IPN Health Blog

Soviet medicine rises from the grave

In ten days time, the World Health Organization's IGWG will get together to finalise its Plan of Action on IP and health.  When I last checked, talk of a 'Medical Research and Development Treaty' was still in the document.

Today my colleague Paul Howard (from the Manhattan Institute) and myself have an op-ed explaining why this treaty will actually undermine drug research. 

One would have thought the Soviet Union had provided ample evidence of why centralised planning can never work: yet twenty years on from the collapse of Soviet communism we find ourselves still having to explain why such ideas are bad.

A prize turnip of an idea

After years of campaigning, activists have narrowed the debate about health care in poor countries to a single premise: Patents drive up the cost of medicines, so patents are bad.

As part of this campaign, activist groups such as Medecins sans Frontieres and Knowledge Ecology International regularly cite the fact that few drugs have been developed for several tropical diseases. On the basis of this, they claim that markets are incapable of providing drugs that people need.

It takes quite a distortion of the evidence to support this claim.  Nevertheless, the NGOs argue that the current market-based system through which drugs are developed needs to be dismantled, and replaced with a system where government experts decide what needs to be researched.  They would then allocate 'prizes' to drug developers who are able to develop efficacious medicines that meet the terms of the prize.

Without breaking into much of a sweat, I can think of three immediate objections:

• This would result in the immediate politicisation of drug research, with research being allocated to political rather than clinical priorities.  I can't see how this would be an improvement on the current system.
• the value of the prize will never be a true reflection of the market value of the invention, no matter how clever the prize awarding committee.  If the prize is too low, companies will be reluctant to compete for future prizes, leading to fewer new drugs. If the prize is too high, the new system will squander taxpayers' money and divert effort from other areas of research.
• Prizes were widely used in the Soviet Union to stimulate research.  Not only did the USSR produce very few novel drugs, but many scientists risked life and limb trying to escape to the West where their talents would be properly rewarded.

Can any readers think of any more objections, or even reasons why I'm wrong? The comments are open.

How much influence do NGOs have on the politics of public health?

Daniel Drezner of the University of Chicago has recently published an interesting paper which questions the power that 'global civil society' has to influence international health policies.

Taking the genesis and progress of the TRIPS agreement as a case study, Drezner makes a  compelling argument that challenges the orthodox view that activists and NGOs were mainly responsible for the reform of TRIPS.

In fact, a host of other reasons, including US security considerations, were responsible for the reforms.  And those reforms often differed considerably than those demanded by the NGOs.

Having said that, it is also true that members of civil society are now colonising many supranational bodies such as the UN and its agencies.  In this way, they are able to get their hands directly on the machinery of policymaking, instead of relying simply on their ability to influence governments from the sidelines.

This undemocratic development is something we should be making more of a fuss about.

Hat tip to Fredrik Erixon