The BPR High School Program invites student writers to research, draft, and edit a college-level opinion article over the course of a semester. Josiah Chu is a high school senior with dual enrollment at Wisconsin Lutheran College.
In 1997, Anchalee Avihingsanon, a young mother in Thailand, battled Human Immunodeficiency Virus (HIV). She was plagued with headaches, fevers, and nausea. Fortunately, she was able to access medication as a hospital employee. However, hundreds of other patients under her care were deprived of life-saving antiretrovirals—the class of drugs used to treat HIV—because they were unaffordable. But this is not an isolated incident.
Across the globe, millions live with HIV, the vast majority of cases propagating in developing countries. Many cannot access antiretrovirals because of patents: laws that protect intellectual property and can make medication unaffordable. Though portraying itself as the defender of global health, the United States actively pressures developing countries to uphold antiretroviral patents, and the WTO’s inaction facilitates this cyclical valuation of profits over human life.
A patent grants the inventor of a product the exclusive right to sell it for a specified period of time—often twenty years. When a pharmaceutical company develops a new drug, they have the exclusive right of production until the patent expires. With little competition, companies can set high prices. As a result, many life-saving drugs are priced far beyond what people can afford, especially in developing countries. These nations have lower per capita incomes, making even “normal” drug prices unaffordable. For example, in Guatemala, a developing country, the average per capita annual income is equivalent to 5480 USD. Thus, high prices hurt developing countries the most.
According to the International Research Group, antiretrovirals in countries with “competitive drug markets” cost, on average, 20 percent of per capita income, compared to over 90 percent in countries with patented drug markets. A Harvard study found that competition pricing would increase antiretroviral use in low and middle-income countries by 30 percent. Simply put, when one company controls the supply of drugs, millions go without them. Despite these predictable harms, the United States continues to defend these monopolies.
Some supporters of drug patents argue that because patents encourage investment in pharmaceutical research by guaranteeing substantial market power, and thus higher profits, eliminating drug patents will disincentivize pharmaceutical innovation. This is true on a global scale, but not for developing countries in particular.
Developing countries constitute one percent of global drug sales; thus, losing them as customers would not significantly affect companies’ profit margins. In fact, a University of California, Berkeley study found no measurable link between patent protections and innovation in developing countries. Thus, the industry’s position amounts to this: people should pay with their lives just so companies keep a fraction of their sales.
This leaves one important question unanswered: if removing patents in developing countries is so beneficial, then why haven’t countries adopted this approach? While some developing countries have expressed interest in opening their pharmaceutical industries in the past, they have been forced to uphold restrictive patent laws under political pressure.
Until 2000, Guatemala did not issue pharmaceutical patents. But the United States’ ambassador, motivated by big pharma lobbyists, threatened to punish Guatemala through trade unless it implemented a patent system. Backed into a corner, Guatemala was forced to comply. But the United States’ influence extends far beyond Guatemala. Though the United States markets itself as “the world’s global health leader,” these policies show a contradicting story.
There are two feasible solutions to this issue. First, the United States should soften its tone towards developing countries; rather than using its seismic economic and political influence to pressure developing countries into maintaining uncompetitive patent laws, it should respect the principle of self-determination and allow countries to make these economic decisions for themselves.
Second, the World Trade Organization (WTO)—the international body governing patents—should protect developing countries that choose to support competitive drug markets. Although the WTO Agreement on Trade-Related Aspects of Intellectual Property Rights allows developing countries to use compulsory licensing—a mechanism that allows for generic competition without the consent of the patent holder—many still refrain from adopting this practice because doing so risks trade retaliation. As noted by the British Medical Journal, the WTO should strengthen its non-challenge provisions to protect developing nations from retaliation when they use compulsory licensing, ensuring that countries can reduce drug prices without fear of economic reprisals. Until then, the WTO’s silence bolsters a system that values profit over human life.
Despite political and economic pressure, some developing countries have been able to move away from drug patents. Looking back at Anchalee’s story, many of her patients would have likely died without affordable medication. In 2008, Thailand, Anchalee’s home country, passed this exact policy, waiving patents and decreasing the price of drugs by 30 times. As a whole, antiretroviral use in Thailand increased fourfold.
Thailand is not alone. Since 2001, 24 other countries have stopped issuing pharmaceutical patents. Veronica Wirtz, a professor at Boston University’s School of Public Health, along with eight other scholars, concluded that access to life-saving medication has substantially increased in these countries. The past has proven one fact to be true: removing patents has given hope to thousands. And the same can be true around the globe.