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TEDxZurich 2012

Ellen 't Hoen: Pool medical patents, save lives

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Views 392,041

Patenting a new drug helps finance its immense cost to develop -- but that same patent can put advanced treatments out of reach for sick people in developing nations, at deadly cost. Ellen 't Hoen talks about an elegant, working solution to the problem: the Medicines Patent Pool.

- 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

In 2002, a group of treatment activists met
00:17
to discuss the early development of the airplane.
00:21
The Wright Brothers, in the beginning of the last century,
00:25
had for the first time managed
00:30
to make one of those devices fly.
00:32
They also had taken out numerous patents
00:34
on essential parts of the airplane.
00:37
They were not the only ones.
00:39
That was common practice in the industry,
00:41
and those who held patents on airplanes
00:44
were defending them fiercely
00:47
and suing competitors left and right.
00:48
This actually wasn't so great for the development of the aviation industry,
00:51
and this was at a time that in particular the U.S. government
00:56
was interested in ramping up
01:00
the production of military airplanes.
01:02
So there was a bit of a conflict there.
01:05
The U.S. government decided to take action,
01:07
and forced those patent holders
01:11
to make their patents available to share with others
01:13
to enable the production of airplanes.
01:17
So what has this
01:23
got to do with this?
01:26
In 2002, Nelson Otwoma, a Kenyan social scientist,
01:30
discovered he had HIV and needed access to treatment.
01:35
He was told that a cure did not exist.
01:40
AIDS, he heard, was lethal,
01:44
and treatment was not offered. This was at a time
01:47
that treatment actually existed in rich countries.
01:51
AIDS had become a chronic disease.
01:53
People in our countries here in Europe, in North America,
01:56
were living with HIV, healthy lives.
02:00
Not so for Nelson. He wasn't rich enough,
02:03
and not so for his three-year-old son, who he discovered a year later
02:06
also had HIV.
02:10
Nelson decided to become a treatment activist
02:13
and join up with other groups.
02:16
In 2002, they were facing a different battle.
02:18
Prices for ARVs, the drugs needed to treat HIV,
02:25
cost about 12,000 [dollars] per patient per year.
02:30
The patents on those drugs were held
02:34
by a number of Western pharmaceutical companies
02:36
that were not necessarily willing
02:42
to make those patents available.
02:45
When you have a patent, you can exclude
02:48
anyone else from making, from producing or making
02:51
low-cost versions, for example,
02:55
available of those medications.
02:58
Clearly this led to patent wars breaking out
03:02
all over the globe.
03:06
Luckily, those patents did not exist everywhere.
03:09
There were countries that did not recognize
03:13
pharmaceutical product patents, such as India,
03:15
and Indian pharmaceutical companies
03:18
started to produce so-called generic versions,
03:21
low-cost copies of antiretroviral medicines,
03:25
and make them available in the developing world,
03:29
and within a year the price had come down
03:32
from 10,000 dollars per patient per year
03:35
to 350 dollars per patient per year,
03:39
and today that same triple pill cocktail
03:41
is available for 60 dollars per patient per year,
03:45
and of course that started to have an enormous effect
03:48
on the number of people who could afford access
03:51
to those medicines.
03:54
Treatment programs became possible,
03:56
funding became available, and the number of people
03:58
on antiretroviral drugs started to increase very rapidly.
04:01
Today, eight million people
04:08
have access to antiretroviral drugs.
04:11
Thirty-four million are infected with HIV.
04:14
Never has this number been so high,
04:18
but actually this is good news,
04:20
because what it means is people stop dying.
04:21
People who have access to these drugs stop dying.
04:24
And there's something else.
04:26
They also stop passing on the virus.
04:27
This is fairly recent science that has shown that.
04:30
What that means is we have the tools
04:34
to break the back of this epidemic.
04:36
So what's the problem?
04:40
Well, things have changed.
04:45
First of all, the rules have changed.
04:47
Today, all countries are obliged to provide
04:51
patents for pharmaceuticals that last at least 20 years.
04:57
This is as a result of the intellectual property rules
05:02
of the World Trade Organization.
05:05
So what India did is no longer possible.
05:07
Second, the practice of patent-holding companies have changed.
05:10
Here you see the patent practices
05:15
before the World Trade Organization's rules, before '95,
05:20
before antiretroviral drugs.
05:24
This is what you see today,
05:26
and this is in developing countries, so what that means is,
05:29
unless we do something deliberate
05:32
and unless we do something now,
05:34
we will very soon be faced with another drug price crisis,
05:36
because new drugs are developed,
05:42
new drugs go to market, but these medicines are patented
05:44
in a much wider range of countries.
05:47
So unless we act, unless we do something today,
05:50
we will soon be faced [with] what some have termed
05:55
the treatment time bomb.
05:59
It isn't only the number of drugs that are patented.
06:02
There's something else that can really scare
06:07
generic manufacturers away.
06:10
This shows you a patent landscape.
06:11
This is the landscape of one medicine.
06:15
So you can imagine that if you are a generic company
06:19
about to decide whether to invest
06:22
in the development of this product, unless you know
06:24
that the licenses to these patents
06:27
are actually going to be available,
06:29
you will probably choose to do something else.
06:32
Again, deliberate action is needed.
06:35
So surely
06:39
if a patent pool could be established
06:41
to ramp up the production of military airplanes,
06:45
we should be able to do something similar
06:49
to tackle the HIV/AIDS epidemic.
06:53
And we did.
06:56
In 2010, UNITAID established the Medicines Patent Pool
06:58
for HIV.
07:04
And this is how it works:
07:07
Patent holders, inventors
07:09
that develop new medicines
07:13
patent those inventions,
07:16
but make those patents available
07:19
to the Medicines Patent Pool. The Medicines Patent Pool
07:21
then license those out to whoever needs access to those patents.
07:24
That can be generic manufacturers.
07:28
It can also be not-for-profit drug development agencies,
07:29
for example.
07:33
Those manufacturers can then sell those medicines
07:35
at much lower cost to people who need access to them,
07:37
to treatment programs that need access to them.
07:42
They pay royalties over the sales to the patent holders,
07:45
so they are remunerated for sharing their intellectual property.
07:49
There is one key difference
07:59
with the airplane patent pool.
08:03
The Medicines Patent Pool is a voluntary mechanism.
08:07
The airplane patent holders were not left a choice
08:12
whether they'd license their patents or not.
08:15
They were forced to do so.
08:17
That is something that the Medicines Patent Pool cannot do.
08:19
It relies on the willingness of pharmaceutical companies
08:23
to license their patents and make them available
08:26
for others to use.
08:30
Today, Nelson Otwoma is healthy.
08:34
He has access to antiretroviral drugs.
08:39
His son will soon be 14 years old.
08:43
Nelson is a member of the expert advisory group
08:47
of the Medicines Patent Pool,
08:50
and he told me not so long ago,
08:52
"Ellen, we rely in Kenya and in many other countries
08:54
on the Medicines Patent Pool to make sure
09:00
that new medicines also become available to us,
09:03
that new medicines, without delay, become available to us."
09:09
And this is no longer fantasy.
09:14
Already, I'll give you an example.
09:17
In August of this year, the United States drug agency
09:22
approved a new four-in-one AIDS medication.
09:25
The company, Gilead, that holds the patents,
09:29
has licensed the intellectual property to the Medicines Patent Pool.
09:32
The pool is already working today, two months later,
09:36
with generic manufacturers to make sure that this product
09:40
can go to market at low cost
09:43
where and when it is needed. This is unprecedented.
09:46
This has never been done before.
09:50
The rule is about a 10-year delay for a new product
09:52
to go to market in developing countries, if at all.
09:55
This has never been seen before.
09:58
Nelson's expectations are very high,
10:02
and quite rightly so. He and his son will need access
10:06
to the next generation of antiretrovirals
10:10
and the next, throughout their lifetime,
10:13
so that he and many others in Kenya and other countries
10:16
can continue to live healthy, active lives.
10:21
Now we count on the willingness of drug companies
10:26
to make that happen. We count on those companies
10:29
that understand that it is in the interest, not only in the interest
10:31
of the global good, but also in their own interest,
10:35
to move from conflict to collaboration,
10:38
and through the Medicines Patent Pool they can make that happen.
10:44
They can also choose not to do that,
10:47
but those that go down that road may end up
10:50
in a similar situation the Wright brothers ended up with
10:56
early last century, facing forcible measures
10:59
by government. So they'd better jump now.
11:03
Thank you. (Applause)
11:08
Translated by Joseph Geni
Reviewed by Morton Bast

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About the speaker:

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.

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

More profile about the speaker
Ellen 't Hoen | Speaker | TED.com