UN Secretary General Ban-Ki-Moon’s UN High Level Panel on Access to Medicine (UNHLP) finally surfaced this week with its long awaited Report. Ring-fenced by its narrow charge, it evidenced the Panel’s wasteful one-dimensional effort. Yet despite its crabbed conclusion regarding IP’s “Incoherence” with medical access, the Panel’s majority may have performed a public service. They created a complete compendium of flawed proposals providing policy makers with a single source for elegantly-worded but unsound policy suggestions then linked them with the counterproductive measures necessary to put them into play.
The UN Panel unfortunately squandered its 9-month gestation period. It stuffed into one repository every long-discarded remnant of anti-patent and pro-price-control schemes buried in IP’s historic landfill. Its Report expressly recommended directives to carry out each of them, demonstrating their counterproductive unworkability. After cramming each policy device into a trashcan of unworkable IP stratagems, they waited until the last minute and dumped it on the doorstep of the UN General Assembly. As University of Chicago Economist Tomas Philips concisely explains in this weekend’s WSJ, the UNHLP’s recommendations are nonsensical.
Nevertheless, they are dangerous, not because responsible IP lawmakers may believe they could work, but because they will tempt irresponsible foreign governments to adopt more measures to free-load U.S. and other developed-world biopharma discoveries. Government incompetence, corruption and sometimes cruelty already block citizen access to essential medicines by failing to provide for the education of medically-trained providers while fostering deprivation of other prerequisites, including everything from roads to vaccine refrigeration. Government attitudes and the absence of such infrastructural essentials are the predominant barriers to world medical access, not patent incoherence. Misguided government priorities effectively block delivery and distribution of WHO-designated essential medicines, the vast majority of which are off-patent. The UNHLP Report’s encouragement of irresponsible pricing schemes like compulsory licensing will shrink not expand medical access in the years ahead. Sadly, if enough countries adopt the Panel’s ill-considered advice, the rest of the responsibly-governed UN member nations will be similarly deprived. The Panel’s flawed recommendations inevitably will deter investment in the invention, development and distribution of new much-needed therapies.
Fortunately, however, the Report has attracted widespread backlash, not only from the usual pro-patent “suspects” but also from our nation’s traditionally reserved research universities and medical centers and our own State department.
Five University advocacy associations collaborated in a strong letter of concerted objection, closing with the following observation;
“We believe that the proposals in the U.N. Panel’s Report would stymie rather than support that goal; accordingly, we hope that those proposals will not serve as the basis for further work within the United Nations. Instead, universities, the federal government, NGOs and the private sector must cooperate to find innovative ways within the current system to optimize global access to new and extant drugs, therapies, and other health technologies and scientific advances.
Significantly, after noting the wisdom of an informed minority of Panelists, the US State Department expressed its firm disappointment with the Report, and also highlighted its most dangerous aspect —it’s potential misuse as a foundation for future UN action and access implementation efforts.
“In this respect, we note the concerns raised by the several Panelists who have practical experience in managing medicine research and development that taking forward the recommendations of the Panel could have significant unintended negative consequences. The Panel has now concluded its work and missed a key opportunity to provide practical observations regarding the complex issues surrounding access to medicines. The Report instead offers only a narrow perspective on a subset of those issues and articulates divisive policies that, if implemented, could severely undermine the innovation critical for the development of medicines and health technologies as well as private sector, university and government-funded research. This divisive approach does not provide the consensus necessary to proceed. (emphasis added)
Freed in this instance from the overbearing influence of IT megatechs, the Administration has acted responsibly regarding the Report’s counterproductive advocacy and encouragement of patent piracy policy bearing the potential of undermining needed medical access. State’s Ann Blackwood and her cabinet level colleagues throughout the Administration deserve our thanks and support for their firm stand, especially now, while the Report awaits approval by the UN General Assembly.
We live in an imperfect world. Its incomplete access to needed medicines is a painful reminder of that reality. But we have made, and are making, significant progress in life science innovation and its distribution, even within the Hobbesian landscape of undeveloped third world countries. Yes, that progress has been delivered through an existing patchwork of imperfect but limited solutions, including profit driven, philanthropic, NGO and government activities. World suffering however will not be eliminated by abandoning initiatives that are working, including today’s proven incentives to biopharma innovation, development and distribution enabled by patents and competitive markets. Rather than building on this progress by suggesting constructive ways to fill the gaps in our existing system the Panel Majority’s Report proposes replacing the entire world system with unworkable theoretical proposals economists and hands-on manufacturers like Panelist Sir Andrew Witty say will not work. Bill Gates, who certainly knows a thing or two about effectively addressing world shortages of needed health care, may have said it best. Echoing the reasoning underlying Winston Churchill’s famous description of Democracy’s superiority compared to all other systems of government, Gates said “it is better than most any other systems we can imagine.”
Indeed this Session of the UN General Assembly will better serve world public health by focusing its attention on the growing problem of anti-biotic drug-resistant “superbugs” as suggested by the Washington Post’s Editorial Board on Monday of this week.
These adaptive pathogens have amply demonstrated their potential to reverse progress already made addressing debilitating diseases long thought to have been permanently extinguished. These bugs lurk everywhere, irrespective of any country’s developmental status. UN programs to address this immanent public health care threat are not only urgently needed, unlike the UNHLP Report on Medical Access they have real potential for broad-based support within the UN General Assembly.