drug industry


Guest post: Drug prices hurting Russia’s battle against HIV, hepatitis | 

By Natalie Flath, aka Natasha, a health advocate and activist based in St. Petersburg, Russia.

Andre Scvorstov protests outside the Russian headquarters of drug-makers Roche and Merck with sign: “Merck, You are Reducing the Russian Population.”
Andre Scvorstov protests outside the Russian headquarters of drug-makers Roche and Merck with sign: “Merck, You are Reducing the Russian Population.”
Natalie Flath

St. Petersburg, Russia — On a morning walk down Dostoevsky street here in Russia’s second largest city, with my head phones on to block out the sounds on the street, I try to catch up on the news around the world before I start the work day.

“Euromaiden protests in Kiev.” Hey, that’s where my babushka was born.

“University students crowd the streets of Caracas.” That’s where my mom was born.

“Policeman kills an ex-soldier in Tacoma.” That’s where I was born.

Less noticed are these recent news items:

The Guardian WHO calls for access to hepatitis C drugs

NPR WHO calls for high-priced drugs for millions with hepatitis C

FT Price of hepatitis C drug attacked

Many people are, of course, paying attention these days to the unrest and conflicts in Ukraine, and perhaps most are aware of Russia’s ongoing battle with high HIV rates. But few have paid much attention to the needs of the many thousands of residents in this city, not to mention the 150 million people worldwide, infected with hepatitis C – and how the marketplace approach to this global health need is failing.

I’ve been working with St. Petersburg civil society, two grassroots NGOs, for almost 18 months now. I got this gig from first networking with other organizations while still working in Seattle doing biomedical HIV prevention research. After volunteering one summer to work here with HIV-positive children in a tuberculosis sanitorium, I decided to reach out to activists.

That was before people were paying much attention to Russian activists, other than maybe the outspoken punk rockers Pussy Riot, and before the Ukrainians kicked out their president and Russia annexed Crimea.

What I was focused on was the fact that Eastern Europe and Central Asia, a territory mixed with high- and middle-income countries, is experiencing one of the fastest growing HIV and TB epidemics in the world. I was curious to dig deeper into the faces behind the numbers, tap into my Eastern European roots, and discover all the hype about the grassroots movement.

St. Petersburg is a big, urban city and perhaps not your typical rural village that the term “global health” seems to evoke – but what’s happening here deserves as much attention as the iconic poor, rural village in Africa.

My coworker and HIV-positive friend, Andre, showed me his new tattoo – an angel of death sprawling over his liver.

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PATH & Sanofi start major production of synthetic anti-malaria drug | 

African child with cerebral malaria

Mike Urban

African child with cerebral malaria

Malaria remains one of the world’s biggest killers and also a massive economic drag on poor countries, poor families.

One of our best weapons against this scourge is a drug known as artemisinin, which is harvested from the plant sweet wormwood and, as a crop, is about as predictable as corn or hog futures.

A major new initiative to be launched tomorrow in Italy by Seattle-based PATH in collaboration with the French drug maker Sanofi aims to introduce more predictability – and more of the drug.

“Our goal is to stabilize both the price and supply,” said Ponni Subbiah, head of global drug development for PATH’s subsidiary OneWorld Health – a non-profit drug company based in San Francisco that PATH acquired in 2011 to expand its global health expertise in this area usually left up to commercial drug makers.

On Thursday, at Sanofi’s manufacturing facility in Garessio, Italy, Subbiah and others will officially launch industrial scale production of  semi-synthetic artemisinin aimed at producing 35 metric tons of it – approximately 70 million antimalarial treatments. Continue reading

Drug industry loses in India – fight over ‘patents vs poor’ to continue | 

green pills
Flickr, sparktography

The Indian Supreme Court has rejected a drug patent application by the international pharmaceutical firm Novartis, an event that merited coverage by the New York Times, BBC and many other media – news which you might think is mostly a matter for the business page or drug industry insiders.

In fact, the case may represent one of the most difficult dilemmas in global health. It is a fight that is far from over.

The Indian high court’s legal resolution (or perhaps ‘latest phase’) of this long-running battle between the Indian government and Novartis, as I wrote about last October in a post called Patents vs the Poor, is regarded on all sides as representing much more than what Novartis can charge for the particular cancer drug, Gleevec (or Glivec), at issue.

What’s at stake is one of global health’s most difficult balancing acts – how to expand access of life-saving medicines to the poor while also protecting the legitimate interests of the drug industry when it comes to patent protection and intellectual property. The high court’s decision is being reported as a victory of the generic drug industry, which is big in India, over Western drug makers. As the New York Times put it:

On the one hand, it will help maintain India’s role as the world’s most important provider of cheap medicines, which is critical in the global fight against HIV/AIDS and other diseases…. On the other hand, the ruling could cost lives in the future. Drug company executives and others argue that India’s failure to grant patents for critical medicines …  is a shortsighted strategy that undermines a vital system for funding new discoveries.

That’s what Novartis’ head of corporate research, Paul Herrling, told me:

Paul Herrling
Paul Herrling

“If a breakthrough compound like this cannot be patented in India, that has major consequences for innovation in India and elsewhere,” said Paul Herrling. “This isn’t really about Gleevec … This is just one part of a much larger issue.” Continue reading

Op-Ed: How a new trade agreement will hurt poor’s access to medicines | 

Guest Column by James Love, director of Knowledge Ecology International


President Barack Obama, in his 2013 State of the Union address, referred to an international trade proposal called the Trans Pacific Partnership Agreement, or TPP for short. It’s a massive set of trade negotiations with a lot at stake, affecting about 40% of all global commerce from the use of the internet to the price of drugs.

drug money
Flickr, Brooks Elliott

Salon called the Trans-Pacific Partnership the biggest trade deal you’ve never heard of, and speculated it “could potentially be the most significant foreign and domestic policy initiative of the Obama Administration.”

So why haven’t you heard of it? Three reasons:

  • First, the negotiations of the TPP are held in secret, making it hard to report.
  • Second, trade agreements are perceived to deal with technical and obscure issues that news editors think would bore most readers to death.
  • Finally, the White House makes it sound as if the trade agreement simply imposes “our” norms on foreigners, making it seem less relevant to U.S. readers

The TPP, in fact, will be a game-changer for all of us and is woefully lacking in media coverage.

Enough is known by activists about the negotiations to paint a fairly clear picture of its impact on global prices for medicines. That’s what I’m focusing on here. In particular, the TPP is poised to reverse major concessions on intellectual property rights protection for medicines in developing countries that were put in place in 2007 by the Bush Administration.

I think it’s both surprising and worth reporting that the Obama Administration is actually more hostile to the interests of the global poor than was the Bush Administration. 

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Obama Admin opposes making other nations share cost of drugs | 

Flickr, by Rodrigo Senna

Fake drugs on the rise

On the face of it, this might sound a bit odd.

But then, that’s the way politics and foreign policy often sound. Odd.

The U.S., which pays for something like 70 percent of the costs of researching and developing new drugs, this week at the World Health Assembly meeting in Geneva opposed creating a mechanism requiring other nations to pay more — a fair share.

In short, the Obama Administration opposed a plan to reduce our disproportionate spending on drug development.


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Why we still don’t have a cure for AIDS — a novel explanation | 

Open Door Press

If someone discovered a cure for AIDS, would the pharmaceutical industry be able to – or even want to — develop it?

That’s one of the questions explored in Through These Veins, the first novel by Anne Marie Ruff, a veteran journalist who has covered AIDS, medical research, biodiversity and other international issues for many publications.

It’s perhaps also a question worth asking in reality this week as international leaders have been meeting at the United Nations and throughout New York City to debate, among other things, how best to fight disease in poor countries.

HIV infection is today, in rich countries at least, no longer a death sentence but rather a manageable, chronic disease almost like diabetes thanks to the development of effective anti-HIV drugs.

That’s obviously of life-saving benefit to millions of people infected with HIV who can get these drugs.

It’s also one of the great success stories for what some might call the “medical-industrial-complex.” At the risk of sounding a bit crass, people with HIV, like people with other chronic diseases, have to keep buying these products in order to stay alive.

Is there just as much market incentive for a drug company to spend hundreds of millions of dollars to find a cure for AIDS? Ruff doesn’t think so.

“I would challenge you to show me a pharmaceutical company that can afford to undertake the very expensive, risky, and long-term research necessary to develop a cure for HIV/AIDS, or almost any other disease for that matter,” she told me. “The sales model simply will not support the effort.”

(Maybe not for drug companies. But I should note that there are medical scientists at the Fred Hutchinson Research Center exploring a gene-modification approach to curing HIV infection.)

Ruff says she isn’t necessarily criticizing the drug industry (though one fictional company, Klaus Pharmaceuticals, is certainly the bad guy in her novel). Drug makers are simply responding to market forces, she says, and are legally required to their shareholders to pursue the most lucrative business strategy.

Unfortunately, she says, the money is in treating and not curing. And the scientific community, Ruff adds, tends to follow the money also. Continue reading

Al Jazeera: The great billion-dollar drug (and vaccine) scam? | 

Flickr, anolob

The pharmaceutical industry often trots out some pretty stunning numbers to explain why their drugs cost so much. A journalist and South African scholar scrutinizes the numbers for Al Jazeera.

In the first part of a two-part series called “The great billion dollar drug scam,” investigative journalist Khadija Sharife begins her analysis (interestingly, oddly, labeled by Al Jazeera as an opinion piece) with a focus on the Gates Foundation-backed global vaccination project known as GAVI, the Global Alliance for Vaccines and Immunization:

Alongside pneumococcal diseases such as meningitis and pneumonia, rotavirus-related diarrhoea is a primary childhood killer in developing countries, thought to snuff out the lives of 500,000 children each and every year. An overwhelming 85 per cent of these children are African and Asian. The need for medical miracles is as great as ever, but corporate mispricing generates huge profits, while driving up the price of life saving medicines.

British-based drug corporation GlaxoSmithKline (GSK) recently offered a five-year deal to supply poor nations with 125 million doses of the rotavirus vaccine – Rotarix – at $2.50 a dose, just five per cent of the current going price in Western markets. Through the GAVI group, the international vaccine agency financed by developed nations such as the UK, it is hoped that GSK and pharmaceutical multinational Merck – who, between them, dominate the rotavirus vaccine market – will provide a secure line of low-cost drugs for as many as forty countries in the near future.

But is it really a discount, and if so, who is paying the cost?

I think this is easy enough to answer: Yes, these are clearly discounts (about one-tenth what the vaccine costs in the U.S.) and we in the rich world are basically subsidizing cheaper vaccines for the poor world.

Is it enough of a discount? Some think not. Others think we’re getting a pretty good deal and need to be more sympathetic to the much-maligned drug industry. Continue reading

Owen Barder: Should we pay less for vaccines? | 

Owen Barder

Owen Barder, a development expert at the Center for Global Development, asks “Should we pay less for vaccines?

Barder’s post was prompted by the critical response some advocacy groups, like Oxfam and Médecins Sans Frontières (aka Doctors Without Borders) made after the successful fund-raising effort on June 13 by the Global Alliance for Vaccines and Immunization, a massive project getting vaccines out to poor kids.

As I noted at the time, these organizations and others were glad to see GAVI receive $4.3 billion in new funding but they felt the alliance was a bit too friendly to the drug industry and too willing to accept industry pricing.

This issue, of what constitutes fair vaccine pricing for poor countries, came up repeatedly this week at Seattle’s Pacific Health Summit. I intend to write about that in a separate post later.

For now, I urge you to read Barder’s excellent take on the critics of GAVI and the vaccine manufacturers. Continue reading