the Malaysian Government to roll out free treatment in 21 public hospitals. It is estimated that over 450,000 Malaysians are infected with Hepatitis C, and that the new treatment plan will make it possible for Malaysia to eliminate the disease by 2025.
You can read more about Third World Network’s project here.