Today we are concerned about generation of knowledge, which will be relevant to the poor, for example, new knowledge, which impacts on the diseases of the poor, and so on. Development of technology for the poor people is generally neglected. Take the diseases of the poor as an example. In 1998, the global spending on health research was $ 70 billion, but just $ 300 million was dedicated to vaccines for HIV/AIDS and about $ 100 million to malaria research. Of 1,223 new drugs marketed worldwide between 1975 and 1996, only 13 were developed to treat tropical diseases – and only 4 were the direct results of the research done by pharma industry. The lesson is that not only the funding of research in rich countries is skewed but also the priorities, as they largely deal with the needs of the rich.
The access to drugs at affordable costs has been on the agenda of poor nations. It is interesting to note that the issue of ‘patents and the patients’ had taken the shape of ‘patents vs. the patients’. What has brought this issue into sharp focus is the HIV/AIDS case in South Africa. CIPLA from India offered a cocktail of three anti-retroviral drugs for US $ 350 for a treatment for one year, as against the multinational drug pharma companies, whose offer was have been around $ 10,000. Eventually these companies were forced to bring down the cost of the treatment to less than $ 600. This has raised the issue of availability of medicines at an affordable price to the poor of the world
But another question that arises is also about the necessity of finding ways and means by which drugs of interest to the poor of the world, be it Malaria, TB and so on, could be created. The key question is, who will work on these? It is obvious that there is a pressure on large drugs and pharma companies to provide the maximum value to their shareholders rather than provide value to the poor of the developing nations. Their research portfolio is obviously heavily slanted towards drugs, which bring in maximum profits to the firms and not towards the drugs for the poor. Therefore, there is no substitute to creating new drugs for the poor excepting through public funding (national as well as international) and also through meaningful public/private partnerships.
Drugs for Malaria is a good example. If one goes to the market, one finds that the drugs for Malaria available today have been largely developed by CSIR laboratories like Central Drug Research Institution in Lucknow. Can this model be extended beyond India. What about countries like Africa, who neither have the money to buy the medicines nor do they have the scientific capacity that countries like India have a new model. For this we require.
I propose that the solution is to create a global knowledge pool for global good through global funding. The global fund should be created and managed by an international body. The funding would be given for creating new knowledge and products for identified diseases of concern to the poor. The research agenda will be set and programs monitored by this body. The norms for sharing the intellectual property arising out of this could be decided in such a way that the access at affordable prices to the poor is ensured. For this to happen, a new awakening will have to arise in the global community about concerns of the poor. India could be an ideal destination for this, since although it is economically poor, it is intellectually rich.