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Let Them Eat Protease Inhibitors

Activists campaigning to get AIDS treatments and other critical medicines to poor people around the world propose radical changes in the financing of global pharmaceutical research and development. The activists suggest that the World Trade Organization (WTO) discard global intellectual property protections and replace them with incentive programs for scientists. The companies that research, design, and produce the drugs would no longer support large sales teams to persuade physicians to prescri

Susan Warner

Activists campaigning to get AIDS treatments and other critical medicines to poor people around the world propose radical changes in the financing of global pharmaceutical research and development. The activists suggest that the World Trade Organization (WTO) discard global intellectual property protections and replace them with incentive programs for scientists. The companies that research, design, and produce the drugs would no longer support large sales teams to persuade physicians to prescribe them.

New research would be financed through tax levies or other financing, which, proponents say, would bring greater efficiency and fairness to the research process. Opponents charge that such ideas represent a throwback to an era of slow-paced, government-orchestrated science.

ON A WORLD STAGE

Led by the nonprofit Consumer Project on Technology (CPTech) based in Washington, DC, the advocates want WTO members to reconsider its policy towards patents and poor countries. With WTO provisions set to take effect in...

INCENTIVE FOR INNOVATION

Innovators also could be paid through direct funding from governments or existing institutions such as the National Institutes of Health or nonprofit organizations. Another idea suggests the use of open-source public goods models, such as the Human Genome Project or the Linux software system, according to Love and Hubbard.

Still another way to structure the payout would be through the use of what Love and Hubbard call competitive "intermediators." These mechanisms would be similar to pension funds, except that intermediators would manage research and development assets. Consumers or employers could be required to make minimum contributions into the funds, and the intermediators would compete to attract the most funds and make successful investments, the way that mutual funds handle a 401(k) plan.

<p>James Love</p>

Courtesy of James Love

The pharmaceutical industry remains unconvinced. Mark Grayson, a spokesman for the Pharmaceutical Research and Manufacturers of America (PhRMA), says the proposals could set medical research back nearly 25 years to a time before the Bayh-Dole Act created intellectual property incentives for universities to commercialize government-financed research. Since then, he says, the entire biotech industry has grown up on the promise that investors would be rewarded for successful drug development.

"Government has not been very good at commercializing research," Grayson says. "Look at our arch-enemy, Russia, where there was a central planning authority. They had great science but not many new medicines."

The US government also remains skeptical of public interventions into what is now a private market. In a letter to the World Health Organization last fall, William Steiger, director of the Office of Global Health Affairs at the US Department of Health and Human Services, opposed a shift in trade policy that would focus on nonproprietary models that remove intellectual property protections.

Oxfam's Bailey points out that governments already fund a great deal of research through the National Institutes of Health in the United States and through research tax credits. Public universities also finance a significant level of research. In the United Kingdom, most academic research is still publicly funded. "The big pharmaceutical companies like to gloss over how much public funding there already is," he says. "The public sector already has a very active role in research."

In the end, Bailey predicts, frustration with the current system of research and development, even among drug companies, may give the new ideas traction. "The current system is extraordinarily inefficient," he adds. "There's a lot of duplication of research and when you boil it down, remarkably little innovation."

Susan Warner swarner@comcast.com is a freelance writer in Philadelphia.

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