How US Interests Threaten Indian Healthcare

At this crucial juncture, acceptance of US demands on IP enforcement will have a distressing effect on the availability of next generation generic medicines from India

A patient in South Sudan holding her anti-retroviral drugs. Credit: UNDP/Brian Sokol

The bio-pharma industry’s interests are getting in the way of global health care. Credit: UNDP/Brian Sokol

As Prime Minister Narendra Modi wrapped up his visit to the United States with an address to the US Congress, it should be a matter of concern for people in India that Washington is trying to push its broken intellectual property system on our government – a system of ever-expanding intellectual property (IP) barriers that have caused medicine prices to skyrocket, leaving American patients empty-handed with US insurance companies struggling to manage the cost of reimbursing expensive patented medicines.

These policies, which don’t even domestically work for people in America, should not be forced on people living in India or anywhere else in the world.

Current US IP laws enable pharmaceutical companies to charge exorbitant prices for medicines. For instance, it costs over $100,000 annually for new cancer medicines and $1,000 per pill for the new hepatitis C treatments.

The patent-based innovation system, which is essentially a market and not health-driven model, has also not guaranteed innovation for major diseases. Public health challenges – for example drug development of new antibiotics, antimalarials and research into effective rapid diagnostic kits for TB – are ignored and shelved by the pharmaceutical industry. The billions of dollars of profits from spiraling high drug prices, rather than funding research and development are being diverted to share buybacks and dividends, designed to boost executive pay.

Paradoxically, the US not only insists on turning a blind eye to the ‘access and innovation’ crisis but actually demands new and detrimental IP laws in countries that manufacture and widely use low cost generic medicines to deliver health, worsening an already tragic situation, with millions of people driven into debt with rising out-of-pocket healthcare costs.

Unfortunately, US bio-pharma industry interests are getting in the way of global health care.

India unreservedly produced generic treatments before 2005 when its affiliation with the World Trade Organization necessitated it to start granting patents. This new product patent system first affected cancer patients who are unable to afford expensive, patented cancer medicines costing lakhs per month. In 2012, India issued its first compulsory license (CL), a tool used by governments to override a company’s patent to allow for generic competition. The compulsory license brought down the cost of sorafenib tosylate, a kidney and liver cancer drug, by 97%.

The US government has continuously pressured India to ease the grant of patents to its companies, up the ante on IP enforcement and to put a moratorium on CLs to ensure that US-based multinational pharmaceutical companies enjoy their monopolies without any checks for abuses. Earlier this year, India was once again placed on the US Trade Representative (USTR)’s “Special 301” Report. This coercion has persisted via multiple avenues of bilateral engagement on IP, including the existing US-India Trade Policy Forum and the creation of a new high-level IP working group, which was announced jointly by President Barack Obama and Prime Minister Modi in September 2014.

Modi’s visit comes barely a month after the Indian Patent Office caved in to US pressure and granted US-based pharmaceutical company Gilead Sciences a patent for its hepatitis C drug sofosbuvir – a drug that studies show costs the manufacturer about $100 per 12-week treatment course to make but is sold for $1,000 per pill in the US. The decision comes a little over a year after India initially rejected the patent, which led to increased pressure from the US to grant more patents to its pharmaceutical companies. This step backwards takes away a lifesaving option for patients in many hieric medicines from India.

Indian officials must resist US pressure that undermines its supply of generic drugs, especially during high-level bilateral visits including Modi’s current visit to the US. It must find a strategy to diplomatically reject the IP laws and practices of the US that have led to an unparalleled global health crisis and instead continue to strike a balance between industrial production of generic drugs and the IP system, a policy that has ensured 99% reduction in the cost of medicines to save and improve millions of lives across the world.

Leena Menghaney is Regional Head – South Asia at Médecins Sans Frontières’ Access Campaign.