In particular, “differential pricing” — companies charging
different prices in different markets according to purchasing power
— is a feasible means of achieving this, provided certain conditions
was a widely held view among a diverse group of 80 experts from 21
countries and a wide range of professional backgrounds, participating
in a workshop organized jointly by the World Health Organization,
World Trade Organization, Norwegian Foreign Ministry and Global Health
Council, a broad-based US organization in the healthcare field.
workshop examined in detail ways to reduce pharmaceutical prices in
low-income countries and how to increase financing so that the world’s
poorest people can obtain necessary medicines and healthcare.
HIV/AIDS, malaria and tuberculosis featured prominently, but a wide
range of other diseases that affect poor people were also discussed.
Director-General Gro Harlem Brundtland said the meeting had been
constructive and helpful.
is clear that the price of medicines does matter — especially for
people in poor countries,” she said.
heard from the experts that much lower prices can be achieved for the
poorest countries. Equally important is strengthening health systems,
and, for the poorest countries, securing additional international
financing,” Dr Brundtland said.
attended as experts in their own right. They came from: developed and
developing country governments; international research-based
companies; generic pharmaceutical companies from Asia, Africa and
Latin America; non-governmental organizations; consumer and treatment
groups; universities; and international organizations.
participants clearly approached the issues from different points of
view, there was broad recognition that differential pricing could play
an important role in ensuring access to existing drugs at affordable
prices, particularly in the poorest countries, while the patent system
would be allowed to continue to play its role in providing incentives
for research and development into new drugs,” said Adrian Otten,
director of the WTO’s Intellectual Property Division.
of the organizers, the WHO and WTO, will each report on the outcome to
forthcoming meetings in their organizations to be held in the next few
months. In May, the WHO holds its World Health Assembly, and in June
the WTO’s Council on Trade-Related Aspects of Intellectual Property
Rights (TRIPS) will hold a special discussion on intellectual property
and access to drugs.
participants will be able draw on the ideas and experiences exchanged
in the workshop, for use in their own work, together or separately.
pricing has already been achieved for commodities such as vaccines,
contraceptives and condoms through a combination of high-volume
purchasing, reliable and adequate financing, advocacy, corporate
responsibility and market forces.
challenge is to find ways to expand this to life-saving medicines. The
participants accepted that there is no single formula to achieve this.
A wide mix of options is needed, they said.
property rights stimulate development of new medicines, but must be
implemented in an impartial way that safeguards public health. We also
need to ensure that there are additional incentives for the
development of the drugs needed to address the health problems of
people in poor countries,” Dr Brundtland said.
Among the ideas emerging from the meeting were:
pricing would allow companies that make patented drugs to recover most
of the costs of research and development in richer markets and at the
same time to sell or license production at lower prices in
lower-income countries. Advocates said this could be a win-win
solution if consumers in richer countries do not face higher prices as
to the success of this would be methods of preventing lower priced
drugs from finding their way into rich country markets. A number of
speakers were also concerned that lower prices in developing
countries should not be used as reference points for price controls in
for appropriate strategies suggested in the workshop included:
creating the right conditions so that the market determines
differential pricing; discounts negotiated bilaterally between
companies and purchasers (which could include bulk purchasing on
behalf of many customers); licences agreed voluntarily between patent
owners and generic manufacturers; and global procurement and
and generic drugs back
speakers also felt that generic drug manufacturers play an important
role in bringing competition to pharmaceutical markets and improving
production efficiency, which would reduce prices further.
property and TRIPS safeguards back
acknowledged that intellectual property protection is an important
incentive for research and development into new drugs. Some said there
are also other ways to encourage research and development.
the same time, countries need to be able to make use of the public
health safeguards built into the TRIPS Agreement — including
compulsory licensing (governments allowing others to produce a
patented invention without the patent owner’s permission) and “parallel”
imports (i.e. imports of products supplied by the patent owner or a
licensee at a lower price in another country).
drug prices fall — and many low priced essential drugs are already
available — there is still no guarantee that poor communities can
afford them. This is particularly true for HIV/AIDS drugs. Even with
costs coming down to $500 per patient per year, this is well beyond
the reach of the many countries whose total health expenditure is less
than $10 to $20 per year. In these cases, significant amounts of
external financing is needed.
of the participants also said financing for drugs should not be
considered in isolation. They called for massive increases in finance
to develop effective healthcare systems in general, including
training, education and delivery, as well as for buying the drugs.