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Novartis vs. India: Patents vs. the poor? | 

Flickr, Brooks Elliott

One of the biggest, thorniest dilemmas in global health is coming to a head in India.

(And the biggest player in this arena, the Bill & Melinda Gates Foundation, with a former top Novartis executive running the global health program, has no comment on it. More on that below).

At one level, it’s a narrow legal battle between the drug company Novartis and the government of India over an expensive cancer drug known in the U.S. as Gleevec, and everywhere else as Glivec.

Novartis has challenged India’s denial of patent protection for the drug and the case is now under consideration by the Indian Supreme Court. Those on either side of the argument say the case has major implications for all of global health.

Why? Because this legal battle pits one set of laudable goals, finding new and better drugs, against another equally critical aim, making sure all the people who need these drugs can afford them.

Novartis

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, head of corporate research at Novartis.

“This isn’t really about Gleevec,” added Herrling. “This is just one part of a much larger issue.”

On that last point, many global health advocacy organizations and activists would agree.

Organizations like MSF (Médecins Sans Frontières, aka Doctors without Borders) Oxfam and others focused on ensuring poor people have access to life-saving drugs see Novartis vs. India as central to a much bigger industry-wide push now taking place on a number of fronts.

Judit Rius, MSF

“This is part of a global strategy aimed at lowering the bar, of making it easier for these companies to extend their drug patent monopolies,” said Judit Rius, U.S. manager of MSF’s Campaign for Access to Essential Medicines.

A Novartis win in Indian court would seriously undermine the generic drug industry, Rius said, reducing the supply of cheap drugs that make a life-and-death difference in poor countries.

MSF, Oxfam and other health advocacy organizations have been fighting Novartis on this case for years. It has dragged on within the India court system since 2006, getting filed, denied and then re-filed, with advocates for the drug company arguing that India is improperly protecting its burgeoning generic drug industry while many public health advocates argue Novartis is profit-seeking at the expense of the poor.

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UN health summit makes food, beverage and drug industries nervous | 

Flickr, Roadsidepictures

Members of the United Nations General Assembly met this week to come up with a plan to combat chronic disease in poor countries that appears to have some in the food, beverage and drug industries worried.

Ten years ago, a similar meeting here produced a massive global response to the AIDS pandemic, most notably with the creation of the Global Fund for Fighting AIDS, TB and Malaria (which yesterday, despite clearly saving many millions of lives, got slammed for not working as well as advertised).

The expectation at the UN meeting is that delegates will decide that somebody should do something … and would like to be more specific, but then say they are late for another meeting, grab their hats and coats and make for the door.

Part of the problem is that many chronic diseases are “lifestyle” diseases — lifestyles that a lot of corporations want us to buy into.

The need for action is clear: Chronic or non-communicable diseases (aka NCDs) are the world’s big killers, representing about 60 percent of all causes of death. Cancer, heart disease, stroke, lung disease (mostly from tobacco), diabetes and the like kill many more people — most of them in the developing world — than do infectious diseases like AIDS, TB or malaria.

But governments, donors, the drug industry and health agencies don’t set their global health priorities simply on the basis of the burden of disease, as reasonable as that might sound. Some diseases are too complex, their treatment too expensive, to feasibly act against in poor countries.

Many of the NCDs are, however, easily and cheaply treated or prevented. High blood pressure can be treated with drugs costing pennies per day. Tackling some of the biggest killers, the World Health Organization says, can be done at a cost of about $1.20 per day.

Simply educating people about a healthy diet and the risks of tobacco or excessive alcohol use could do a lot.

It all sounds do-able, this aim to shift the global health agenda to include these non-contagious killers. So why the pessimism about getting a meaningful game plan out of this UN meeting?

Part of the problem is the concerns of industry. These health goals sometimes run up against powerful commercial interests in the food, beverage and pharmaceutical industries.

UN

UN Secretary General Ban ki-Moon

“There is a well-documented and shameful history of certain players in industry who ignored the science, sometimes even their own research, and put public health at risk to protect their own profits,” UN Secretary General Ban Ki-moon said Monday in a speech on the NCDs.

Ban cited the tobacco and alcohol industries, but also makers of processed foods high in salt, sugar and fat — and the media companies that advertise unhealthy products. Continue reading