[A-List] Unhealthy accumulation

["Michael Keaney" <michael.keaney@xxxxxx>]

Le Monde / Marketing drugs to rich nations means poor ones go without /
Veronique Lorelle

The international humanitarian aid NGO, Medecin sans Frontieres (MSF), has
decided to resort to black humour in its bid to make the good and the great
of this world more aware of the problems of disease faced by third world
countries: "You are suffering from a serious solvency insufficiency. Sorry,
you are too poor to receive treatment" is one of the messages of the
interactive exhibition it has organised at Sciez, near Evian, the venue of
the G8 summit.According to MSF, neglected diseases, which threaten the lives
of tens of millions of people, mainly in Africa, accounted in 2002 for less
than 0.001% of the $60-70bn spent a year on medical research throughout the
world. Between 1975 and 1999 only 1% of all registered medicines were used
for the treatment of tropical diseases and tuberculosis.

Private laboratories, which supply more than 90% of medicines used in the
world, concentrate on the needs of solvent countries. In the wake of the
large mergers that have taken  place in recent years, 20 pharmaceutical
groups have cornered 65% of the world medicines market (which rose by 8% to
just over $400bn in 2002).

The only thing that interests such mammoth groups are "blockbusters",
money-spinning medicines whose annual sales top the $1bn mark after market
launches that cost $800m. The effect of this scramble for market share is
that the laboratories concentrate their efforts on chronic diseases, cancer,
diabetes, cardiovascular complaints and diseases of old age.

Barely 8% of pharmaceutical spending goes on the developing countries, even
though they are where 75% of the world's population lives. Africa, which
accounts for less than 2% of the world medicines market, is of no interest
to the laboratories.

Most of the treatments now available in Africa were devised during the
colonial period and destined for use by the white population, or else
developed by the US army with the aim of protecting its soldiers.

Such products, when they have not become ineffective because of diseases
becoming resistant to them, are  often of poor quality. According to a
survey carried out this spring by the World Health Organisation (WHO), 40%
of artemisinin-based antimalarials are counterfeit or do not contain active
ingredients.

Steps have been taken to improve, at least in theory, the developing
countries' access to medicines. At the end of 2001, an agreement signed in
the Qatari capital, Doha, contained provisions to allow such countries to
copy drugs developed by the large laboratories in the case of public health
emergencies (while paying royalties to the patent holder), or to obtain
supplies from neighbouring countries if they lacked manufacturing capacity,
as is the case with Eritrea and Sudan, for example.

But the US heavily protects its laboratories (six out of the world's 10
leading laboratories are American), and has since blocked the agreement,
which Washington would like to see restricted to three diseases, Aids,
tuberculosis and malaria.

In July MSF is due to launch its "Drugs for Neglected Disease Initiative".
This North-South research  network includes among its members the Institut
Pasteur in France, the WHO, the Oswaldo Cruz Foundation in Brazil, the
Indian Council for Medical Research and the Malaysian health ministry.

"Since the market does not respond to patients' needs - contrary to what the
Americans claim - that effort will have to be undertaken by individuals or
states," says Pierre Chirac of MSF. "Two years ago, the G8 summit in Okinawa
enabled the Kofi Annan Aids fund to be set up. We hope the G8 meeting in
Evian will support our initiative."

Meanwhile, under pressure from NGOs, laboratories have in some cases been
forced to hand over their formulae. In April the Swiss pharmaceutical firm,
Roche, gave the Brazilian government the patent rights and  production
technology of a drug that is effective against Chagas disease, a parasitosis
widespread in Latin America.
Last January another Swiss firm, Novartis, which is the only laboratory run
by a former hospital doctor, inaugurated a research institute in Singapore
that specialises in such tropical diseases as dengue fever and tuberculosis,
and is cofinanced by the state of Singapore.
"We want to discover products which do not exist, and we shall waive our
margins so that the developing countries can afford to buy them," says the
institute's head of corporate research, Paul Herrling. "We're not talking
about giving away money or developing products discovered by chance, but
about building up genuine pharmaceutical expertise."

The French company, Aventis, which in 1995 suspended production of a
substance that was effective against sleeping sickness on the grounds that
it was not profitable, has relaunched it after discovering that it was also
effective in removing women's facial hair. <I> May 27</I>

The Guardian Weekly 20-3-0605, page 29