Millions of people die of easily curable diseases every year because patent-protected drugs are too expensive. And few pharmaceutical companies are interested in researching cures for tropical diseases, reports Eithne Donnellan
Every day in hospitals, clinics and homes around the world, millions of people are dying unnecessarily because they cannot get the drugs they need. Their deathbeds are mainly in the underdeveloped countries of Africa and Asia, and the diseases wiping them out include tuberculosis and malaria, each of which claims the lives of about two million people every year.
These illnesses are easily curable with proper medication, which is widely available in the developed world. The snag is that it comes at a price.
For millions in developing countries, the price is too high. As the Nobel Prize-winning aid agency, Médecins Sans Frontières (MSF), puts it, these people are seen as "too poor to cure". The agency, which works in more than 80 countries, is intensifying its campaign to increase access to life-saving drugs in developing countries. It estimates that one-third of the world's population lacks access to essential drugs. In the most impoverished parts of Africa and Asia, this figure is over 50 per cent.
Many factors influence access to effective medicines, including quality of diagnosis and accurate prescribing, but price is the principal problem. Once pharmaceutical companies develop and patent drugs, they can charge what they like for them and debar others from making cheaper variations of the treatment available for the lifetime of the patent, usually 20 years.
However, MSF's Access to Medicines adviser, Nathan Ford, stresses that it is the responsibility of governments and international agencies, as well as pharmaceutical companies, to make drugs affordable for all. He points out that governments can override patents if the products covered by the patent are essential but unaffordable. However, governments were "bullied" for years by the pharmaceutical industry into not doing so, he says. He points out that steps were initiated in the US, for example, to override patents on costly drugs to treat anthrax infections after the September 11th attacks.
Ford says MSF is careful not to "demonise" pharmaceutical companies but claims specific practices within the industry are "terrible", such as its inequitable pricing policies, which meant for years that AIDS drugs cost the same in the the US as in "the middle of nowhere in southern Sudan". They cost up to $15,000 per patient per year.
But this situation has now changed. Earlier this year, 39 pharmaceutical companies that were suing the South African government (to prevent it importing cheap medicines for the 25 per cent of its people of working age who are HIV-positive) backed down in the face of international public outrage. Drugs are now available to treat AIDS patients in Africa for about $300 per year each. Although an improvement, even this is too much for many.
A Co Wexford nurse, Suzi Lyons, has seen at first hand the consequences of patients being deprived of access to drugs. People were dying in the streets of Tigray province in northern Ethiopia from kala-azar, a parasitic disease caused by sand flies, when she and other MSF staff set up a treatment programme. "We brought in drugs which were either not available there or which they wouldn't have been able to afford," she says.
She also saw people die from TB in Sudan because no treatment was available.
"It's really really very difficult. It does make you so angry when you know the illness is curable but there is nothing you can do because the treatment is not available," she says. "You have to be realistic about life and accept there are differences between rich and poor and differences in standards of living, but there are some things which you think should not be acceptable.
"You can't blame just one company or institution. It needs a more global change of mindset, from Western governments taking more interest and effecting policy changes to forcing companies to make changes. Unfortunately profits are put before people, I think, in a lot of situations."
Ford agrees and criticises the pharmaceutical industry for neglecting to put money into researching cures for illnesses in developing countries because the in- vestment wouldn't reap rich profits. Of 1,393 new drugs developed between 1975 and 1999, less than 1 per cent are for the treatment of tropical diseases.
He says a survey to be published shortly in the Lancet would reveal that two-thirds of drugs produced over the past 25 years gave little or no therapeutic gain.
"When pharmaceutical companies sit down and decide what new drug they should develop, they will go for the 15th version of Viagra rather than desperately needed new malaria treatment," says Ford. The public sector also has to take re-sponsibility, he believes. It should invest in re-search and development rather than depending on the private sector to do so, he says. He feels it is vital that governments regulate the pharmaceutical sector.
Médecins Sans Frontières is visiting Dublin with an exhibition to increase awareness of this issue. Housed in a 48-foot trailer, it will be at Merrion Square today from 10 a.m. to 5 p.m.