Health for Sale
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- Citation
- Cataloging
- Transcript
The film investigates the problem of access to essential pharmaceutical drugs in developing countries, taking into account economic, political, medical and social perspectives. Why is it that 15 million people die from easily curable diseases in the Southern hemisphere every year? That's 40,000 people a day, a stadium on Cup Final day. A daily massacre that could so easily be avoided. Why isn't it? In an attempt to answer this question, the documentary links together the First and Third World in a long trip inside the Pharma maze.
The worldwide pharmaceutical market is dominated by the so-called Big-Pharma, which is composed by no more than 10 pharmaceutical companies based in USA or Europe. Thanks to the TRIPS Agreements, created by the WTO (World Trade Organization) in 1995, medicines is treated like any other goods. This means that the pharmaceutical companies owning the large number of patents on drugs worldwide can act as monopolists deciding and imposing the prizes. Further more they can decide the type of research to be made, without taking into consideration the needs of developing countries.
Citation
Main credits
Mellara, Michele (film director)
Mellara, Michele (screenwriter)
Rossi, Alessandro (film director)
Rossi, Alessandro (screenwriter)
Cogo, Michele (screenwriter)
Other credits
Director of photography, Michele Mellara; editing, Fabio Bianchini Pepegna; music, Nicola Bagnoll, Alessandra Reggiani.
Distributor subjects
No distributor subjects provided.Keywords
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(classical music)
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- [Narrator] The 10 largest
pharmaceutical companies
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form the so-called Big Pharma,
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which controls the world
pharmaceutical market.
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(classical music)
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In 2004, global spending
on prescription drugs
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amounted to $500 billion.
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In 2002, Big Pharma's
overall profit
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amounted to $35.9 billion.
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The profit made by Big Pharma
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exceeds the combined
total profits
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of the other 490 multinationals
on the Fortune 500 list.
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In 2004 Big Pharma registered
a total pretax profit
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of $205 billion,
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nearly as much as the gross
national product of Denmark.
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Here is a list of the 10
most widely-sold medicines
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in the world according
to the most up-to-data
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available for 2004.
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The most widely-sold medicine
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is the cholesterol-reducing
Lipitor,
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produced by Pfizer.
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It made $10.3 billion over
the course of just one year.
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Next comes another
cholesterol-reducing drug,
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Zocor, produced by Merck.
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It made $6.1 billion
in one year.
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The third most widely-sold
medicine is Zyprexa,
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an antidepressant
produced by Eli Lilly.
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It made $4.8 billion in a year.
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Among the remaining seven
most widely-sold
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medicines in the world,
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there are two istreatalsis,
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one for high blood pressure,
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one antidepressant,
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one for heart problems,
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one for asthma and
one for anemia.
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With a total annual turnover
of around $48 billion.
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All of these drugs was
sold in rich countries
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such as the United States,
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the European Union and Japan.
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(classical music)
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Geneva is the financial
heart of Europe.
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It is here that we must
start our investigation
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in order to understand the
political and economic problems
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of access to
pharmaceutical drugs.
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All the international
organizations
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which deal with pharmaceuticals
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have their base in Geneva.
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The World Health
Organization, WHO,
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the World Intellectual
Property Organization, WIPO,
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Medecins Sans Frontieres
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and, naturally, the World
Trade Organization, WTO.
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- And the WTO today,
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which covers many,
many different areas
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of international trade,
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trade in goods,
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trade in services.
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It covers a wide range of issues
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from tariffs and duties on goods
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to subsidies to
non-tariff rules.
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- [Narrator] The WTO
has 150 member states.
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Almost the entire planet.
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The world trade system is
governed by WTO agreements.
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- We started to look
into the new rules
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on pharmaceutical patenting
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that came out of the
World Trade Organization,
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which are called the
Trade-Related Aspects
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of Intellectual Property Rights,
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the TRIPS agreement
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because we saw that medicines
that were under patent
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were so much more expensive
than medicines
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that were not patented.
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(classical music)
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- [Narrator]
The International Federation
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of Pharmaceutical Manufacturers
& Associations, IFPMA,
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has its base in Geneva.
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- We have 26 member companies
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and we have 55
national associations,
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which are in 55 countries
around the world
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and the issues that we work on
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are basically regulatory issues
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because the
pharmaceutical industry
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is the most regulated
manufacturing
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industry that there is.
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Everything is regulated,
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from the clinical trials
to the patents
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to the pricing in many countries
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and so we work on
these regulatory issues.
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(speaking in Italian)
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- [Narrator] Here are the
five infectious diseases
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that kill the most people
every year,
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according to 2004 data.
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Various forms of
pulmonary disease,
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four million deaths.
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AIDS, 2.8 million deaths.
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Diarrhea, 1.8 million deaths.
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Tuberculosis, 1.6
million deaths.
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Malaria, 1.6 million deaths.
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The list goes on,
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accounting for 15 million
deaths a year.
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85% of the affected live
in the southern hemisphere,
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yet they account for only 11%
of world spending on health.
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In rich countries,
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15% of the world sick
spend the remaining 89%.
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- One, the medicines that
are desperately needed,
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diagnostic tools that
are desperately needed
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to diagnose people properly
or diagnose children properly,
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are not available.
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They are not being developed.
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Second, medicines that
we knew were available,
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for example,
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AIDS medicines,
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were not available in
developing countries
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because they were priced
out of reach
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of the ability of people in
developing countries to pay.
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And third, there were
medicines that existed
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that actually were
developed for use
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to treat tropical diseases,
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but that were no longer produced
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even though the
needs were there.
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The people who needed
the medicines existed,
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but as consumers.
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They did not exist as a market.
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They do no exist because
they don't have enough money
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to pay for the treatment.
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- [Narrator] What's
the difference
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between a generic medicine
and a brand name one?
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Actually they contain the
same active ingredients
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and they're made
in the same way.
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They are identical.
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The brand name ones are patented
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and so they generally
cost a lot more.
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But who regulates
the patenting system?
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Remember one word.
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TRIPS.
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- TR-TR-TRIPS.
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- TRIP, TRIP, TRIP.
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- TRIPS agreement.
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- What it means is...
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- Trade-Related Intellectual
Property.
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Proper, property.
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- Is an agreement covering
intellectual property systems
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and their impact on
international trade.
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It really was the
first major effort
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in the GATT WTO system to create
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a relationship between trade
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and intellectual
property protection.
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- [Narrator] A patent is a
legal title granted by the state
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giving its holder a
temporary monopoly
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on the use of an invention
for a limited area and time.
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(gramophone sounds)
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The patent can cover a product
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or the process used
in making something.
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From the start the
existence of patents
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was justified by the fact
that exclusive rights
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to commercial exploitation
simulates new inventions,
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which when the patent expires
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would pass into the
public domain.
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In recent years, even
genetically modified organisms
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have been patented,
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including plants, animals
and microorganisms
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and the list could go on.
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- There is an important
link between the
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TRIPS agreement and
access to drugs.
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- Because it treated
medicines as any other sector.
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- The TRIPS agreement
obliged all countries
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that the members to they
weren't have any say in
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now around 150 countries
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to adopt the patent protection
for pharmaceuticals.
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- Before the TRIPS agreement,
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countries either don't
grant patents on medicines
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or they grant for
a shorter period,
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five years, 10 years,
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but now you have to
give for 20 years.
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- The patent owner can
charge high prices.
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He may act as a monopoly.
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- So in this 20 year period,
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no other generic medicine
can enter into the market.
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- The patent owner can
charge the price
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that the market may bear
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and this means that many people
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will not be able to
purchase and use
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these patented drugs.
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- This is the problem with the
TRIPS agreement that there...
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It kind of gives the patent
holder a monopoly of the market
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and generic medicines
cannot enter into market
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and because there's
no competition,
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the patent holder is
able to keep prices
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as high as it wants.
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- [Narrator]
TRIPS represents the triumph
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of the particular interest
of the great
00:10:19.374 --> 00:10:22.018
European and American
multinationals
00:10:22.018 --> 00:10:24.548
over the general interests
of billions of people
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in developing countries.
00:10:27.178 --> 00:10:28.609
Trade ministers were not aware
00:10:28.609 --> 00:10:30.589
that in signing
these agreements,
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they were at the same
time condemning
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billions of the world's
poorest citizens to death.
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TRIPS has imposed a regime
of intellectual property
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currently dominant in the
United States and in Europe
00:10:42.771 --> 00:10:44.947
on the entire world.
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Also, the idea that
intellectual property rights
00:10:47.965 --> 00:10:50.095
acted as a stimulus
for innovation
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because they guarantee
higher profits
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to be reinvested in
research and development
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cannot be said to be true.
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- Many of these products are
developed in rich countries
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because these are the countries
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which have the investment
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which have the scientists
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which have the
technological strength
00:11:11.294 --> 00:11:13.294
to produce these things.
00:11:14.662 --> 00:11:16.670
But I think it's important
to point out
00:11:16.670 --> 00:11:18.059
that one of the reasons
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an open international
trading system is important
00:11:22.077 --> 00:11:26.160
is that it does enable
people in poorer countries
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to benefit from these products.
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- [Narrator]
97% of patents worldwide
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are held by people or businesses
00:11:34.877 --> 00:11:37.325
in industrialized countries
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and more than half of the
royalties are paid to the USA.
00:11:41.836 --> 00:11:43.692
Even in developing countries,
00:11:43.692 --> 00:11:46.077
80% of patents are
granted to those
00:11:46.077 --> 00:11:50.419
who are resident in
industrialized countries.
00:11:50.419 --> 00:11:52.461
Even the United States
sometimes finds it hard
00:11:52.461 --> 00:11:53.782
to enforce TRIPS
00:11:53.782 --> 00:11:56.152
like in October 2001
while still reeling
00:11:56.152 --> 00:11:57.975
from the Twin Towers attack,
00:11:57.975 --> 00:11:59.414
there was widespread panic
00:11:59.414 --> 00:12:01.723
about anthrax and a new
bioterrorism attack.
00:12:01.923 --> 00:12:03.843
There was an explosion
in the number of reports
00:12:03.843 --> 00:12:05.184
of anthrax contagion,
00:12:05.184 --> 00:12:06.502
culminating on October the 5th
00:12:06.502 --> 00:12:07.934
with the death of
Robert Stevens,
00:12:07.934 --> 00:12:09.012
a photographer working
00:12:09.012 --> 00:12:11.117
for the American
Media Press Agency.
00:12:11.117 --> 00:12:13.084
There was even a rumor
that President Bush himself
00:12:13.184 --> 00:12:14.502
had been infected
00:12:14.502 --> 00:12:15.582
and the only antibiotic
00:12:15.582 --> 00:12:17.309
known to be effective
against anthrax,
00:12:17.309 --> 00:12:18.309
Cipro,
00:12:18.342 --> 00:12:19.767
produced by Bayer
at the same time,
00:12:19.767 --> 00:12:22.270
still under patent until
the end of 2003,
00:12:22.270 --> 00:12:25.477
became virtually unobtainable.
00:12:25.477 --> 00:12:27.276
The US government
decided to ask Bayer
00:12:27.276 --> 00:12:29.575
to provide an enormous
supply of the drug
00:12:29.575 --> 00:12:33.542
at less than the $5 a pill
that was the retail price.
00:12:38.488 --> 00:12:40.461
Given the German
company's reluctance,
00:12:40.461 --> 00:12:42.126
the US government
announced it's approval
00:12:42.126 --> 00:12:44.208
of two generic pharmaceuticals,
00:12:44.208 --> 00:12:45.938
doxycycline and penicillin
00:12:45.938 --> 00:12:47.794
as a treatment against anthrax.
00:12:47.794 --> 00:12:48.921
Under these pharmaceuticals,
00:12:48.921 --> 00:12:50.933
should be available as generics
00:12:50.933 --> 00:12:52.617
because they could be
produced by a number
00:12:52.617 --> 00:12:53.934
of pharmaceutical companies
00:12:53.934 --> 00:12:57.119
and so be relatively
cheap and easy to obtain.
00:12:57.119 --> 00:12:59.001
(classical music)
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The front page of the
New York Times read
00:13:01.161 --> 00:13:03.163
"American law is very clear.
00:13:03.163 --> 00:13:04.775
"When the United
States government
00:13:04.787 --> 00:13:05.994
needs a patented product,
00:13:05.994 --> 00:13:08.051
"any official authorized
to make purchases
00:13:08.051 --> 00:13:10.904
"can ignore the
patent and license
00:13:10.916 --> 00:13:13.044
someone else to make it."
00:13:13.044 --> 00:13:14.885
The next day Bayer responded
00:13:14.885 --> 00:13:16.522
saying that it was
not at all impressed
00:13:16.522 --> 00:13:18.250
by the US government's actions.
00:13:18.250 --> 00:13:21.083
(classical music)
00:13:22.726 --> 00:13:26.235
Actions violating the
infamous TRIPS,
00:13:26.235 --> 00:13:28.023
but the threat of non-compliance
of TRIPS
00:13:28.023 --> 00:13:30.710
extended into Canada with
more and more offers arriving
00:13:30.710 --> 00:13:34.438
from pharmaceutical
companies producing generics.
00:13:34.438 --> 00:13:36.276
So on October the 25th,
00:13:36.276 --> 00:13:39.224
the US government gained
the upper hand.
00:13:39.224 --> 00:13:40.731
Under the threat
of the generics,
00:13:40.731 --> 00:13:44.234
Bayer agreed to produce
all the pills the US needed
00:13:44.234 --> 00:13:46.817
at the cost of only $0.95 each.
00:13:48.225 --> 00:13:50.745
In the end, however, there
were only three deaths
00:13:50.745 --> 00:13:51.975
from anthrax poisoning
00:13:51.975 --> 00:13:54.523
and a few dozen
cases of contagion.
00:13:54.523 --> 00:13:57.356
(classical music)
00:13:58.223 --> 00:14:00.223
(speaking in Spanish)
00:15:03.386 --> 00:15:05.642
- [Narrator] Parallel imports.
00:15:05.642 --> 00:15:08.156
Thanks to article six
of the TRIPS agreement,
00:15:08.156 --> 00:15:09.480
in the interest of public health
00:15:09.480 --> 00:15:11.455
and for limited periods only,
00:15:11.455 --> 00:15:13.511
it is possible to import
a pharmaceutical drug
00:15:13.511 --> 00:15:17.172
from the company which offers
the best economic conditions
00:15:17.172 --> 00:15:21.339
without asking the patent
holder's permission.
00:15:28.171 --> 00:15:30.171
(speaking in Spanish)
00:15:46.257 --> 00:15:48.641
- [Narrator]
Compulsory licenses.
00:15:48.641 --> 00:15:51.269
Thanks to article 30
of the TRIPS agreement,
00:15:51.269 --> 00:15:53.118
it is possible for a
country experiencing
00:15:53.118 --> 00:15:54.985
a healthcare emergency,
00:15:54.985 --> 00:15:56.494
one country,
00:15:56.494 --> 00:15:58.109
to produce a generic
pharmaceutical
00:15:58.109 --> 00:16:00.315
without paying the
patent rights.
00:16:00.315 --> 00:16:03.315
This license has a
limited duration.
00:16:05.359 --> 00:16:08.879
- They have passed a
compulsory license bill
00:16:08.879 --> 00:16:12.701
that a country can ask
for a compulsory license,
00:16:12.701 --> 00:16:16.868
but they have made the rules
and regulations so difficult
00:16:18.195 --> 00:16:19.811
that it is not practical.
00:16:19.811 --> 00:16:22.311
What they should therefore do,
00:16:23.453 --> 00:16:27.106
that the third world
should have a very simple
00:16:27.106 --> 00:16:30.273
practical compulsory
licensing system.
00:16:31.395 --> 00:16:34.228
(classical music)
00:18:19.091 --> 00:18:20.125
- Developing countries,
00:18:20.125 --> 00:18:22.553
when they wanted to make
use of the flexibilities,
00:18:22.553 --> 00:18:24.224
there was a lot of
pressure on them
00:18:24.224 --> 00:18:26.360
from the pharmaceutical
companies as well as
00:18:26.360 --> 00:18:28.772
some of the
industrialized countries
00:18:28.772 --> 00:18:31.102
not to make use of
this flexibility.
00:18:31.102 --> 00:18:33.289
This was a case of
say South Africa
00:18:33.289 --> 00:18:34.594
when they wanted to make use,
00:18:34.594 --> 00:18:36.503
change their loss
and the flexibilities
00:18:36.503 --> 00:18:38.267
that any pharmaceutical
companies
00:18:38.267 --> 00:18:40.570
took South African
government to court about it.
00:18:40.570 --> 00:18:42.536
- Hundreds of
protesters affiliated
00:18:42.548 --> 00:18:43.922
to the AIDS lobby group,
00:18:43.922 --> 00:18:47.781
the Treatment Action Campaign
and Labor Federation Cassato,
00:18:47.781 --> 00:18:50.954
are marching through
the streets of Pretoria.
00:18:50.954 --> 00:18:52.954
The Pharmaceutical
Manufacturers Association
00:18:52.954 --> 00:18:55.262
is suing the
South African government
00:18:55.262 --> 00:18:57.246
for a law that
enables the country
00:18:57.246 --> 00:18:59.112
to purchase generic drugs
00:18:59.112 --> 00:19:01.916
rather than their more
expensive equivalents.
00:19:01.916 --> 00:19:04.863
- We are ready if necessary
00:19:04.863 --> 00:19:07.259
to take all the
measures necessary
00:19:07.259 --> 00:19:10.156
to get treatment to
people with HIV and AIDS.
00:19:10.156 --> 00:19:13.864
- This case is really
about what comes first,
00:19:13.864 --> 00:19:16.576
commercial interest of
the multinationals
00:19:16.576 --> 00:19:18.726
or the right to life of people.
00:19:18.726 --> 00:19:19.726
- Good afternoon.
00:19:19.730 --> 00:19:20.930
Welcome to One O'Clock Live.
00:19:20.931 --> 00:19:22.075
I'm Sally Burdette.
00:19:22.075 --> 00:19:23.298
News from around the country,
00:19:23.298 --> 00:19:25.114
around the world at lunch time.
00:19:25.114 --> 00:19:26.114
In the headlines,
00:19:26.120 --> 00:19:28.375
drug companies drop their
lawsuit against the government.
00:19:28.402 --> 00:19:30.883
- This is a win-win
situation for the government
00:19:30.883 --> 00:19:33.078
and the Treatment
Action Campaign.
00:19:33.078 --> 00:19:35.321
Not only has the case
been withdrawn,
00:19:35.321 --> 00:19:38.205
but the Pharmaceutical
Manufacturers Association
00:19:38.205 --> 00:19:40.547
has agreed to pay legal costs.
00:19:40.547 --> 00:19:42.394
- They believe a major victory
00:19:42.394 --> 00:19:44.358
that prevented a
pharmaceutical company
00:19:44.358 --> 00:19:45.502
appears withdrawn.
00:19:45.502 --> 00:19:48.519
- We're going to need many
more countries making use
00:19:48.519 --> 00:19:50.226
of the Doha Declaration
00:19:50.226 --> 00:19:52.773
and particularly
producing countries
00:19:52.773 --> 00:19:56.726
because if the larger producing
countries such as India,
00:19:56.726 --> 00:19:59.927
do not allow their
companies to produce
00:19:59.927 --> 00:20:03.008
generic versions of
newer medicines,
00:20:03.008 --> 00:20:04.666
there is at the end of the day,
00:20:04.666 --> 00:20:08.948
there aren't going to be any
sources left to import from.
00:20:08.948 --> 00:20:12.503
(background chatter)
00:20:12.503 --> 00:20:15.366
- [Narrator] In 2005 India
had to bring its patent laws
00:20:15.366 --> 00:20:17.731
into line with TRIPS.
00:20:17.731 --> 00:20:21.419
Patents on pharmaceutical
products were reintroduced.
00:20:21.419 --> 00:20:25.067
The only possible loophole
is article 3D of the new law,
00:20:25.067 --> 00:20:27.792
which states that a patent
cannot be granted for any drug
00:20:27.792 --> 00:20:28.953
which does not represent
00:20:28.953 --> 00:20:32.462
a substantial
pharmaceutical innovation.
00:20:32.462 --> 00:20:35.304
That's why Novartis
anticancer drug Glivec
00:20:35.304 --> 00:20:37.519
did not qualify for a patent
00:20:37.519 --> 00:20:39.756
and why Novartis has taken
the Indian government
00:20:39.756 --> 00:20:41.506
and its law to court.
00:20:48.555 --> 00:20:51.805
- They say that they
want a declaration
00:20:53.321 --> 00:20:56.357
the treaty is unconstitutional.
00:20:56.357 --> 00:20:57.798
That is the prayer.
00:20:57.798 --> 00:20:58.814
They ever had it,
00:20:58.814 --> 00:21:01.184
also another prayer
which is not here,
00:21:01.184 --> 00:21:04.635
the treaty is in
violation of TRIPS.
00:21:04.635 --> 00:21:06.709
So you want a copy of that?
00:21:06.709 --> 00:21:08.381
It's on argument
00:21:08.381 --> 00:21:11.187
that under the TRIPS agreement,
00:21:11.187 --> 00:21:15.571
a private individual cannot
argue in a domestic court
00:21:15.571 --> 00:21:20.490
that any law of any country
is not TRIPS compliant.
00:21:20.490 --> 00:21:23.007
That is only for the
government to do
00:21:23.007 --> 00:21:26.477
and that to in the
W2 dispute panel.
00:21:26.477 --> 00:21:27.597
So a garden door,
00:21:27.597 --> 00:21:29.220
they cannot make a declaration.
00:21:29.220 --> 00:21:31.675
That is what we are waiting
on the court to decide.
00:21:31.675 --> 00:21:33.870
They need not have
challenge treaty at all,
00:21:33.870 --> 00:21:35.723
but since they've
challenged treaty,
00:21:35.723 --> 00:21:36.729
if they succeed,
00:21:36.729 --> 00:21:39.383
it'll impact all the drugs.
00:21:39.383 --> 00:21:42.089
Whether they're cancer
drugs or anticancer drugs
00:21:42.089 --> 00:21:44.686
or antiretroviral
or TB, malaria.
00:21:44.686 --> 00:21:46.693
If we succeed ourselves,
00:21:46.693 --> 00:21:50.050
then it also impacts
favorably on all the drugs
00:21:50.050 --> 00:21:53.217
so treaty challenge impacts
on all drugs.
00:21:59.135 --> 00:22:01.968
(classical music)
00:22:09.475 --> 00:22:11.150
- [Narrator]
India is the main producer
00:22:11.150 --> 00:22:13.773
and exporter of high
quality generic drugs.
00:22:13.773 --> 00:22:15.961
Companies such as
Robaxin and Cipla
00:22:15.961 --> 00:22:17.491
sell their medicines
to many nations
00:22:17.491 --> 00:22:19.044
in the southern hemisphere
00:22:19.044 --> 00:22:22.483
and to organizations including
Medecins Sans Frontieres
00:22:22.483 --> 00:22:25.857
who buy 80% of their
medicines from India.
00:22:25.857 --> 00:22:29.182
These are companies with
very high equality standards.
00:22:29.182 --> 00:22:32.183
Cipla was founded in
the 1930s to allow India
00:22:32.183 --> 00:22:33.637
to break away from
its dependence
00:22:33.637 --> 00:22:36.457
in the British pharmaceuticals
industry.
00:22:36.457 --> 00:22:40.624
Gandhi himself was enthusiastic
about his foundation.
00:22:44.131 --> 00:22:45.204
- No, no, no.
00:22:45.204 --> 00:22:47.133
I like intellectual property.
00:22:47.133 --> 00:22:50.800
I certainly believe
that if somebody invents
00:22:52.242 --> 00:22:53.903
a new drug or something,
00:22:53.903 --> 00:22:56.804
he should be suitably rewarded.
00:22:56.804 --> 00:22:58.728
There is no question about that.
00:22:58.728 --> 00:23:00.658
I've never been against patents.
00:23:00.658 --> 00:23:01.658
Please.
00:23:01.730 --> 00:23:04.504
I have been against monopoly.
00:23:04.504 --> 00:23:06.549
That in the third world,
00:23:06.549 --> 00:23:10.716
any country like India with
1.1 billion people today,
00:23:13.117 --> 00:23:16.117
likely to go to 1.5
billion by 2020.
00:23:18.906 --> 00:23:21.239
We cannot afford a monopoly.
00:23:22.117 --> 00:23:24.950
(classical music)
00:23:42.139 --> 00:23:43.339
- [Narrator] The golden age
00:23:43.372 --> 00:23:46.529
of the India pharmaceutical
industry began in 1972,
00:23:46.529 --> 00:23:48.124
when Indira Gandhi
abolished patents
00:23:48.124 --> 00:23:50.199
on pharmaceutical products
as a means of addressing
00:23:50.199 --> 00:23:52.116
internal health crises.
00:23:53.010 --> 00:23:57.177
This considerably boosted
the production of generics.
00:23:58.745 --> 00:24:03.812
- In 1984, the Italian local
pharmaceutical industry,
00:24:05.544 --> 00:24:07.780
the indigenous Italian industry,
00:24:07.780 --> 00:24:09.813
was on top of the world.
00:24:09.813 --> 00:24:11.527
You had Carlo Erba,
00:24:11.527 --> 00:24:13.616
you had Farmitalia.
00:24:13.616 --> 00:24:14.860
You had all the large...
00:24:14.860 --> 00:24:15.860
Lipitea.
00:24:15.952 --> 00:24:18.457
All the large Italian companies.
00:24:18.457 --> 00:24:21.694
They were manufacturing
in Italy and exporting.
00:24:21.694 --> 00:24:25.027
Then in 1984, like what
India did in 1995,
00:24:27.032 --> 00:24:31.386
they reintroduced what is
called product patterns
00:24:31.386 --> 00:24:33.066
and the minute they reintroduced
00:24:33.066 --> 00:24:36.674
the Italian pharma
industry went down.
00:24:36.674 --> 00:24:40.052
The same is likely
to happen to India.
00:24:40.052 --> 00:24:43.488
If you look at the
disease pattern in India,
00:24:43.488 --> 00:24:45.821
110 million mental patients,
00:24:46.838 --> 00:24:49.430
18 million heart patients,
00:24:49.430 --> 00:24:51.538
60 million diabetics,
00:24:51.538 --> 00:24:54.153
60 million asthmatics.
00:24:54.153 --> 00:24:57.279
One in three Indians
is got latent TB.
00:24:57.279 --> 00:25:00.495
50 million hepatitis B cases.
00:25:00.495 --> 00:25:04.162
By 2015 we will have
35 million HIV positive
00:25:07.012 --> 00:25:09.179
so these figures cannot...
00:25:10.760 --> 00:25:13.927
India simply cannot
afford a monopoly.
00:26:15.915 --> 00:26:19.255
But what the government
has essentially done
00:26:19.255 --> 00:26:23.338
has neglected the poor
man on the street in India
00:26:24.827 --> 00:26:28.994
and they have virtually
committed selective genocide
00:26:30.528 --> 00:26:34.595
that by 2015 hardly any
Indians will be able
00:26:35.481 --> 00:26:39.998
to afford lifesaving
and essential drugs.
00:27:04.645 --> 00:27:07.728
(background chatter)
00:27:38.918 --> 00:27:40.985
(speaking in local language)
00:29:17.895 --> 00:29:20.728
(classical music)
00:29:27.047 --> 00:29:29.723
- [Narrator] The impact
of HIV/AIDS in Africa
00:29:29.723 --> 00:29:30.973
is devastating.
00:29:32.202 --> 00:29:34.633
Not only does it cause
millions of deaths,
00:29:34.633 --> 00:29:36.794
but it is dealt a harsh
blow to the already
00:29:36.794 --> 00:29:39.518
fragile economies and
has caused changes
00:29:39.518 --> 00:29:42.377
in patterns of behavior
and lifestyle.
00:29:42.377 --> 00:29:44.019
(classical music)
00:29:44.019 --> 00:29:47.102
(background chatter)
00:30:22.437 --> 00:30:25.270
(classical music)
00:30:47.258 --> 00:30:49.325
(speaking in local language)
00:32:46.464 --> 00:32:50.214
(speaking in local language)
00:33:02.163 --> 00:33:04.538
- AIDS is a neglected disease.
00:33:04.538 --> 00:33:07.822
Even though there's a lot of
research going on in AIDS,
00:33:07.822 --> 00:33:09.970
all the research and
development efforts
00:33:09.970 --> 00:33:13.632
are geared towards finding
the next generation
00:33:13.632 --> 00:33:16.419
of medicine to treat the people
00:33:16.419 --> 00:33:19.455
in Europe and in North America
00:33:19.455 --> 00:33:22.924
that need a new generation
of antiretroviral treatment
00:33:22.924 --> 00:33:25.375
to deal with their resistance,
00:33:25.375 --> 00:33:28.356
but the kind of research
we need today on AIDS
00:33:28.356 --> 00:33:32.424
is tools easier to use
on the large scale
00:33:32.424 --> 00:33:34.077
in resource poor settings.
00:33:34.077 --> 00:33:36.668
We need medicines to
treat children with AIDS.
00:33:36.668 --> 00:33:38.433
Children with AIDS
almost do not exist
00:33:38.433 --> 00:33:40.116
in Europe and North America
00:33:40.116 --> 00:33:42.740
so the development of these
products do not take place.
00:33:42.740 --> 00:33:45.129
- [Narrator] The profit made
in the pharmacological sector
00:33:45.129 --> 00:33:49.396
in the 1990s was equivalent
to 25% of the total turnover,
00:33:49.595 --> 00:33:53.190
well over that made by any
other consumer goods sector.
00:33:53.190 --> 00:33:55.665
These are colossal
profit margins.
00:33:55.665 --> 00:33:56.708
To give you an idea,
00:33:56.708 --> 00:33:59.070
the average profit in other
sectors in the same period
00:33:59.070 --> 00:34:01.735
was 3.3% of turnover
00:34:01.735 --> 00:34:03.746
so you would expect there
to be a huge investment
00:34:03.746 --> 00:34:05.722
in research and development.
00:34:05.722 --> 00:34:09.497
Yet Big Pharma only
invested about 11% to 14%
00:34:09.497 --> 00:34:11.097
in research and development
00:34:11.097 --> 00:34:13.806
while their expenditure
in marketing and admin
00:34:13.806 --> 00:34:17.082
amounted to 36% of turnover.
00:34:17.082 --> 00:34:19.709
- It is true that
there are prices
00:34:19.709 --> 00:34:23.640
which are high so to
speak at the beginning
00:34:23.640 --> 00:34:26.323
compared to the end
price of the drug,
00:34:26.323 --> 00:34:28.261
but marketing also
is part of this
00:34:28.261 --> 00:34:32.049
because the company
has eight to 10 years
00:34:32.049 --> 00:34:34.645
of the exclusive right
under the patent
00:34:34.645 --> 00:34:38.812
and that company is competing
with other patented drugs.
00:34:44.502 --> 00:34:48.508
The research company has
to recoup to catch back
00:34:48.508 --> 00:34:50.644
the cost of research
and development
00:34:50.644 --> 00:34:52.923
over an eight year period
00:34:52.923 --> 00:34:55.340
or frequently it can be less.
00:34:56.698 --> 00:34:58.557
- [Narrator] In
the 1970s, roughly
00:34:58.569 --> 00:34:59.959
17 new chemical compounds
00:34:59.959 --> 00:35:02.418
were recorded each year.
00:35:02.418 --> 00:35:04.757
Since then there's been
a constant reduction
00:35:04.757 --> 00:35:07.375
in genuine pharmaceutical
innovations,
00:35:07.375 --> 00:35:11.891
arriving at the mere 23
substances approved in 2004,
00:35:11.891 --> 00:35:14.767
of which only four can
be considered significant
00:35:14.767 --> 00:35:16.517
therapeutic advances.
00:35:19.228 --> 00:35:22.611
- The expense comes essentially
00:35:23.599 --> 00:35:27.782
in what is called evergreening.
00:35:29.228 --> 00:35:32.040
That means how if I have
a good product,
00:35:32.040 --> 00:35:35.344
how do I extend the patent life.
00:35:35.344 --> 00:35:36.384
But tell me something.
00:35:36.384 --> 00:35:37.747
If you have a drug,
00:35:37.747 --> 00:35:39.872
say an antidepressant drug,
00:35:39.872 --> 00:35:42.972
how many patents should
a drug really have?
00:35:42.972 --> 00:35:45.336
Two, three, four, five?
00:35:45.336 --> 00:35:47.295
Now there are drugs today,
00:35:47.295 --> 00:35:49.812
controlled by the
multinationals,
00:35:49.812 --> 00:35:51.753
where there are 240 patents
00:35:51.753 --> 00:35:53.825
on the same drug.
00:35:53.825 --> 00:35:56.499
Different crystalline forms
of the drug,
00:35:56.499 --> 00:35:59.013
different SORS, different ESTAS.
00:35:59.013 --> 00:36:02.044
Then metabolites, probe drugs,
00:36:02.044 --> 00:36:04.543
new drug delivery systems.
00:36:04.543 --> 00:36:06.997
So the whole thing
is camouflaged
00:36:06.997 --> 00:36:09.997
so that they can
extend patent life.
00:36:11.727 --> 00:36:13.794
(speaking in Spanish)
(not subtitled)
00:36:27.702 --> 00:36:30.737
- Many of the old drugs
were developed
00:36:30.737 --> 00:36:32.178
for different reasons.
00:36:32.178 --> 00:36:33.211
For example,
00:36:33.211 --> 00:36:36.861
for military reasons or
even as a final stage
00:36:38.768 --> 00:36:41.520
of colonialism when
European powers
00:36:41.520 --> 00:36:43.728
were interested in malaria
00:36:43.728 --> 00:36:45.836
because they had many
of their own citizens
00:36:45.836 --> 00:36:47.524
in malarious areas.
00:36:47.524 --> 00:36:50.191
As soon as those motivations go,
00:36:51.597 --> 00:36:53.890
then there is no
motivation to develop,
00:36:53.890 --> 00:36:58.057
no commercial motivation
to develop malaria drugs.
00:37:00.390 --> 00:37:02.457
(voice-over in Italian)
00:38:31.162 --> 00:38:34.712
- If malaria was a disease
in Europe or the US,
00:38:34.712 --> 00:38:37.129
we would cure it very easily.
00:38:38.069 --> 00:38:40.249
The real problem is
that most people
00:38:40.249 --> 00:38:42.832
who have malaria are very poor.
00:38:43.785 --> 00:38:46.202
They cannot afford good drugs
00:38:47.254 --> 00:38:49.965
so they have relied
mainly on old drugs,
00:38:49.965 --> 00:38:52.465
which have resistance to them.
00:38:53.343 --> 00:38:57.010
(speaking in local language)
(not subtitled)
00:39:05.728 --> 00:39:08.628
- You have to prevent
people from getting malaria.
00:39:08.628 --> 00:39:11.341
That includes things
like bed nets.
00:39:11.341 --> 00:39:14.630
It includes things like
controlling the mosquitoes,
00:39:14.630 --> 00:39:15.630
but even so,
00:39:15.722 --> 00:39:18.275
there are hundreds
of millions of people
00:39:18.275 --> 00:39:22.442
who develop malaria and
those people need medicines.
00:39:23.527 --> 00:39:26.610
(indistinct chatter)
00:39:30.110 --> 00:39:33.194
- [Narrator] In March 2007,
the nonprofit organization
00:39:33.194 --> 00:39:36.620
Drugs for Neglected
Diseases, an MSF initiative,
00:39:36.620 --> 00:39:38.082
and Sanofi-Aventis
00:39:38.082 --> 00:39:39.659
developed an anti malaria drug
00:39:39.659 --> 00:39:41.638
that would only cost $1 a pill
00:39:41.638 --> 00:39:43.388
and most importantly,
00:39:43.388 --> 00:39:45.419
will be patent free.
00:39:45.419 --> 00:39:48.284
Anyone will be able to
produce it and improve it.
00:39:48.284 --> 00:39:50.420
Its name is ASAQ.
00:39:50.420 --> 00:39:52.244
Who knows if this new
drug will really help
00:39:52.244 --> 00:39:53.827
those most in need.
00:39:56.619 --> 00:40:00.131
- You can have a free
drug that's given away.
00:40:00.131 --> 00:40:01.231
For example,
00:40:01.364 --> 00:40:04.631
the WHO knows that the medicines
00:40:04.761 --> 00:40:07.777
that were donated
this year by major...
00:40:07.777 --> 00:40:10.546
one of our member companies
for sleeping sickness
00:40:10.546 --> 00:40:13.697
is not getting to many
patients in Africa.
00:40:13.697 --> 00:40:14.943
Not because of the price,
00:40:14.943 --> 00:40:17.657
because the drugs
were given away.
00:40:17.657 --> 00:40:18.927
They're not getting to patients
00:40:18.927 --> 00:40:21.394
because there's no
structure to deliver
00:40:21.394 --> 00:40:22.394
these medicines.
00:40:22.484 --> 00:40:25.467
(indistinct chatter)
00:40:37.890 --> 00:40:40.390
(speaking in Spanish)
00:41:10.382 --> 00:41:12.448
(speaking in local language)
00:42:07.306 --> 00:42:10.247
- What we are proposing
is that governments
00:42:10.247 --> 00:42:15.247
need to clearly spell
what their priorities are.
00:42:15.325 --> 00:42:16.525
For example,
00:42:16.558 --> 00:42:18.628
if they came to Kenya
and someone wanted
00:42:18.628 --> 00:42:20.434
to do business in Kenya,
00:42:20.434 --> 00:42:22.318
we will clearly indicate to them
00:42:22.318 --> 00:42:24.391
that the priority diseases
in this country
00:42:24.391 --> 00:42:26.255
are one, two, three, four, five
00:42:26.255 --> 00:42:28.582
and if someone wanted
to do business,
00:42:28.582 --> 00:42:31.858
they would need to show
that they're covering
00:42:31.858 --> 00:42:35.377
the areas of priority
as they do business
00:42:35.377 --> 00:42:37.108
in the other areas of health.
00:42:37.108 --> 00:42:39.941
(classical music)
00:42:43.058 --> 00:42:44.993
- [Narrator] South Africa
has the highest number
00:42:44.993 --> 00:42:47.481
of HIV positive
people in the world,
00:42:47.481 --> 00:42:49.781
over 6.5 million people.
00:42:50.606 --> 00:42:53.439
(classical music)
00:42:55.471 --> 00:42:58.220
A portion of the anti-HIV
medication arrives
00:42:58.220 --> 00:43:01.051
thanks to a sizable
contribution from the States
00:43:01.051 --> 00:43:03.141
and international organizations,
00:43:03.141 --> 00:43:06.974
as well as the large
humanitarian foundations.
00:43:10.312 --> 00:43:13.673
- It's like the Gates
Foundation today in AIDS.
00:43:13.673 --> 00:43:14.822
They will not treat,
00:43:14.822 --> 00:43:17.628
but they say we will
spend our money
00:43:17.628 --> 00:43:20.397
to develop an AIDS vaccine.
00:43:20.397 --> 00:43:23.256
So who develops the
AIDS vaccine for Gates?
00:43:23.256 --> 00:43:24.589
Merck in America.
00:43:25.866 --> 00:43:28.829
Indians are being used as
guinea pigs for the trials.
00:43:28.829 --> 00:43:30.482
Fine.
00:43:30.482 --> 00:43:31.482
Good.
00:43:31.515 --> 00:43:32.970
I'm not saying no,
00:43:32.970 --> 00:43:37.144
but I asked the Gates
Foundation a question.
00:43:37.144 --> 00:43:40.495
That suppose a
vaccine is developed
00:43:40.495 --> 00:43:41.600
and God willing,
00:43:41.600 --> 00:43:43.600
there will be a vaccine.
00:43:45.960 --> 00:43:48.444
With your money it
is being developed.
00:43:48.444 --> 00:43:52.611
Will India get the know-how
to produce that vaccine free?
00:43:53.497 --> 00:43:54.497
They said no.
00:43:54.530 --> 00:43:57.564
This is the property of Merck.
00:43:57.564 --> 00:44:01.481
So then if Merck charges
$400 per vaccine shot,
00:44:03.863 --> 00:44:06.431
who's going to pay for it?
00:44:06.431 --> 00:44:08.744
I can't copy it anymore.
00:44:08.744 --> 00:44:10.327
Under the new laws.
00:44:11.409 --> 00:44:15.576
So I'm a great believer
that public-funded research
00:44:17.023 --> 00:44:19.464
should be free for the public.
00:44:19.464 --> 00:44:21.960
You should not be
allowed to patent it.
00:44:21.960 --> 00:44:25.058
- [Narrator] In 2004, the
Parliamentary Inquiry Commission
00:44:25.058 --> 00:44:26.640
set up in the UK to control
00:44:26.640 --> 00:44:28.712
the local
pharmaceutical industry
00:44:28.712 --> 00:44:30.622
declared the health minister
00:44:30.622 --> 00:44:32.706
has taken it for granted
for too long
00:44:32.706 --> 00:44:34.356
and has been too optimistic
00:44:34.356 --> 00:44:35.956
that the interests
of public health
00:44:35.956 --> 00:44:39.408
and those of the pharmaceuticals
industry should coincide.
00:44:39.408 --> 00:44:40.719
The result is that the industry
00:44:40.719 --> 00:44:43.827
has been given the green
light for far too long.
00:44:43.827 --> 00:44:45.027
The influence of the industry
00:44:45.108 --> 00:44:47.293
can be seen at all levels
of health assistance.
00:44:47.293 --> 00:44:48.963
From the initial discovery
and development
00:44:48.963 --> 00:44:50.616
of drugs with clinical trials
00:44:50.616 --> 00:44:53.009
to their promotion with
doctor and patient groups,
00:44:53.009 --> 00:44:55.034
up to their prescription
and the setting down
00:44:55.034 --> 00:44:56.791
of clinical guidelines.
00:44:56.791 --> 00:44:58.185
There has been a
definite tendency
00:44:58.185 --> 00:45:00.970
to classify more and more
individuals as abnormal
00:45:00.970 --> 00:45:04.706
or in need of
pharmacological treatment.
00:45:04.706 --> 00:45:07.539
(classical music)
00:45:09.432 --> 00:45:10.817
So the pharmaceutical houses
00:45:10.817 --> 00:45:12.449
with the consensus
of governments
00:45:12.449 --> 00:45:15.556
are altering our
concept to illness.
00:45:15.556 --> 00:45:19.131
(classical music)
00:45:19.131 --> 00:45:20.400
A case in point is that
00:45:20.400 --> 00:45:23.321
of high blood pressure
or hypertension.
00:45:23.321 --> 00:45:26.828
Until 2003 the starting
point of hypertension
00:45:26.828 --> 00:45:28.399
was deemed to be
when blood pressure
00:45:28.399 --> 00:45:30.876
had a maximum of over 140
00:45:30.876 --> 00:45:32.959
and a minimum of over 90.
00:45:34.020 --> 00:45:37.998
After 2003, an expert panel
decided on the existence
00:45:37.998 --> 00:45:39.533
of pre-hypertension,
00:45:39.533 --> 00:45:42.066
which ranges from 120 stroke 80
00:45:42.066 --> 00:45:43.483
to 140 stroke 90.
00:45:44.521 --> 00:45:45.961
And so many people found
00:45:45.961 --> 00:45:48.999
that they had a medical
problem overnight.
00:45:48.999 --> 00:45:51.832
(classical music)
00:46:00.289 --> 00:46:02.117
- [Narrator]
Or an even more serious case
00:46:02.117 --> 00:46:05.214
is that of the so-called
attention deficit disorder
00:46:05.214 --> 00:46:06.745
or hyperactivity,
00:46:06.745 --> 00:46:09.533
particularly common
amongst children.
00:46:09.533 --> 00:46:11.291
And so during the 1990s,
00:46:11.291 --> 00:46:14.351
since it was decided that
this was indeed a disorder
00:46:14.351 --> 00:46:15.967
and not a normal condition,
00:46:15.967 --> 00:46:18.827
the number of children labeled
as being affected by ADD
00:46:18.827 --> 00:46:22.652
has increased sevenfold
to the extent that today
00:46:22.652 --> 00:46:25.894
15% of school age children
in the United States
00:46:25.894 --> 00:46:28.530
take amphetamines regularly
00:46:28.530 --> 00:46:31.524
and the same thing is
happening in other countries.
00:46:31.524 --> 00:46:33.389
So if during the next few months
00:46:33.389 --> 00:46:36.382
your children start
getting too exuberant,
00:46:36.382 --> 00:46:38.484
take heart in knowing you
can soon calm them down
00:46:38.484 --> 00:46:41.101
with a healthy dose of Ritalin.
00:46:41.101 --> 00:46:43.278
- Over the last few
decades we've seen
00:46:43.278 --> 00:46:45.885
a kind of privatization
of healthcare
00:46:45.885 --> 00:46:48.209
and a privatization of research,
00:46:48.209 --> 00:46:49.513
privatization of health research
00:46:49.513 --> 00:46:52.297
and a privatization of the
development of new products,
00:46:52.297 --> 00:46:54.637
which of course has
led to a system
00:46:54.637 --> 00:46:56.005
that will serve the market,
00:46:56.005 --> 00:46:57.310
but if the market doesn't exist,
00:46:57.310 --> 00:46:58.865
you're not served.
00:46:58.865 --> 00:47:02.081
So that I feel is
a huge barrier.
00:47:02.081 --> 00:47:04.787
It's a little difficult to
ask pharmaceutical companies
00:47:04.787 --> 00:47:07.015
that have been established
to make money
00:47:07.015 --> 00:47:09.427
and satisfy their shareholders
00:47:09.427 --> 00:47:10.850
to do things that
will ultimately
00:47:10.850 --> 00:47:12.999
not bring a lot of money.
00:47:12.999 --> 00:47:15.056
You need the
governments involved.
00:47:15.056 --> 00:47:17.092
You need governments
to regulate things.
00:47:17.092 --> 00:47:20.201
You need different
funding sources
00:47:20.201 --> 00:47:23.807
and you need the
health sector involved
00:47:23.807 --> 00:47:25.175
in setting the priorities.
00:47:25.175 --> 00:47:28.008
(classical music)
00:47:34.664 --> 00:47:36.851
- [Narrator] Pharmaceutical
companies tend to produce
00:47:36.851 --> 00:47:38.857
a massive marketing operation,
00:47:38.857 --> 00:47:41.028
dressed up as science
financing research,
00:47:41.028 --> 00:47:42.181
sponsoring conferences,
00:47:42.181 --> 00:47:43.981
studies, publications
00:47:44.041 --> 00:47:46.327
supporting associations
00:47:46.327 --> 00:47:47.990
in such a way that many medics
00:47:47.990 --> 00:47:50.804
feel that they shouldn't bite
the hand that feeds them.
00:47:50.804 --> 00:47:53.637
(classical music)
00:47:59.088 --> 00:48:01.918
In the west spending on
medicines is increasing
00:48:01.918 --> 00:48:04.623
by about 7% a year,
00:48:04.623 --> 00:48:08.290
while the GNP is only
increasing by 2%.
00:48:11.023 --> 00:48:14.012
How much longer will the health
systems of wealthy countries
00:48:14.012 --> 00:48:16.916
be able to withstand the
increasing cost of medicines
00:48:16.916 --> 00:48:21.523
and guarantee their citizens
free access to them?
00:48:21.523 --> 00:48:24.160
How much longer will the
problem of access to medicine
00:48:24.160 --> 00:48:26.266
be confined to poor nations?
00:48:26.266 --> 00:48:29.099
(classical music)
00:48:32.516 --> 00:48:35.599
(African drum music)
00:49:20.426 --> 00:49:24.093
(speaking in local language)
00:49:25.032 --> 00:49:28.115
(African drum music)
00:50:25.249 --> 00:50:28.249
(ambient music)
00:50:59.957 --> 00:51:02.957
(chanting)
Distributor: First Hand Films
Length: 52 minutes
Date: 2007
Genre: Expository
Language: English; Portuguese; Hindi; Spanish / English subtitles
Grade: College, Adults
Color/BW:
Closed Captioning: Available
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