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Monday, April 18, 2011

Big Pharma sets the agenda

Both my parents are pharmacists, so I grew up surrounded by medicines and people who relied on them to stay alive. The idea, then, that access to vital treatment should ever be denied horrifies me. What horrifies me more is that there is a bunch of lobbyists in Brussels who get paid handsomely to argue that such access should be restricted to the better-off.

Using freedom of information rules, I have obtained a few hundred documents exchanged between the European Commission and pharmaceutical corporations. Not everything I asked for has been released but there is enough here to realise that the myopic profit-fixated recommendations of Big Pharma are routinely swallowed by civil servants and regurgitated as official EU policy.

Right now, I’m looking at a 2008 letter about talks aimed at reaching a free trade agreement (FTA) between the EU and South Korea. It is signed by Brian Ager from the European Federation for Pharmaceutical Industries and Associations (EFPIA) and was sent to a number of high-flyers in the Commission, including David O’Sullivan, then its director-general for trade.

Ager was adamant that the EU must have strong provisions on intellectual property included in any deal with Seoul. In particular, he wanted a clause relating to “data exclusivity”. That is a fancy way of saying that makers of generic drugs should be banned from using information (on safety and clinical trials, for example) that the “originator” of a medicine hands over to the authorities when registering that product. Data exclusivity is a monopoly power, different from patents. And the measures advocated by Ager stretch beyond the main international system on patents: the trade-related aspects of industrial property rights agreement (TRIPS).

As the EU has been pushing for six years of data exclusivity to apply to new medicines introduced in Russia and China, Ager argued that the same timeframe should apply with Korea. “A weaker regime in the context of the EU-Korea FTA agreement (sic) would have a negative effect beyond the single country, setting a precedent that may adversely influence other negotiations,” he wrote.

It is significant that Ager wanted the EU to be even more aggressive towards the Koreans than the Americans had been. A draft US-Korea agreement – still not ratified by either side in 2011 – provides for a data exclusivity system of only five years, he noted.

This does not mean that Washington is naturally inclined to be more generous to generics. In 2001, Jordan signed a free trade agreement with the US. Under it, the data exclusivity arrangements for many medicines was extended from five to eight years. In 2007, Oxfam published a report concluding that by delaying the availability of unbranded versions of medicines, Jordan’s drug prices rose by 20%. This was in a country where 40% of the population did not have health insurance. As a result, Jordanians suffering from heart disease and diabetes faced bills two to six times higher than their neighbours in Egypt, which didn’t have such onerous requirements, paid for the same medicines.

Admittedly, Ager didn’t get everything he coveted. The agreement that the EU eventually signed with Korea – and which MEPs approved in February – provides for the five year system that Ager deemed inadequate. But EFPIA is continuing to demand that the full six years should apply in a separate deal under negotiation with India, the key supplier of generic drugs used to fight AIDS and other major killers in developing countries.

EFPIA’s member companies include Pfizer, GlaxoSmithKline, Novartis and Merck. Of course, it professes to be concerned about healing the poor. But the documents I’ve seen paint a nastier picture.

In 2007, EFPIA’s Brendan Barnes pressurised the EU to torpedo an access to medicines initiative by Brazil. Whereas the Brazilian government wished to have greater attention paid to intellectual property issues by the World Health Organisation (WHO), Barnes contended that that Geneva-based body was not “well-equipped” to deal with such matters. It is obvious from his efforts to persuade the EU to resist “this expansion of the WHO’s mandate” that he wanted intellectual property to continue being treated as a commercial matter, rather than a public health one.

Barnes’s efforts proved effective. Later in 2007, Portugal, then the holder of the EU’s presidency, submitted a paper to the WHO, telling it to pay less attention to intellectual property.

Time and again, the documents given to me indicate there is a cosy relationship between the Commission and Big Pharma. Numerous meetings are held between the two sides, without any input from public health advocates or campaigners against poverty. And I was particularly interested to learn that some emails journalists send to the Commission are passed on to the drugs industry.

Perhaps the most troubling aspect of the correspondence is the inconsistency in it. While Big Pharma does everything to thwart competition from cheaper generics, it still sucks up to the EU hierarchy by proclaiming its commitment to “competitiveness” at every opportunity. In one 2010 letter EFPIA’s Andrew Whitty wrote: “The challenge is to find a policy approach that delivers fast access to medicine, enhanced competitiveness, balanced budgets and reward for innovation.”

Call me old-fashioned but I believe health care is about trying to make sick people recover or – in terminal cases – relieving their pain. The logic of profit and loss, of competitiveness and balanced budgets should be viewed as irrelevant in this debate, especially when it relates to the world’s poorest.

·First published by New Europe (www.neurope.eu), 17-23 April 2011

1 comment:

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