TEDxZurich 2012
Ellen 't Hoen: Pool medical patents, save lives
Ellen 't Hoen: 藥物專利聯盟，拯救生命
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為新藥申報專利可以幫助負擔巨額的研發費用 -- 但專利的存在卻使發展中國家的患者無法接受先進的治療方法，喪失活下去的機會。 Ellen 't Hoen 介紹的是一個非常巧妙解決方案：藥物專利聯盟。（於TEDxZurich 錄製）
Ellen 't Hoen - Medicine law expert
The founder of the Medicines Patent Pool, Ellen 't Hoen works (and makes change) at the place where profit and health collide: patented drugs. Full bio
The founder of the Medicines Patent Pool, Ellen 't Hoen works (and makes change) at the place where profit and health collide: patented drugs. Full bio
Double-click the English transcript below to play the video.
00:17
In 2002, a group of treatment activists met
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2002年 一群為愛滋病治療積極奔走的活躍人士
00:21
to discuss the early development of the airplane.
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聚在一起討論飛機早期的發展
00:25
The Wright Brothers, in the beginning of the last century,
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萊特兄弟在上世紀初
00:30
had for the first time managed
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首次成功實現
00:32
to make one of those devices fly.
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人工飛行
00:34
They also had taken out numerous patents
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萊特兄弟還為飛機的核心部件
00:37
on essential parts of the airplane.
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申報了大量的專利
00:39
They were not the only ones.
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當時 並非只有萊特兄弟這麼做
00:41
That was common practice in the industry,
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這種做法在業界普遍存在
00:44
and those who held patents on airplanes
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而這些飛行器專利的持有者
00:47
were defending them fiercely
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大力維護自己的專利權
00:48
and suing competitors left and right.
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對競爭者的任何侵權行為一定控訴到底
00:51
This actually wasn't so great for the development of the aviation industry,
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實際上這種做法不利於航空工業的發展
00:56
and this was at a time that in particular the U.S. government
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而當時 美國政府又特別希望
01:00
was interested in ramping up
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可以大幅提高
01:02
the production of military airplanes.
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軍用飛機的產量
01:05
So there was a bit of a conflict there.
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所以矛盾也就出現了
01:07
The U.S. government decided to take action,
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美國政府決定採取行動
01:11
and forced those patent holders
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強迫專利持有者
01:13
to make their patents available to share with others
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將其持有的專利與他人共享
01:17
to enable the production of airplanes.
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從而實現飛機的量產
01:23
So what has this
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那麼這兩者
01:26
got to do with this?
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又是如何產生聯繫的呢？
01:30
In 2002, Nelson Otwoma, a Kenyan social scientist,
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2002年 一位名叫Nelson Otwona的肯尼亞社會科學家
01:35
discovered he had HIV and needed access to treatment.
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被發現攜帶HIV病毒 需要接受治療
01:40
He was told that a cure did not exist.
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醫生告訴他愛滋病是無法治愈的
01:44
AIDS, he heard, was lethal,
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愛滋病是一種致命的疾病
01:47
and treatment was not offered. This was at a time
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沒有可以治愈愛滋病的療法 但實際上
01:51
that treatment actually existed in rich countries.
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當時在富裕的國家治療方法是存在的
01:53
AIDS had become a chronic disease.
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愛滋病已經變成一種慢性病
01:56
People in our countries here in Europe, in North America,
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在歐洲在北美 在我們的國家
02:00
were living with HIV, healthy lives.
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攜帶HIV病毒的人們也可以健康地生活
02:03
Not so for Nelson. He wasn't rich enough,
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但對於Nelson情況卻不是這樣
02:06
and not so for his three-year-old son, who he discovered a year later
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Nelson不是有錢人 他三歲的兒子更不是
02:10
also had HIV.
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在Nelson被診斷出HIV病毒後一年
他的兒子也被查出攜帶HIV
他的兒子也被查出攜帶HIV
02:13
Nelson decided to become a treatment activist
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Nelson決定成為一名治療活躍人士
02:16
and join up with other groups.
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並加入了其他團體
02:18
In 2002, they were facing a different battle.
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在2002年 他們面臨的是一場不同的戰鬥
02:25
Prices for ARVs, the drugs needed to treat HIV,
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ARVs是一種用於治療HIV的藥物
02:30
cost about 12,000 [dollars] per patient per year.
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而當時ARVs的價格高達每名患者每年一萬兩千美元
02:34
The patents on those drugs were held
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西方的一些製藥公司
02:36
by a number of Western pharmaceutical companies
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持有這些藥物的專利權
02:42
that were not necessarily willing
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而這些製藥公司並不太希望
02:45
to make those patents available.
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將持有的專利與他人共享
02:48
When you have a patent, you can exclude
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只要持有專利便可以限制他人
02:51
anyone else from making, from producing or making
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製造或是生產
02:55
low-cost versions, for example,
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廉價的產品 比如說
02:58
available of those medications.
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生產廉價的藥品
03:02
Clearly this led to patent wars breaking out
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很顯然 這種做法觸發了
03:06
all over the globe.
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全球範圍內的專利戰
03:09
Luckily, those patents did not exist everywhere.
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幸運的是 這些專利並非無處不在
03:13
There were countries that did not recognize
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有一些國家 比如像印度
03:15
pharmaceutical product patents, such as India,
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並不承認醫藥產品專利
03:18
and Indian pharmaceutical companies
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一些印度製藥公司
03:21
started to produce so-called generic versions,
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開始生產所謂的
03:25
low-cost copies of antiretroviral medicines,
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通用版和廉價版的抗逆轉錄藥物
03:29
and make them available in the developing world,
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並將這些藥物投放到發展中國家
03:32
and within a year the price had come down
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一年之內 這些藥物的價格便從
03:35
from 10,000 dollars per patient per year
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每名患者每年一萬美元
03:39
to 350 dollars per patient per year,
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下降到每名患者每年350美元
03:41
and today that same triple pill cocktail
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而今天每名愛滋病患者每年只需花費60美元
03:45
is available for 60 dollars per patient per year,
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便可以接受三聯雞尾酒療法
03:48
and of course that started to have an enormous effect
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當然 產生的影響是巨大的
03:51
on the number of people who could afford access
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越來越多的患者
03:54
to those medicines.
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將能夠負擔起藥物費用
03:56
Treatment programs became possible,
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有可能接受治療
03:58
funding became available, and the number of people
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有能力支付費用 並且服用抗逆轉錄藥物患者的
04:01
on antiretroviral drugs started to increase very rapidly.
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人數開始大幅增長
04:08
Today, eight million people
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現在有800萬人口
04:11
have access to antiretroviral drugs.
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能夠拿到抗逆轉錄藥物
04:14
Thirty-four million are infected with HIV.
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而感染HIV病毒的患者有三千四百萬
04:18
Never has this number been so high,
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這個數字是前所未有的
04:20
but actually this is good news,
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但事實上這是好消息
04:21
because what it means is people stop dying.
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因為這意味著人們的死亡率在降低
04:24
People who have access to these drugs stop dying.
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能夠獲得藥物治療的人便可免於一死
04:26
And there's something else.
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除此之外
04:27
They also stop passing on the virus.
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病毒攜帶者也不會繼續傳染給其他人
04:30
This is fairly recent science that has shown that.
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最新的科學研究已經表明了這一點
04:34
What that means is we have the tools
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這就意味著
04:36
to break the back of this epidemic.
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我們已經有辦法可以抑制愛滋病毒的傳播
04:40
So what's the problem?
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那麼 問題是什麽呢？
04:45
Well, things have changed.
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嗯 情況已經變了
04:47
First of all, the rules have changed.
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首先 規則變了
04:51
Today, all countries are obliged to provide
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現今 所有國家都必須為藥物申報專利
04:57
patents for pharmaceuticals that last at least 20 years.
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每項專利的時限最少為20年
05:02
This is as a result of the intellectual property rules
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世貿組織的知識產權法
05:05
of the World Trade Organization.
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促成了這一結果
05:07
So what India did is no longer possible.
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所以 印度的做法不再可行
05:10
Second, the practice of patent-holding companies have changed.
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其次 持有專利的公司也改變了自己的做法
05:15
Here you see the patent practices
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這張圖顯示的是 世貿組織出臺知識產權法規之前
05:20
before the World Trade Organization's rules, before '95,
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也就是1995年之前 抗逆轉錄藥物出現之前
05:24
before antiretroviral drugs.
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藥物專利申報的情況
05:26
This is what you see today,
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而這張圖顯示了現在藥物專利的申報情況
05:29
and this is in developing countries, so what that means is,
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這是在發展中國家 也就意味著
05:32
unless we do something deliberate
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除非我們能夠慎重考慮
05:34
and unless we do something now,
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馬上採取一些行動
05:36
we will very soon be faced with another drug price crisis,
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否則要不了多久就會發現 我們將面臨另一場藥物價格危機
05:42
because new drugs are developed,
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因為不斷在開發新藥 不斷有新藥投入市場
05:44
new drugs go to market, but these medicines are patented
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但這些藥物都有專利限制
05:47
in a much wider range of countries.
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而且這些專利被更多國家認可
05:50
So unless we act, unless we do something today,
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因此 除非我們現在馬上採取行動
05:55
we will soon be faced [with] what some have termed
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否則很快我們便將面臨
05:59
the treatment time bomb.
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一些人所說的治療時間炸彈
06:02
It isn't only the number of drugs that are patented.
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不僅僅是申報專利藥物的數量
06:07
There's something else that can really scare
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使得通用製藥商退避三舍
06:10
generic manufacturers away.
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還有一些其他的因素
06:11
This shows you a patent landscape.
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從這裡 可以看到專利分佈圖
06:15
This is the landscape of one medicine.
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這是一種藥物的專利分佈圖
06:19
So you can imagine that if you are a generic company
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因此 可以想像如果你是一家通用製藥公司
06:22
about to decide whether to invest
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正要決定是否投資開發一項產品
06:24
in the development of this product, unless you know
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那麼除非你知道
06:27
that the licenses to these patents
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確實可以獲得
06:29
are actually going to be available,
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這項產品的專利許可
06:32
you will probably choose to do something else.
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否則你可能另有打算
06:35
Again, deliberate action is needed.
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再次強調 我們必須慎重考慮並採取行動
06:39
So surely
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因此 可以肯定的是
06:41
if a patent pool could be established
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如果通過成立一個專利聯盟
06:45
to ramp up the production of military airplanes,
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可以大幅提升軍用飛機的量產
06:49
we should be able to do something similar
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那麼我們也應該能夠用類似的方式
06:53
to tackle the HIV/AIDS epidemic.
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解決HIV或愛滋病毒的傳播
06:56
And we did.
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我們確實做到了
06:58
In 2010, UNITAID established the Medicines Patent Pool
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2010年 國際藥品採購機制（UNITAID）成立了
07:04
for HIV.
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HIV藥物專利聯盟
07:07
And this is how it works:
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它的運作方式是這樣的
07:09
Patent holders, inventors
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研發新藥物的專利持有者 藥物發明者
07:13
that develop new medicines
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為新發明的藥物
07:16
patent those inventions,
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申報專利
07:19
but make those patents available
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但向藥物專利聯盟開放這些新藥物的專利許可權
07:21
to the Medicines Patent Pool. The Medicines Patent Pool
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藥物專利聯盟再將這些專利許可權
07:24
then license those out to whoever needs access to those patents.
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授權給任何有需要的人
07:28
That can be generic manufacturers.
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可能是通用製藥商
07:29
It can also be not-for-profit drug development agencies,
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也可能是非盈營利藥物開發機構
07:33
for example.
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等等
07:35
Those manufacturers can then sell those medicines
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然後這些製藥商便能夠以極低的價格
07:37
at much lower cost to people who need access to them,
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向有需要的人和治療計劃
07:42
to treatment programs that need access to them.
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出售這些藥物
07:45
They pay royalties over the sales to the patent holders,
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通過銷售營利 他們向專利持有者支付版權費用
07:49
so they are remunerated for sharing their intellectual property.
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因此專利持有者也因為
分享自己的知識產權獲得報酬
分享自己的知識產權獲得報酬
07:59
There is one key difference
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這與飛機專利聯盟
08:03
with the airplane patent pool.
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唯一不同的地方在於
08:07
The Medicines Patent Pool is a voluntary mechanism.
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藥物專利聯盟是一個自發的機制
08:12
The airplane patent holders were not left a choice
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飛機專利持有者並沒有選擇的餘地
08:15
whether they'd license their patents or not.
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無論是否願意
08:17
They were forced to do so.
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他們都不得不授權自己的專利
08:19
That is something that the Medicines Patent Pool cannot do.
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藥物專利聯盟沒有權力強迫任何人
08:23
It relies on the willingness of pharmaceutical companies
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完全依賴製藥公司的自願自發
08:26
to license their patents and make them available
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向他人授權自己的專利權
08:30
for others to use.
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為他人所用
08:34
Today, Nelson Otwoma is healthy.
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今天 Nelson Otwoma可以健康地生活
08:39
He has access to antiretroviral drugs.
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他能夠接受抗逆轉錄藥物的治療
08:43
His son will soon be 14 years old.
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他的兒子也馬上要14歲了
08:47
Nelson is a member of the expert advisory group
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Nelson是藥物專利聯盟
08:50
of the Medicines Patent Pool,
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專家顧問團的一員
08:52
and he told me not so long ago,
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不久前他曾告訴我
08:54
"Ellen, we rely in Kenya and in many other countries
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“Ellen 在肯尼亞以及許多其他的國家
09:00
on the Medicines Patent Pool to make sure
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我們全都依賴藥物專利聯盟
09:03
that new medicines also become available to us,
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確保我們能夠獲得新藥
09:09
that new medicines, without delay, become available to us."
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確保我們能夠及時地獲得新藥物”
09:14
And this is no longer fantasy.
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這已經不再是空想
09:17
Already, I'll give you an example.
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這已經是現實 我和大家分享一個實例
09:22
In August of this year, the United States drug agency
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今年8月 美國藥品局
09:25
approved a new four-in-one AIDS medication.
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批准了一個新的四合一愛滋病藥物
09:29
The company, Gilead, that holds the patents,
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擁有該藥物專利權的Gilead公司
09:32
has licensed the intellectual property to the Medicines Patent Pool.
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已經向藥物專利聯盟授權該專利的使用許可
09:36
The pool is already working today, two months later,
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今天 僅僅兩個月後 聯盟已經在和通用製藥商合作
09:40
with generic manufacturers to make sure that this product
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確保這個產品
09:43
can go to market at low cost
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可以最低的成本 在需要的時刻地點
09:46
where and when it is needed. This is unprecedented.
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投放市場 這是前所未有的
09:50
This has never been done before.
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以前從未發生過
09:52
The rule is about a 10-year delay for a new product
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在以前 一劑新藥面世後通常需要十年的時間
09:55
to go to market in developing countries, if at all.
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才能投放發展中國家市場
09:58
This has never been seen before.
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以前從未有過
10:02
Nelson's expectations are very high,
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Nelson有非常高的期望
10:06
and quite rightly so. He and his son will need access
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也是理所當然的 他和他的兒子這終其一生中都需要
10:10
to the next generation of antiretrovirals
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下一代以及再下一代更新的
10:13
and the next, throughout their lifetime,
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抗逆轉錄藥物
10:16
so that he and many others in Kenya and other countries
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這樣他和許許多多生活在肯尼亞和其他國家的人們
10:21
can continue to live healthy, active lives.
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才能夠健康積極地生活下去
10:26
Now we count on the willingness of drug companies
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現在 我們依賴的是藥物公司的自願自發
10:29
to make that happen. We count on those companies
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我們依賴的是這些藥物公司能夠明白
10:31
that understand that it is in the interest, not only in the interest
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由對立轉向協作
10:35
of the global good, but also in their own interest,
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這不僅僅是符合全球利益的
10:38
to move from conflict to collaboration,
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也是符合他們自身利益的
10:44
and through the Medicines Patent Pool they can make that happen.
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通過藥物專利聯盟 這一切都有可能實現
10:47
They can also choose not to do that,
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當然他們也可以選擇不合作
10:50
but those that go down that road may end up
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但是可能會落得
10:56
in a similar situation the Wright brothers ended up with
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上世紀初萊特兄弟一樣的下場
10:59
early last century, facing forcible measures
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政府將會採取強制措施
11:03
by government. So they'd better jump now.
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所以 最好還是現在就行動
11:08
Thank you. (Applause)
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謝謝（掌聲）
ABOUT THE SPEAKER
Ellen 't Hoen - Medicine law expertThe founder of the Medicines Patent Pool, Ellen 't Hoen works (and makes change) at the place where profit and health collide: patented drugs.
Why you should listen
Ellen ’t Hoen is an independent medicines law and policy consultant. In 2009, she founded the Medicines Patent Pool at WHO/UNITAID, to accelerate the availability of low-cost HIV treatments, especially antiretroviral medicines, in developing countries through patent licensing. In June 2012 she stepped down from the MPP, but remains involved in supporting it.
She is a research fellow at the IS HIV/AIDS Academy of the University of Amsterdam and authored the book The Global Politics of Pharmaceutical Monopoly Power. Drug patents, access, innovation and the application of the WTO Doha Declaration on TRIPS and Public Health. It's available as a free download .
Before founding MPP, from 1999 until 2009 she was the Director of Policy and Advocacy at Médecins sans Frontières’ (MSF) Campaign for Access to Essential Medicines. She won several awards for her work on the effects of exposure to the drug (DES) in the 1980s and 1990s, including the prestigious Harriet Freezerring award in 1989. She is a member of the World Health Organization’s Expert Advisory Panel on Drug Policies and Management and a member of the advisory board of Universities Allied for Essential Medicines (UAEM).
More about this speaker
Website: http://www.medicinespatentpool.org/
Twitter: @ellenthoen, @medspatentpool
Ellen 't Hoen | Speaker | TED.com