India is known as the “pharmacy of the world”, supplying vital generic medicines at low prices to health services including the NHS. You’d think it would be in the interest of the UK government to keep it that way. Yet, as campaigners writing to the Guardian last month pointed out, a trade deal nearing completion with India could take a wrecking ball to that arrangement – cheered on by big pharma, which stands to profit.
It’s about patents, a once-dusty subject that has become a life-and-death issue. Put simply, pharmaceutical companies that invent a new medicine are entitled to a patent on it in the US, UK and Europe lasting up to 20 years, allowing them a monopoly on sales at high prices. They spend billions on research and recoup billions. That’s the bargain. Once the patent has expired, generics companies can copy the drug, competing to sell it at affordable prices.
But India, which only began to recognise drug patents after joining the World Trade Organization in 1995, still has some different rules. An important one is that public health – the need of the sick for a medicine – can trump the interests of the company making a patent claim, leading to it being refused.
This is one of the provisions the UK is gunning for in its free trade agreement negotiations, which have seen 14 rounds of talks. London also wants the inventor companies to be allowed to extend or renew their patents, with a modification tweak here or a minor reformulation there. It’s a practice familiar to wealthy countries, known as evergreening. The UK also wants India to abolish the right of NGOs or doctors to challenge a patent before it is granted. India’s patent-busting has saved countless lives: it was the influx of the country’s affordable generics that drove down the price of HIV treatment from more than $10,000 to less than $100 a year.
Patent-lengthening on important medicines is hard to defend. The US writer John Green took up the cause of bedaquiline, a rare and important new antibiotic against multi-drug-resistant TB. Johnson & Johnson (J&J), which invented it – all credit to them – revealed that they planned to renew their patent on bedaquiline when it expired last year. Mr Green mobilised his substantial online following to petition J&J and tell everyone they know that the company’s actions were immoral and bad business, naming a lot of the company’s widely sold brands. Within days, J&J backed down.
The hand of big pharma has been detected in the FTA discussions. The UK is headquarters to AstraZeneca and GlaxoSmithKline, which employ thousands of well-paid people. The proposals will enhance their bottom lines. No doubt that explains why the EU takes the same hardline approach in trade talks with Delhi. If western nations get their way, however, it would mean a higher NHS drugs bill. A quarter of NHS medicines are cheap generics made in India. We will be paying high prices for extra years before the generic equivalents come online, surely robbing Peter to pay Paul.
When leading charities warned last November that tightening IP laws would be bad for India and bad for the NHS, a government spokesperson said ministers only wanted to strike “a balance between encouraging innovation and ensuring access to affordable medicines”. But what is being proposed would, it seems, tip the scales too far towards profits – and away from patients.
