Lancet Editorial Urges Reform of World Trade Rules
"The time has come for the pharmaceutical industry and the governments who represent them in trade disputes to acknowledge that the world is facing an extraordinary challenge" in the AIDS pandemic, an editorial in this week's issue of the Lancet states. The editorial describes the three-year battle between the South African parliament and the Pharmaceutical Manufacturers Association of South Africa over a law that would permit the parallel importation of drugs produced under license in other countries at cheaper prices. The South African government passed the Medicines and Related Substances Control Amendment of 1997 to "ensure access to life-saving drugs, particularly AIDS drugs, which are typically priced far beyond what most South Africans can afford." But pharmaceutical companies said that the law, which "would allow the government to bypass the monopoly granted to companies holding patents in South Africa," was "unjust, unnecessary and unwise." The industry claims that by ignoring patent rights, the law "allows the expropriation of intellectual property rights without due process mandated by South African patent law[,] ... will rob companies of income they need to cover the costs of research and development ... and endanger consumers by encouraging the importation of substandard drugs." PMA has filed suit against the South African parliament in Pretoria's high court, and has also been "persuading many western governments to exert pressure on South Africa."
Is Drug Pricing the Problem?
The editorial notes that the industry group also argued that South Africa's "lack of an infrastructure capable of providing basic health services" is the country's "main health care problem." The group said that because the system is not sufficient to deliver and oversee the use of AIDS drugs, resistant HIV strains are likely to develop, "making a bad situation even worse." The editorial acknowledges that "lower drug pricing is not the whole answer" to alleviate the problems in South Africa's health care infrastructure, but health teams working with HIV patients in cities, towns and villages "should get that chance" at affordable drugs. The Lancet editorial concludes, "Rather than fighting the efforts of these nations to deal with this crisis, industry experts and government officials should be working with WHO to ensure that trade agreements that currently threaten already fragile economies can be adjusted to meet any crisis affecting the health of developing nations now and their very existence as trading nations in the future" (Lancet, 1/27).