New York Times editorial: India's Choice

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The New York Times. January 18, 2005

EDITORIAL

India's Choice

For an AIDS patient in a poor country lucky enough to get antiretroviral

treatment, chances are that the pills that stave off death come from

India. Generic knockoffs of AIDS drugs made by Indian manufacturers -

now treating patients in 200 countries - have brought the price of

antiretroviral therapy down to $140 a year from $12,000.

That luck may soon run out. India has become the world's supplier of

cheap AIDS drugs because it has the necessary raw materials and a

thriving and sophisticated copycat drug industry made possible by laws

that grant patents to the process of making medicines, rather than to

the drugs themselves. But when India signed the World Trade

Organization's agreement on intellectual property in 1994, it was

required to institute patents on products by Jan. 1, 2005. These rules

have little to do with free trade and more to do with the lobbying power

of the American and European pharmaceutical industries.

India's government has issued rules that will effectively end the

copycat industry for newer drugs. For the world's poor, this will be a

double hit - cutting off the supply of affordable medicines and removing

the generic competition that drives down the cost of brand-name drugs.

But there is still a chance to fix the flaws in these rules, because

they are contained in a decree that must be approved by Parliament.

Heavily influenced by multinational and Indian drug makers eager to sell

patented medicines to India's huge middle class, the decree is so tilted

toward the pharmaceutical industry that it does not even take advantage

of rights countries enjoy under the W.T.O. to protect public health.

In November 2001, members of the World Trade Organization agreed that

countries can issue compulsory licenses to permit generic production of

patented drugs without the patent holder's agreement in order to protect

public health, at home or abroad. But under the Indian decree, getting a

compulsory license would be slow and difficult; each application would

face a fight from multinational drug firms and the governments that do

their bidding. India should adopt laws that expedite compulsory

licenses, including allowing challenges to proceed after production

begins instead of holding it up. In addition, India must close an

important loophole affecting the sick overseas: under the current rules,

Malawi, for example, could not import from India an inexpensive version

of a medicine that is not under patent in Malawi. This needs to be changed.

Industry lobbyists managed to insert two noxious provisions in the

decree that go well beyond the W.T.O. rules. The decree would limit

efforts to challenge patents before they take effect. Also, it is

uncomfortably vague about whether companies could engage in

" evergreening " - extending their patents by switching from a capsule to

tablet, for example, or finding a new use for the product. This

practice, a problem in America and elsewhere, extends monopolies and

discourages innovation.

While some drugs - those that existed before 1995 - will always be off

patent in India, some widely used drugs are at risk. So are new

generations of much more expensive AIDS drugs that will soon be needed

worldwide as resistance builds to current medicines. If the decree is

not changed before Parliament approves it, it will be very difficult for

India to supply them. India's parliamentarians must keep in mind that

this arcane dispute is actually a crucial battleground for the health of

hundreds of millions of people in India and worldwide.

http://www.nytimes.com/2005/01/18/opinion/18tues2.html