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One of the appalling statistics that came out of a survey in 2000 was the percentage of the HIV/AIDS infections in Africa. It was reported that nearly 80% of the total number of affected people was from this continent. Now if this report sounds dreadful, one might get a bigger shock by looking at the picture of modern healthcare methodologies in Africa. Despite being a developing nation, Africa gets scarcely one percent of modern drugs.
The value of all medical drugs transported to Africa amounts to the expenses spent on advertising by the leading pharmaceutical companies in the United States of America.
Under the light of this reality, this paper is going to discuss the genuine scenario in developing countries that don’t have an affordable access to life-saving medicines.
It might be noted that access to medicines is a fundamental human right, and there is a yawning gap between crisis and cure in a capitalistic social setup. Due to increased political pressure, many drug manufacturing companies have been forced to review their business strategies and produce medicines that are relatively less expensive.
Moreover, it is also mandatory to formulate a well-organized delivery system that would ensure a proper and timely delivery of the medicinal goods to Africa and other Third World countries. Modern healthcare remedies are needed to be deployed in order to combat the menace of HIV and other diseases in the underprivileged tropics. (“Access to Medicine in Developing Countries”, 2000)
Access to medicine in developing countries has always been a matter of great disputation, mainly because of the convoluted interaction between macroeconomic development, patterns of diseases and healthcare requirements and provisions. It has been an inescapable paradox for many countries where the national economic status can only be attained by improved health status. Hence, lack of supply of life-saving drugs hinders the scope and opportunity of national healthcare. (“Improving Access to Medicines in Developing Countries”, 2005)
The impoverished countries find it a mammoth task to meet both ends successfully. It has been proposed that only a large scale international funding can inject some fruitful results in the context of healthcare and economic boost.
The World Health Organization (WHO) and the World Trade Organization (WTO) are working together to provide the best possible framework for improved health status as well as the macroeconomic development of developing nations. WTO is primarily concerned with the organized growth of a capitalist, free market global economy.
On the other hand, WHO is focused on improving health conditions by providing healthcare models that can be applied to both developed as well as developing nations. Institutional and public sector frameworks play a crucial role in realizing the objectives of WHO to the best possible extent. The newly incepted Global Health Fund is working relentlessly to provide remedies for HIV/AIDS, TB and Malaria.
The Trade-Related Aspects of Intellectual Property Rights (TRIPS agreement) are held, in some cases, as obstacles for access to essential medicines in developing countries. Ever since WTO finalized the TRIPS agreement in April 1994, this issue has been a matter of great debate. The main problems in accessing medicines, as viewed by experts, are the increasing expenses, which can shoot up to 66% of total expenditure in developing nations.
Today’s scenario as far as having access to essential medicines is concerned is an alarming one, with more than one-third of the world’s population are deprived of indispensable drugs. According to the WHO, developing countries, especially those in Asia and Africa, must be provided with an all-encompassing solution in terms of health priority problems, and they must be able to gain access to life-saving medicines at an affordable deal.
To make matters worse, the poorer section of societies in developing countries find themselves all at sea due to their inability to physically access life-saving drugs. So both availability and affordability are the key areas of concern. Now under these circumstances, the introduction of strong and worldwide product patents for drugs, as implemented through the TRIPS agreement, may cause drastic increase in prices for essential medicines.
The ‘legal monopoly’ that comes with such rigid patent system prevents anybody from producing, selling or distributing medicines in an unauthorized manner. Even if there is no patent laws, access to medicines is going to be a problem for the developing countries, due to adequate purchasing capabilities and required infrastructure.
Majority of the medicines for HIV/AIDS are still under ‘live’ patent coverage. It doesn’t make for affordable access to such medicines either. And since more than 95% of HIV/AIDS affected people are from developing countries, and 50% of them belong to the productive age group of below 25 years, serious socio-economic consequences are perceived with very little signs of relief.
Before TRIPS were put to effect, most developing countries and some developed countries did not impose patent laws on medicines even if they were manufactured with innovative technological aids. But today, most of these nations being WTO members have to enforce the patent laws laid down by TRIPS. This has led to hike in prices of patented medicines.
It is worth noticing that even under the TRIPS guidelines, patents are to be given only on applications received from 1995 onwards for new therapeutic inventions. So any medicine manufactured before 1995 should not be unaffordable for the developing nations. Manufacturers of the newer and more innovative pharmaceutical products file for patents only in countries where business of piracy runs rampant.
Parallel import of drugs is another important issue that came into consideration after the TRIPS agreement. The Intellectual Property Rights owners of specific brands of medicines face problems when goods, legally distributed in the market of one country, are imported to another without the necessary legal authorization. Now, as long as there is no discrepancy in Intellectual Property Rights in two different countries, article 6 of TRIPS defends parallel import.
But considering the economic side of such imports, it might be noted that price of the same medicine in one country may rise or fall to a great extent in another. So developing countries, without violating the Intellectual Property Rights protection, may find a way out to access essential but expensive drugs from its neighboring countries. (Watal, J. 2000)
In addition to what is discussed above, one must bear in mind the supply side process concerning manufacture and distribution of medicines. The specific issue related to accessibility to medicines is directly linked with the development and implementation of more efficient and cost-effective measures in manufacturing and distributing drugs.
A number of speculative theories and ideologies have been put forward to address the issue of maximizing the available resources to achieve a standardized health status around the globe. However, the aim of this paper is not to get into a particular ideological standpoint, or to promote distinct solutions, but to gain a deeper insight into the real constraints of manufacturing and distributive activities.
One has to take into account the diverse theoretical concepts, the macroeconomic environment of international economics and technological nuances of the pharmaceutical sectors. Once we identify the constraints, it will be easier to suggest feasible solutions in terms of easy and regular access to medicines for the developing countries. The policies adopted by pharmaceutical companies are worth taking a look at.
