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A revised framework for global medicine access

A revised framework for global medicine access. Sanjay Basu. Reblaw X. The pipeline. Market failure. Social support & Adherence difficulties. Monopoly pricing of medicines & tech. Better treatment outcomes. R&D. Infrastructure inadequacy. Lack of financing.

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A revised framework for global medicine access

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  1. A revised framework for global medicine access Sanjay Basu Reblaw X

  2. The pipeline Market failure Social support & Adherence difficulties Monopoly pricing of medicines & tech Better treatment outcomes R&D Infrastructure inadequacy Lack of financing

  3. Price v. production cost of key AIDS drugs Source: HMS, 2002

  4. R&D spending? Source: Securities & Exchange Commission, 2003

  5. Source: Jim Kim, Harvard Medical School, 2001

  6. Source: Univ of Minnesota, 2001

  7. World Pharmaceutical Market Source: IMS Health, 2002

  8. Rhetoric v. Reality • TRIPs & the WTO • Parallel importation • cross-border trade of patented goods • Compulsory licensing • generic production, primarily for domestic market • Special 301

  9. What generics can help do… Source: Oxfam, 2003

  10. The Doha Declaration “We recognize that WTO members with insufficient or no manufacturing capacities in the pharmaceutical sector could face difficulties in making effective use of compulsory licensing under the TRIPS Agreement.”

  11. Information onslaught... • PhRMA budget: $150 million/year • $1 million for an "intellectual echo chamber of economists” • $2.5 million in payments to research and policy organizations "to build intellectual capital” • $17.5 million to fight price controls and protect patent rights in foreign countries and in trade negotiations • $9.4 million for public relations Source: NYTimes, 1 June 2003

  12. Intellectual echo chamber... • Attaran and “off-patent essential medicines” • Roger Bate and “Africa Fighting Malaria” • DiMasi’s “$800 million” R&D figure • Data exclusivity, diversion Source: Public Citizen, 2001

  13. Post-Doha: • USTR (originally with EU and Japanese support) broke initial deadline for negotiations • 17-page decision • Possible implementation by Canada?

  14. The new USTR proposals: • Chile – CAFTA – ARTA – FTAA – PPP • Singapore – Indonesia/Thailand – ASEAN • SACU

  15. Positive trends... • New infrastructure being built in southern Africa by Brazil • March-ins through Bayh-Dole: Norvir • Expansion beyond AIDS and into the United States: Xalatan glaucoma case • Pooled R&D approach (www.essentialinventions.org) • New non-market approaches: DNDi

  16. More information… www.essentialmedicines.org www.accessmed-msf.org www.cptech.org/ip/health Dying for Growth: Global Inequality and the Health of the Poor (Kim et al., 2000) Pathologies of Power: Health, Human Rights and the New War on the Poor (Farmer, 2003) The Political Economy of Social Inequalities: Consequences for Health & Quality of Life (Navarro, 2002) Global Intellectual Property Rights: Knowledge, Access and Development (Drahos & Mayne, 2002)

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