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Contagious confusion

I had to read the headline twice. Then I read the article twice. I still don’t get it.

What I first thought it said was,

International development minister urges firms to pool HIV patients

Weird, obscure line, but no weirder than a lot of things that come out of the international development department, and potentially a lot more sensible. I suppose it might make sense for the big southern African companies, especially, to combine their employee health programmes. But if it were more effective, wouldn’t they already be doing it? Wouldn’t the South African government, in any case (now they have got rid of that barking health minister), be the one doing the urging?

What it actually said was,

International development minister urges firms to pool HIV patents

Now that makes a lot less sense. It is quite up to the standard we have come to expect from DFID, a real candidate for economic illiteracy of the day.

[Mike Foster MP] wants companies to contribute to a “patent pool”, which the international drug-purchasing facility, Unitaid – set up by a number of donor countries, including the UK – is trying to establish.

“While it is absolutely vital that we work to reduce the human cost of HIV by focusing our efforts on preventing new infections, we must also face up to the stark reality of the treatment challenge we face. The pharmaceutical industry has an opportunity to act now to help prevent future human catastrophe. It is time for them to state their clear commitment to make new HIV medicines affordable to those who need them most.”

According to the all-party report, if HIV patents are put in a pool, generics companies – which make the cheap combinations now used in Africa – will be permitted to make low-cost copies of newer drugs and devise new combinations in a single pill, which is important for people living in poverty.

What can this possibly mean? There’s no real explanation here of how a ‘patent pool’ might work. It sounds like pharmaceuticals companies are being offered to the opportunity to swap an unstable legal monopoly for an internationally approved cartel, and to pose as humanitarians while doing so. Would that really lower the cost of HIV medication, and improve its effectiveness in general? It is far from obvious why that should be the case. Would medicines that are both cheaper and more effective be permitted to flow back to Western countries? I doubt it.

Which points up the weirdness of the whole exercise. In order to be economic in Western countries, HIV medicines have to be very expensive to buy there. That is not just because they are expensive to develop, but because the absolute numbers of people who need them are small. In the West, just as in poorer parts of the world almost no individual can afford to pay for their own treatment. So there’s a different sort of cartel effect maintaining the oligopolistic market. Government protects the patentees; and government subsidies end up paying for the consequences.

You don’t have to be a believer in the efficacy of beetroot and garlic as anti-virals to notice that the difference between the scale of the epidemic in parts of Africa and the richest parts of the world is not a consequence of the availabilty of drugs – or at least not the availabilty of anti-retrovirals. We have fewer people getting the disease in the first place. But we have fewer people with all sorts of infectious diseases. Malaria and dengue are not more treatable than they were when they were endemic in Europe, and the US, less than a century ago. The difference is better living conditions that everyone will work for if they have the chance.

Patent pooling, it seems to me, is no better than patent farming, in that it seeks to exploit artifical restrictions on innovation that just happen to be there for the benefit of a restricted interest group. It is an exercise in dinosaur husbandry, with little real relevance to improving the lives of us mammals. A reconfiguration of corporarate welfare, with its concentration on subsidising treatment of a particular disease, and bureaucrats swapping targets with bureaucrats, is a distraction from the less collectively ‘manageable’ task of avoiding the spread of infection, which is the invisible part of the virtuous circle of the people who are not sick getting better general health and more comfortable lives. That isn’t going to come from government drug programmes. I suspect it might come from “people living in poverty” having a bit more access to the non-patent and never-patent – but still restricted – technologies of choosing their own priorities and exploiting their own comparative advantages.

6 comments to Contagious confusion

  • I think one interesting point raised by a video of a clever man whose name I have forgotten from a university giving a talk a few weeks ago that is relevant here was that most of the cost of drug development, and thus of the cost of drugs, isn’t actually development, it’s the testing imposed by regulations. That doesn’t necessarily mean that regulations requiring stringent testing are a bad thing per se, though it might, but it does mean that if it is the State, or the population via the State, imposing very high costs on development, then the companies have some kind of a reciprocal right to support from that State in terms of recouping the costs imposed by it.

    Also in that talk he said that the US aeroplane industry had had a patent pool for a very long time, and prospered anyway, even though effectively it meant they could not enforce patents. That arose apparently because the Wright Brothers, having flown their one aeroplane, then went primarily into the patent enforcement business rather than the developing aeroplanes business, which meant that when WWI rolled around, the USA didn’t have any aeroplanes- though, as is the American Way, they had a number of lawyers with broad smiles and bulging waistcoats.

  • Kevin B

    A minor nit to pick, but the main action we in England took to get rid of malaria and dengue fever was to drain the swamps around London where these diseases were endemic.

    Of course, now that we are restoring the swamps, in the guise of wetlands, it is increasingly likely that malaria at least will make a comeback here. The chattering classes will, of course, blame Global Warming, regardless of whether the temperature is going up or down.

    Instituting the AIDS equivalent to draining the swamps has proven politically difficult, both here and in Africa, so we are left solely with trying to treat the disease. Since the politicians have little regard for the sufferers and are largely seeking political capital, they will come out with these sorts of blame shifting initiatives, putting the onus on Big Pharma to go against their own interests.

    Should some enterprising pharmaceutical company come up with the AIDS equivalent of DDT – say a vaccine – then it will be instituted in the West, then, probably after the disease is largely eradicated here, some do-gooder will come up with some dodgy statistical data-dredge that links it with cancer, and the vaccine will be banned worldwide.

    And the politicians will make all sorts of pious declarations while the people of Africa die.

  • Kevin B

    On the subject of patent pooling, (well actually patent squatting), I see that one Bill Gates is seeking to patent the idea of pumping warm surface water down into the waters of the Gulf of Mexico to bring up colder water and thus reduce the strength of tropical hurricanes.

    Apart from being a stupid idea even if it works, (especially if it works), you’ll know who to sue when you’re sitting, boarded up, in your Florida, Gulf Coast or Caribean home and a strange ship lands on your head.

  • Rich Rostrom

    There was a recent series of guest posts at the Volokh Conspiracy about the patent wars over the invention of the sewing machine (in the 1850s).

    One problem was that various inventors had patents on different key elements. No single manufacturer could make
    a satisfactory sewing machine.

    The conflict was finally resolved when all the players formed a “patent pool”. After that, anyone could use all the pieces to build proper sewing machines, by paying royalties to the pool. The various patent-holders got agreed-upon shares of royalty revenue.

    It didn’t prevent competition between manufacturers.

    I don’t know that the proposed pool is similar, but it could be.

  • Alisa

    Rich, the big difference would be that that pool, IIUC, was voluntary.

  • llamas

    The Minister’s suggestion is a masterpiece of legerdemain, worthy of a Paul Daniels (does that date me?).

    How does a patent pool help the developer of some AIDS wonder-drug recoup the investment required to bring it to market?

    Comparisons with other, previous patent pools such as the sewing-machine pool and the US airplane makers’ pool, are completely invalid. In those cases, the pool agglomerated a number of different patents, which all-taken-together, allowed all makers to produce and prosper. Without the pool, no-one could make anything. With the pool, everyone could make everything, and the intellectual-property owners were properly compensated for their contributions.

    This is completely different. The actual material cost of making the drugs is (relatively) de minimis and it’s generally not (that) hard to do. The people who developed the drugs are quite capable of making them for an extremely low cost, as cheap or cheaper than the generic makers can.

    The issue is how they can recover their vast development cost – not the cost of actually making the pills. And pooling their development with low-cost producers will not help them do that. Not one tiny little bit. This is nothing more than another attempt to hijack the intellectual property of those who have developed these drugs so that they can be made and sold at prices that will please voters. The only thing that’s different is the colour of the lipstick.

    llater,

    llamas