AIDS, Malaria and Tuberculosis account for 6 million deaths each year. Existing drugs could help treat these diseases but the high cost of these drugs means that the majority of people in developing countries cannot afford them. In terms of HIV/AIDS only 300,000 (5%) of the 6 million people infected in poor countries have access to life prolonging medication.
With Bill C-9, Canada became the first country with a large chemical industry to take advantage of new international rules. On August 30th, 2003 the World Trade Organization (WTO) began allowing the international sale of generic drugs. This directive allows industrialized countries such as Canada to create generic drugs here (which can be 10 to 20 times less expensive then current drugs) for sale in countries that don’t have a drug industry. Many health advocates believe that by allowing compulsory licensing, where companies pay a royalty to create and sell patented drugs, increased competition will lower prices and develop cheaper forms of production. It was hoped that with a strong bill Canada could set a precedent, shaming other industrial nations into opening their markets; further increasing supply, lowering costs and potentially saving hundred of thousands to millions of lives.
In the view of both national and international health groups Bill C-9 contains various fatal flaws that seriously undermine it’s purpose. Many see it as a reversal of the gains public health advocates won internationally with the August 30th, 2003 WTO decision. Srinivas Murthy studies medicine at McGill University and presented on the bill to Parliament. Murthy believes that the bill must be changed before adoption and a clear campaign to help deal with the developing worlds health problems must be formulated.
"As the bill is worded it will set a poor standard for (other nations) to follow. It sets back much of what was achieved internationally and actually hurts the sick and dying in the developing world."
The first major issue comes from the bill allowing brand-name patent holders to step in and take over contracts that generic companies negotiate. After investing into negotiations generic companies may be forced out by wealthy brand name companies seeking to kill competition. Unlike a bidding war that would lower prices this provision gives an unfair advantage to the patent holder. There will also be a two-year time limit on contracts, further undermining generic producers.
Secondly, the bill limits the drugs that will be made available. Rather then allowing for countries to treat all diseases they will be forced to go and entreat the Canadian government every time they need a different medication. The bill also limits more user-friendly AIDS medications that combine several drugs in one pill and prohibits the speeding up of bureaucratic processes in the case of a national medical emergency.
Thirdly, millions of people will be exempted from receiving access to affordable medicines. Only WTO members and a handful of other nations will be allowed to purchase generic drugs. Countries like Vietnam and East Timor, which are not part of the WTO, will be denied access.
Lastly, NGOs provide massive amounts of infrastructure in war torn or developing countries and they will not be able to purchase generic drugs. Only governments will be allowed to make orders. While fine in principle, in reality governments cannot always manage public health. In countries such as the Democratic Republic of Congo, groups like Medicin San Frontier or the Red Cross often assess and provide treatment for large areas of the country. Allowing only for governmental purchase means that many people who could receive treatment will be allowed to die.
Health advocates point out that none of these conditions are required under WTO rules. Several groups, including Medicin San Frontier and the Canadian HIV/AIDS Legal Network, have stated these conditions go against what Canada has committed it would do internationally.
Historically the Liberal government has catered to the desires of big pharmaceutical companies. They have limited the generic drug industry in Canada during their time in power and fought for strong patent protection internationally. Many of the presenters to the body overseeing the bill, the Standing Committee on Industry, Science and Technology, have noted a serious bias in favour of brand name drug companies. Several health advocates have picked out Paddy Torsney, the Liberal MP for Burlington Ontario, along with several other Liberal MPs as actively representing brand name pharmaceutical business interests.
Richard Elliot of the Canadian HIV/AIDS Legal Network who has been watching the proceedings has concerns over the possible direction of the committee process.
"Some MPs attending the Committee meetings seem to be more interested in protecting the interests of the multionational brand-name pharmaceutical companies than in honouring our stated commitments to poor countries getting cheaper medicines."
Paul Martin and many senior Liberals past and present have received sizable campaign contributions from major brand name drug companies. Major brand name pharmaceutical companies donated tens of thousands of dollars to Paul Martin’s recent leadership campaign. Rx&D, the main Canadian research-based pharmaceutical lobbying group, contributed $21,000. Until late last year the former Ontario Liberal Minister of Health, Murray J. Elston, headed Rx&D.
Bill C-9 returns to the Standing Committee on Industry, Science and Technology for further review and amending in the middle of April. Depending on the timing of the up coming election it will then be brought in front of Parliament for final reading sometime this spring or early summer.
