Oxfam Points Finger

Aid charity Oxfam has issued a damning report claiming that the pharmaceutical industry is denying medicines to millions of poor people. It also says that pharma's unwillingness to change the way it does business in developing countries undermines the industry's own future.

The report, Investing for Life: Meeting Poor People's Needs for Access to Medicines Through Responsible Business Practices, casts a critical eye on the world's 12 largest pharma companies, plus Gilead, which has a portfolio of anti-HIV medicines. The companies were interviewed in late 2006 and early 2007, and the report looks at how they set drug prices, their strategies for protecting their intellectual property, and their track records in inventing medicines aimed at treating diseases that predominantly affect developing countries.

It doesn't make pretty reading for pharma. It claims failure to implement tiered pricing mechanisms in a transparent and systematic way denies medicines to poor people in developing countries. The focus on donations is, it says, too strong. And it doesn't think enough research is being done for diseases that largely affect the developing world.

Sarah Houlton

Perhaps most important, however, is Oxfam's claim that industry's insistence on upholding its patents plays a huge role in preventing access to essential medicines—the United Nations estimates the number of people affected at almost 2 billion. The World Health Organization (WHO) has asserted that generic competition is key to improving access, and Oxfam says that the IP protection regime established under the TRIPS (Trade-Related Aspects of Intellectual Property Rights) agreement presents "major obstacles" for access to affordable new drugs as it gives pharma companies monopolies that keep prices high.

This fails to take into account the fact that if there were no way of recouping the huge cost of discovering a drug, pharma R&D would dry up and there would be no new medicines at all. Drug discovery is an expensive business, and it's not something that academia and charity foundations have the ability or resources to succeed at themselves unless they get lucky. They need Big Pharma's skills and resources.

What the Oxfam report skirts over and then largely ignores is the number of projects drug companies are involved with on a joint public–private basis. These combine industry's skills, particularly at medicinal chemistry, with the resources of charities, academia, and NGOs, to develop drugs for diseases that disproportionately affect the developing world. Novartis, for example, has set up an entire research center in Singapore, with the help of funding agencies such as the Wellcome Trust and the local government. It is focusing on drugs to treat dengue, tuberculosis, and malaria, three major unmet medical needs in the developing world. Similarly, GlaxoSmithKline has a dedicated site at Tres Cantos in Spain, where it's looking for malaria drugs. And Pfizer has provided WHO with access to its library of antiparasitic lead compounds. The large compound collections built up over many years of research represent one of Big Pharma's greatest assets in determining starting points for drug discovery projects. These are just three examples.

Industry has hit back at the report, with the Association of the British Pharmaceutical Industry (ABPI) describing it as "disappointing" that the agency continues to focus on claims that industry isn't doing enough to improve access to medicines, despite evidence of a "vast and growing investment by companies in sustainable partnerships and initiatives."

ABPI is particularly annoyed about the continued focus on industry's defense of intellectual property. The organization says that in many countries it doesn't matter how cheap medicines are, patients still can't afford to buy them. India is a good example: It may have the world's cheapest prices for essential medicines, but two-thirds of Indians still go without.

ABPI's director general, Richard Barker, believes Oxfam should stop criticizing the industry and look to work with it instead. "We acknowledge our responsibility to cooperate with governments, philanthropists, world bodies, and major nongovernmental organizations, such as Oxfam, to try to improve the health of those living in developing nations," he said. "Access to the right treatment is vital for many of the world's poor, but this should be combined with addressing the causes of poverty."

Sarah Houlton is Pharmaceutical Executive's global correspondent. She can be reached at sarah@owlmedia.co.uk