Environmental Engineering Reference
In-Depth Information
attainable standard of health', which includes the right to the availability of essential
medicines as defined by the World Health Organization (WHO) (United Nations
economic and Social council committee on economic, Social, and cultural rights
to health, governments have implicit duties to ensure that pharmaceutical systems
are institutionally sound and fair and that patients who need drugs get them. this is
a relatively novel view and suggests that blind faith in the primacy of commercial
interests is being challenged by alternative paradigms that put social issues squarely
on the top of any agenda.
to be sure, pharmaceutical research and development (r&D) have value and
promise. In the past 50 years, there has been large-scale production of drugs that
save or enhance life. Important advances have been made in diseases such as heart
disease, diabetes, and cancer as well as HIv/aIDS and cystic fibrosis. But there
has been also an undeniable slow-down in pharmaceutical r&D. as Marcia angell
(2004, 14) writes, 'the stream of new drugs has slowed to a trickle, and few of them
are innovative in any sense of the word. Instead, the great majority are variations of
oldies but goodies—“me-too” drugs'.
the structure of the industry has also changed in recent decades with the mega-
mergers of companies. commercially friendly policy such as tax concessions and
the rigorous application of intellectual property law have become even more critical
for the robustness of an industry accustomed to a high rate of return on its capital
investment. while supporting industry is desirable for governments from an economic
perspective, for the simple reason that governments want to attract investment, a
dilemma arises from pharmaceutical policy, because supportive commercial policy
may undermine health outcomes of the international standards for pharmaceutical
patents. the construction of the international regime—the World Trade Organization
(wto) in 1995 and the trade-related aspects of Intellectual Property rights
(trIPS) agreement are cases of the primacy of the economic model in international
institutions. but this chapter shows that the hegemony of commercial interests is
increasingly being challenged by alternative paradigms that put social issues such as
the right to medicines first.
the value of having global governance in place when it affects national
health outcomes needs to be re-examined, particularly when those international
institutions are guided by principles of economics. John ralston Saul points out
that globalisation is flawed in that it is imagined through the lens of economics. He
writes that 'the central perception of Globalization is that civilization should be seen
through economics, and economics alone' (Saul 2005, 35). Globalisation has meant
the lessening of competition through monopolies such as those permitted under the
trIPS agreement. It is not necessarily a positive phenomenon for those who stand to
lose considerably. the primacy accorded to economic models needs to be rethought,
particularly when faced with potentially devastating effects on social policy as a
result of their application. this is the case in the pharmaceutical sector, particularly
in relation to the application of the trIPS agreement. this chapter illustrates how
concerns about health are slowly infiltrating economic paradigms.
