By Astha Agrawal:
There are very few instances when I felt proud of Indian laws (from their framework to implementation). This story is about that rare one.
There was a time when approximately 8,000 lives were lost every day for the scarcity of necessary drugs against AIDS. There is a time, today, when not as many, but lives nevertheless, are lost to fatal (not unpreventable/incurable) diseases. There are multitudes of reasons as to why people die of diseases and why health risk is very high. It is no secret that poverty and its allies have pervaded the lives of most people on this planet. True. Nonetheless, if I had to glean out the most pressing concern exacerbating health insecurity, despite brilliant strides in the world of science and medicine, it would be the lack of three A’s — availability, accessibility, and affordability — of important drugs. A partial, but fundamental, answer to this challenge is generic drugs. Generic Drugs are not protected by the patent regime; use the same ingredients, to the same effect as their branded equivalents/patented remedies, but at a mere fraction of their price. The difference in price can be as high as 99%, making it truly a matter of life and death.
We are amidst a global fight for access to medicines. The manifestation of this battle is an on-going tussle between the current system of medical innovation drawing its elixir from patents regime (documented in WTOs Trade Related Intellectual and Property Rights) and the right to health. It is often, and rightly, iterated that the fruits of innovation barely reach those in whose name the innovation is (I suppose!) done. This is because by travestying safeguarding the motivation and incentive to conduct research and compensating for the heavy cost incurred in the process, big pharmaceutical giants have erected blood sucking monopolies. (Note that both the claims can be questioned, and there are better ways to address them). So much so that it will not be an exaggeration to call them the mightiest industry in the world.
India did something laudable in the 1970’s. It altered its patent law on the pretext that, with a poor population of humungous proportion, it could not endure the monopolies on food and medicines. Since then, it has grown the largest industry of generic drugs. India is the leading supplier of affordable, high-quality medicines to Latin America, Africa and Asia (approx. 200 countries worldwide) making it ‘the pharmacy of the developing world’. We have all heard of ARV treatment of HIV/AIDS, Dots for Tuberculosis, and many other drugs for cancer. Not long back in our recent past, these medicines were out of the pockets of even a middle class person. With the market competition amongst multiple generic manufacturers in India, the price for say ARV, has been brought down by 99%! Not just the law but successive governments and courts have also maintained India’s stance vis-a-vis patents. In 2005, in adherence to TRIPs agreement of World Treaty Organisation (WTO), India started giving out patents. But TRIPs allowed some flexibility for developing countries to act according to their national interest. India has made successful use of it by passing a pertinent law that makes ‘evergreening’ — an innovation of sorts in the drug that forms the basis of prolonging the life of the patent in question – of patents difficult. A year ago, the Supreme Court’s judgement that rejected a Swiss Pharma giant Novartis’s claim of evergreening reinforced the belief.
It is notable that the pharmaceutical industry has a big economic and political clout in western countries. Which is why, even when the international law permits variation, they use their leverage to deter developing countries from modifying patent regimes. On top of that, they now sign bi and multi-lateral agreements to twist the arm, for instance India – EU Free Trade Agreement that seeks to detrimentally modify India’s patent laws and affects Indian courts’ jurisprudence to rule over them. Why should there be a second thought over the fact that public health takes precedence over astronomical profits? A commercially guided patent regime may hanker after a billion dollars, but what about a billion lives?
I do not suggest that everything is hunky-dory at the health front in India. It is obviously not! But what we do have needs to be safeguarded to be able to promote and advance it. There is very little public debate and a clear lack of awareness about/over the importance and question of generic medicine. To sustain its resonance in the political consciousness of our leaders, this, to do the minimal, shouldn’t be elided. While the unManifesto campaign is on, what is unsurprisingly visible is the consistent presence of health security as one of the top three promises. Health expenditure in India is just 1% of total GDP. Only a minuscule number of people have health insurance as most have to pay for health from their own pockets. In this situation, it is extremely important that they are ensured quality medicines at affordable prices! It constitutes a critical part of health policy. I don’t know if health is wealth. But it surely is life.