All eyes on India’s drug patent case

This week, India’s highest court will hear final arguments in a landmark case that could severely limit access to affordable medicine. The Swiss pharmaceutical company, Novartis, took the government of India to court after it denied the company a patent for a modified version of an existing cancer drug. This process, known as evergreening, is clever way to extend a drug’s patent life by tweaking it before its patent expires. You would think these minor tweaks would result in a superior drug capable of curing all ills or, at the very least, improve the existing formulation. But, in all too many cases, evergreening doesn’t result in enhanced benefits, though it certainly deepens Big Pharma’s pockets. And of course we all know they’re cash strapped. Stephanie Nolen of the Globe and Mail reports here.

They Go to Die: A TB/HIV and Human Rights Film

“If we turn an epi­demic into an emo­tion, we moti­vate change.” - Jonathan Smith

In his film, Jonathan Smith – an epidemiologist and Director of the Visual Ethnography Project at Yale University – aims to put humanity back into research. He’s invited into the homes of four mine workers living with HIV/TB co-infection and, in the broader context of human life, he takes viewers beyond cold epidemiological data and into the lives of the men. They are not unlike many others seeking work in the South African mining industry. But not all work is created equal: poorly ventilated mines are perfect terrain for TB transmission, and mines, combined with HIV, are currently the two largest driving factors of the TB epidemic in South Africa.

The message is simple: mine workers become sick and they go home to die because they’re not provided with the essential health care or medicine required to keep them alive. But death is not inevitable: HIV/TB co-infection is largely preventable and treatable – so long as there’s the will to do it.

Jonathan is on a mission to do just that: he’s seeking to raise enough funds to complete post-production of the film with the hope that viewers, like you, will create the pressure and impetus necessary to improve the working conditions in mines and impact the lives of hundreds of thousands of workers looking to make an honest living.

Interested in meeting Jonathan in person? Join him in Vancouver at UBC for a viewing of the film!

Date: 4:00PM, Friday, October 21st
Location:  Norm Theatre, Student Union Building, UBC, 6138 Student Union Blvd.
Admission: Free

A portrait of HIV/AIDS in sub-Saharan Africa

I came across this photo-essay in the Walrus archives. It’s easy to get lost in the enormity of the pandemic but I think these photos help humanize the data.

Another impressive declaration but will it help increase access?

On June 27th, over 30 international parliamentarians attended the Global Fund
Partnership Forum
in São Paulo, Brazil. At the conclusion of the Forum, attendees adopted a statement titled, São Paulo Parliamentary Declaration On Access To Medicines And Other Pharmaceutical Products. It aims to achieve many things, including a commitment to: 

Oppose, and refrain from pursuing or adopting, provisions in bilateral and regional trade and investment agreements, that would undermine access to medicines and other pharmaceutical products, including provisions that would further limit the use of policy options such as compulsory licensing and parallel importing; data exclusivity restrictions; linkage between patent status and registration of generics; patent term extension; and enforcement measures and investment provisions that include intellectual property rights.

While stated commitments serve to send a clear political message, how well do they translate into action?

The most significant public health amendment to the TRIPs Agreement–known as the Doha Declaration–has yet to result in equitable access. Although 60 countries have utilized TRIPs flexibilities in order to gain access to lower cost drugs, the global intellectual property (IP) system continues to flex its muscle and effectively block affordable access. While there have been tremendous gains in the global scale up of essential medicine, particularly for HIV drugs, equitable access still remains precarious at best. There are many reasons for this, one of which is the movement toward greater IP protection, known as “TRIPS plus”, which essentially looks like the TRIPs agreement on steroids.

While the São Paulo Declaration gives me hope that smart people with political leverage are going to bat for a great cause, I wonder how much impact it will have on access. Is this (and other stated declarations) a necessary first step toward equitable access, or better yet, global IP reform? Or will it become just another optimistic statement that will crumble in the face of stringent IP rules that have systematically failed to meet the health needs of the global poor?

I tip my hat to the parliamentarians who helped draft this document. My only hope is that it translates into tangible health improvements for people who require medicine but can’t afford it.


Dear Government: please update the CAMR website

Much has occurred since 2004, the year Canada’s ambitious humanitarian law known as Canada’s Access to Medicines Regime (CAMR) came into force. In 2008-2009, one order of an HIV-drug left Canada for Rwanda, which highlighted the need to simplify the law and make it more user-friendly. (This order marked the one and only time the law was used.) Later, two reform bills (S-232 and C-393) entered Parliament in an attempt to amend the unworkable law. They both died in the Senate however: S-232 following prorogation in 2009 and C-393 after it was effectively stalled by Conservative Senators and left to die on the order paper when Parliament dissolved in 2011. CAMR raised many eyebrows and a handful of stories emerged online and in Canadian newspapers. Heck, even celebrities such as K’naan started talking about CAMR. But according to the Government of Canada website dedicated to CAMR, nothing new has occurred since March 13th, 2008. I’m not suggesting the government give a shout out to K’naan but it wouldn’t hurt to update the “what’s new” section. Just sayin’.

Wonder Drug Inspires Deep, Unwavering Love Of Pharmaceutical Companies

Just kidding. That’s the title of a satire I found buried in the Onion archives. Pretty darn funny.

HIV positive babies?

Sounds like an oxymoron, right? Well, sadly, it’s not. HIV transmission from mom to baby (affectionately referred to as Prevention of Mother-to-Child Transmission of HIV) has almost been eliminated in wealthy countries due to effective prevention strategies but the same can’t be said for many poor regions. While the reasons for this are complex, one factor remains: there is very little market incentive for pharmaceutical companies to develop paediatric HIV drugs that are appropriate and safe.

Thankfully, the Drugs for Neglected Diseases initiative (DNDi)a not-for-profit organization that uses an alternative model to develop medicine for neglected diseases–is doing something about it. On July 18th at the 6th International AIDS Society (IAS) Conference on HIV Pathogenesis, Treatment and Prevention, DNDannounced the launch of a new program that aims to address this unmet need. More details can be found here. According to Dr. Bernard Pécoul, the Executive Director of  DNDi:

There are millions of children with HIV/AIDS in low- and middle-income countries, but their needs are absent from the HIV research and development agenda, and this is largely because they are poor and voiceless and do not represent a lucrative marketWorking with partners, we hope to help fill this terrible gap and offer improved treatment options for children with HIV/AIDS.

I can imagine a world where more people are able to live a healthy and fruitful life. Ideally, this begins with a healthy childhood. Props to DNDi for refusing to accept such a grim global reality.