Thank you for sharing!

Your article was successfully shared with the contacts you provided.
The recent meeting of the 59th World Health Assembly in Geneva discussed several approaches for improving access to health care in the developing world, including attacking the perceived problem of patents on crucial medicines like anti-malarials and anti-retrovirals. Some would have us believe that patents on these medicines are little more than vehicles for driving prices artificially high when in fact they are essential for facilitating the complex business deals needed to deliver drugs in the first place. Patents do not cause drugs to be expensive as much as the high costs of research, development, regulatory approval and distribution do. However, even these commercialization-related costs are not the real barrier for getting drugs delivered to patients in poverty-stricken regions like those in sub-Saharan Africa. Ridiculous taxes, import duties and regulatory barriers are one set of important problems that must, and can, be eliminated immediately. In many cases, taxes and import duties reach well above 50%. Frequently, after drugs have been found safe and effective by careful regulatory review in the United States, Europe and Japan, and used widely by citizens there, an additional regulatory review period involving 30-odd months and high fees is imposed before importation is allowed to poverty-stricken regions, all in the name of the “public interest.” Even drugs provided for free often get tremendous import duties tacked on anyway, plus they face the same regulatory costs as expensive drugs. All of these costs are borne by the poverty-stricken populations. While some of these costs actually may be serving as important subsidies to local governments and economies, those can and already are being more efficiently provided directly by the United States and others. Of the new drugs that are essential and patented, many already are being provided to these regions at ultra-low cost or for free. They’re getting there, but not to the patients. The problem is distribution, not price and not patents. Poor rule of law and predictable business relationships so poison the local environment that simple distribution channels cannot develop. Strengthening the rule of law will empower local populations at the grassroots level to develop the businesses they need to get distribution done. Enforcing patents internationally helps prevent these businesses from getting distracted when their essential medicines are shunted towards the black markets, which would erode both initial supply and local distribution. Address basic health care first Access to basic health care is a more critical problem that screams for solution. When doctors, nurses, hospitals and long-established essential treatments are not even available, it surely is imprudent triage to focus such attention on cutting-edge innovative medicine. The vast majority of the drugs on the World Health Organization’s essential medicines list are not even covered by patents today. Indeed, the many wonderful private, foundation, nongovernmental organization and public efforts already being made to improve access to basic health care in these regions are a proud testament to the effectiveness of this approach. Additional efforts in this direction can have high impact, quickly. Real lives are being lost. Real action is needed. Patents are an important part of the solution. But it’s even more important in the short run to continue to improve access to basic health care and to remove the barriers to distribution for drugs, whether patented or not. We also should continue to help strengthen the rule of law over time. Botswana has long stood as an impressive example of efforts on this front, and new initiatives along these lines by President Bingu wa Mutharika of Malawi offer similar hope. The developed nations of the world interested in improving access to health care, like the United States, should continue to spend financial and political capital to bolster these efforts. F. Scott Kieff is an associate professor at Washington University School of Law and a research fellow at Stanford University’s Hoover Institution.

This content has been archived. It is available through our partners, LexisNexis® and Bloomberg Law.

To view this content, please continue to their sites.

Not a Lexis Advance® Subscriber?
Subscribe Now

Not a Bloomberg Law Subscriber?
Subscribe Now

Why am I seeing this?

LexisNexis® and Bloomberg Law are third party online distributors of the broad collection of current and archived versions of ALM's legal news publications. LexisNexis® and Bloomberg Law customers are able to access and use ALM's content, including content from the National Law Journal, The American Lawyer, Legaltech News, The New York Law Journal, and Corporate Counsel, as well as other sources of legal information.

For questions call 1-877-256-2472 or contact us at [email protected]


ALM Legal Publication Newsletters

Sign Up Today and Never Miss Another Story.

As part of your digital membership, you can sign up for an unlimited number of a wide range of complimentary newsletters. Visit your My Account page to make your selections. Get the timely legal news and critical analysis you cannot afford to miss. Tailored just for you. In your inbox. Every day.

Copyright © 2021 ALM Media Properties, LLC. All Rights Reserved.