Poverty not patent law blocks poorest from getting medications

The debate around enabling people living in developing countries to acquire life-saving medications has been passionate. Proponents for changing Canada’s Access to Medicines Regime (CAMR) maintain that altering patent rules will enable the world’s poorest to have the medications they need when they fall ill.

Indeed, a lack of drugs and other essential medical supplies in low income countries is a major global health challenge. Millions of people perish every year because they cannot get the simple medications they need. Yet are patents a major obstacle to accessing medications for the world’s poorest?

Every year the World Health Organization (WHO) develops a list of essential medicines. An independent panel of experts, chosen equally from developing and developed countries, draws up this list. Currently, 319 drugs are identified as being essential. Of these, 98.6 per cent are generic or are not patented in developing countries.

Patents are not an obstacle to accessing medicines in developing countries. In the words of Uganda’s President Yoweri Museveni, the debate about changing patent rules for drugs is a “red herring.”

The real obstacle to acquiring pharmaceuticals and appropriate care is poverty. Two billion people live on less than $2 a day. Poor people cannot afford generic drugs, even if they are available. For them, reality is stark: no cash, no cure.

For their governments, they do not have the money or choose not to put their limited resources into health care. Military spending is often the preferred alternative for many of the world’s poorest countries and corruption kills by diverting a nation’s revenues into thieving hands and away from the people’s needs.

As a physician, I have visited umpteen clinics and hospitals in Africa. Many of them have had little more than a few boxes of ancient, dusty, out-of-date medications. Trained health-care workers don’t exist; neither does access to reliable diagnostics, electricity, sanitation and potable water. These are the major barriers to care for the world’s poorest -not patents.

Canada can take a leadership role to address this massive global challenge. The Canadian International Development Agency (CIDA) should create a $50-million essential drug fund. This fund could be used to purchase medical supplies for impoverished countries. Its monies could be leveraged with matching funds from other sources: the recipient country, development banks, the private sector, non-governmental organizations, foundations, multilateral institutions and others. CIDA could also assist recipient countries to establish sustainable financing networks and reliable supply systems to acquire and distribute the medical supplies.

Access to skilled medical personnel is also a major obstacle to care. Africa alone has a deficit of more than one million health-care workers. CIDA could help developing countries train personnel by facilitating innovative partnerships between Canadian universities, professional associations and low-income countries.

These train-the-trainer partnerships would build capacity in developing countries. Such a consortium has already developed in the United States with 32 universities. In Canada there are nine partners. But this is not enough.

These workers must be retained and Canada must become a signatory to the international agreement to ban the poaching of health-care workers from low-income countries. It is unconscionable that we as a developed, G8 nation are actively recruiting health-care professionals from impoverished countries to meet our own needs.

Those who are seeking to change patent laws for pharmaceuticals by changing CAMR and those who are against this change share a common objective: enabling the world’s poorest to access the essential medical supplies and care they need when they fall ill. Changing CAMR will not do this because 98.6 per cent of essential medications are already generic. Let’s focus on the real barriers to medical care for the bottom two billion people of the world. It is something Canada can and should pursue for Earth’s poorest.

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