Ellen ‘t Hoen: Pool medical patents, save lives


Translator: Joseph Geni
Reviewer: Morton Bast In 2002, a group of treatment activists met to discuss the early development of the airplane. The Wright Brothers, in the beginning of the last century, had for the first time managed to make one of those devices fly. They also had taken out numerous patents on essential parts of the airplane. They were not the only ones. That was common practice in the industry, and those who held patents on airplanes were defending them fiercely and suing competitors left and right. This actually wasn’t so great for the development of the aviation industry, and this was at a time that in particular the U.S. government was interested in ramping up the production of military airplanes. So there was a bit of a conflict there. The U.S. government decided to take action, and forced those patent holders to make their patents available to share with others to enable the production of airplanes. So what has this got to do with this? In 2002, Nelson Otwoma, a Kenyan social scientist, discovered he had HIV and needed access to treatment. He was told that a cure did not exist. AIDS, he heard, was lethal, and treatment was not offered. This was at a time that treatment actually existed in rich countries. AIDS had become a chronic disease. People in our countries here in Europe, in North America, were living with HIV, healthy lives. Not so for Nelson. He wasn’t rich enough, and not so for his three-year-old son, who he discovered a year later also had HIV. Nelson decided to become a treatment activist and join up with other groups. In 2002, they were facing a different battle. Prices for ARVs, the drugs needed to treat HIV, cost about 12,000 [dollars] per patient per year. The patents on those drugs were held by a number of Western pharmaceutical companies that were not necessarily willing to make those patents available. When you have a patent, you can exclude anyone else from making, from producing or making low-cost versions, for example, available of those medications. Clearly this led to patent wars breaking out all over the globe. Luckily, those patents did not exist everywhere. There were countries that did not recognize pharmaceutical product patents, such as India, and Indian pharmaceutical companies started to produce so-called generic versions, low-cost copies of antiretroviral medicines, and make them available in the developing world, and within a year the price had come down from 10,000 dollars per patient per year to 350 dollars per patient per year, and today that same triple pill cocktail is available for 60 dollars per patient per year, and of course that started to have an enormous effect on the number of people who could afford access to those medicines. Treatment programs became possible, funding became available, and the number of people on antiretroviral drugs started to increase very rapidly. Today, eight million people have access to antiretroviral drugs. Thirty-four million are infected with HIV. Never has this number been so high, but actually this is good news, because what it means is people stop dying. People who have access to these drugs stop dying. And there’s something else. They also stop passing on the virus. This is fairly recent science that has shown that. What that means is we have the tools to break the back of this epidemic. So what’s the problem? Well, things have changed. First of all, the rules have changed. Today, all countries are obliged to provide patents for pharmaceuticals that last at least 20 years. This is as a result of the intellectual property rules of the World Trade Organization. So what India did is no longer possible. Second, the practice of patent-holding companies have changed. Here you see the patent practices before the World Trade Organization’s rules, before ’95, before antiretroviral drugs. This is what you see today, and this is in developing countries, so what that means is, unless we do something deliberate and unless we do something now, we will very soon be faced with another drug price crisis, because new drugs are developed, new drugs go to market, but these medicines are patented in a much wider range of countries. So unless we act, unless we do something today, we will soon be faced [with] what some have termed the treatment time bomb. It isn’t only the number of drugs that are patented. There’s something else that can really scare generic manufacturers away. This shows you a patent landscape. This is the landscape of one medicine. So you can imagine that if you are a generic company about to decide whether to invest in the development of this product, unless you know that the licenses to these patents are actually going to be available, you will probably choose to do something else. Again, deliberate action is needed. So surely if a patent pool could be established to ramp up the production of military airplanes, we should be able to do something similar to tackle the HIV/AIDS epidemic. And we did. In 2010, UNITAID established the Medicines Patent Pool for HIV. And this is how it works: Patent holders, inventors that develop new medicines patent those inventions, but make those patents available to the Medicines Patent Pool. The Medicines Patent Pool then license those out to whoever needs access to those patents. That can be generic manufacturers. It can also be not-for-profit drug development agencies, for example. Those manufacturers can then sell those medicines at much lower cost to people who need access to them, to treatment programs that need access to them. They pay royalties over the sales to the patent holders, so they are remunerated for sharing their intellectual property. There is one key difference with the airplane patent pool. The Medicines Patent Pool is a voluntary mechanism. The airplane patent holders were not left a choice whether they’d license their patents or not. They were forced to do so. That is something that the Medicines Patent Pool cannot do. It relies on the willingness of pharmaceutical companies to license their patents and make them available for others to use. Today, Nelson Otwoma is healthy. He has access to antiretroviral drugs. His son will soon be 14 years old. Nelson is a member of the expert advisory group of the Medicines Patent Pool, and he told me not so long ago, “Ellen, we rely in Kenya and in many other countries on the Medicines Patent Pool to make sure that new medicines also become available to us, that new medicines, without delay, become available to us.” And this is no longer fantasy. Already, I’ll give you an example. In August of this year, the United States drug agency approved a new four-in-one AIDS medication. The company, Gilead, that holds the patents, has licensed the intellectual property to the Medicines Patent Pool. The pool is already working today, two months later, with generic manufacturers to make sure that this product can go to market at low cost where and when it is needed. This is unprecedented. This has never been done before. The rule is about a 10-year delay for a new product to go to market in developing countries, if at all. This has never been seen before. Nelson’s expectations are very high, and quite rightly so. He and his son will need access to the next generation of antiretrovirals and the next, throughout their lifetime, so that he and many others in Kenya and other countries can continue to live healthy, active lives. Now we count on the willingness of drug companies to make that happen. We count on those companies that understand that it is in the interest, not only in the interest of the global good, but also in their own interest, to move from conflict to collaboration, and through the Medicines Patent Pool they can make that happen. They can also choose not to do that, but those that go down that road may end up in a similar situation the Wright brothers ended up with early last century, facing forcible measures by government. So they’d better jump now. Thank you. (Applause)

87 thoughts on “Ellen ‘t Hoen: Pool medical patents, save lives

  1. Pooling medical patents..Collaboration instead of conflict..
    the idea seems to be working.. probably because it remains beneficial to the pharmaceutical companies (who sound reeeally evil)
    Anyway.. In my opinion.. knowledge should be free.. access to techniques should be available.. such a policy in every & all fields can mark a new leap in mankind revolution.

  2. Medicine is so expensive to develop because of government granted monopolies. Maybe removing the government sponsored monopolies would be an easier and more friendly method?

  3. maybe they should stop making these virusses in the first place. it's done deliberate. Power and money. welcome to the real earth.

  4. If I were a med. scientist, I would like to be able to afford a house, a car, holiday and so on, so I have to bring in money. Should my team and I need three years to develop a new medicine, this med needs to pay the salerys, equipment, lab, support staff, etc. for those three years. If this pool can generate the money to pay for all those costs it would be great. Good incentive for studing years, raking up dept in the process and even giving something back to humanity in the end.

  5. This initiative is a good idea for now, but…

    Countries that support patents on medical discoveries should be held liable (and brought to justice) for the crime against humanity they are thereby helping to commit.

    Whoever decided that medicines are inventions was delusional, as they still are merely discoveries of the effects of chemical compounds i.e. forces of nature: which are supposed to not be patentable.

  6. I do like the idea as well, but I would like to know the following: How should the scientist live the years it takes to develop the new drug? Take invention A. The scientist needed to invest 25.000$ in material, clothing, rent, food for a year to invent it. He starts out with -25.000$. His competitors start with +/-0$. He has a choice: Higher price then the others to pay back his dept (no profits here yet), or same price and increasing the dept through interst payment… what would you do?

  7. I personaly would like to see the scientist receives the money he worked for (say the 25.000$) and THEN it must become public domain, so that others can and WILL improve upon it and use it in their own works.
    But most new inventions need time and investment and these should be seen to as well instead of making everything free and forcing those that should think about new cures for cancer and aids to work at drungstore parttime to get by. Goverment founded stuff -> Public imediatly (tax paid it)

  8. Well as far as I know.. pharmaceutical companies do not pay much for scientists. but here generic companies are paying royalties over their sales to the inventors, instead of going to capitalist shareholders.
    Everything in labs or medical field is expensive because of such patent policies & greedy people..
    Research is expensive, sure.. but where is the revenue? I don't see rich scientists
    and by the way, why is it expensive? cause every damn piece is expensive for the same reason
    corrupt system

  9. I'm not sure that sharing patents in this way is a good idea. Although it makes the medicine go out to developing countries faster, investors will be less interested in giving money to research companies that cannot make a profit. Where will researchers get the money to make new medicine?

  10. The short run benefit may seem like its worth it to pool patents, but the long run cost is that drug companies will not have incentive to spend R&D to develop new drugs. If this were to happen, drugs such as cancer will take dramatically longer to cure.

  11. Patents are (at least officially) not put in place to foster companies, but encourage innovation. Although companies (especially the large ones) might not invest without a patent protection scheme, that does not mean that no inventions will be made. In fact, throughout history there have been more examples of people inventing without any incentive. Innovating is a human condition. That side where patents are necessary is just a wrong assumption that was never really tested, let alone proven.

  12. Disallow companies to patent new medications to recover their considerable costs and make a profit will mean there will be no new medicines. These companies exist because they make a profit for their investors, Remove the profit and the company goes away. Sounds crass but facts are sometimes cruel.

  13. Disney can protect Micky for 120 years but an engineer or a scientist only gets 15-20 years on a patent. HOW IS THIS FAIR?!?!?!? >_<

  14. The poor that cannot afford a pharmaceutic will not buy it. They are not clients, not even potential ones. If they buy "pirated" generic drug, the pharmaceutical companies will not lose money. You can have a) company didn't sell a drug, patient died, b) company didn't sell a drug, patient survived. Why is the second option not a simple logical choice to make? The rich will not give away for free something they have to buy with real money. Solution: poor countries shouldn't respect patents.

  15. Poor countries are often dependent on the financial aid of the countries where those patents come from. So, not only are they often unable to muster the technical skills to replicate the drugs, but they're bound to not do so by those who hold their purse strings. To be poor in this world is to be at the mercy of others, unfortunately, and rarely are they merciful.

  16. so the need the company acts on would be serviced by another vendor with another model. maybe even a public body. no great shakes.

  17. I have a more aggressive idea, lets kill everyone with aids/hiv. It would help with global over-population and rid the world of this virus. And the best part is we have the ability to do this already.

  18. Nope. Most research right now is done by governments and charities. The profit model is unnecessary. Police aren't a profitable company so they don't exist? dont be silly. The free market is only successful because of evolution (competition / survival of the fittest) not because of some intrinsic magic quality of corporations. Patents are anti-competitive by definition, thus are antithetical to a healthy market. Ignoring patents lead to better distribution.

  19. they don't tell u the important role of vitamin b12, b6 and folic acid to lower homocystein and stuff – they don't tell you that good carbohydrates raises your serotonin levels with vitamin b6 / from trypophan to serotonin – they don't tell you how zinc-ions regulate the dopamin d2 receptor, no they will sell you psychotropic drugs to make money — oh rich third world… u don't need the drugs of big pharma, only free schools, good food and a working sewer system…

  20. she seems to be missing the point that these drug companies poured masses of money into the research of these drugs, the point of the patents is to make sure the companies can recoup their losses, make a profit and spend their profit on more research and paying their employees. what needs to happen is a change in how drugs of researched, open source pharmaceuticals is a better solution for all drugs, unless shes suggesting that patents can be used with royalties

  21. A correction: Patent holders are rarely the inventors, and that's the point. The patent holders are the firms and corporations who employ the inventors, so as to extract as much benefit with as little cost

  22. If I was a greedy patent holder, I'd rather have a monopoly that royalties. This won't happen unless if someone makes them.

  23. Finally we are finding solutions for our outdated patent model, now if only the same would be applied to our insane copyright rules.

  24. This is a key concept in all patent law crisis that is going to hapen in th world within 10 years (our generation). All medices (beyond HIV/AIDS meds) will have to choose a patent pool. Inclusing which, all inventions must be patented that are in working order and introduced to the pool within five years. the Military industral complex has plenty of hidden patents that are not shared (let alone public.) A multi-industry wide patent pool is needed to move our society forward.

  25. requires a redefination of what a corporation is. Today, america has defined a corporation to be a person and all persons can hold a copyright lifetime plus fifty years. Likewise, corporations have become a method for faimlies to become cultural backlogs to our multi-cultural world (a dangerious mixture for politics (multi and domesitic-national). My solution would be to have lifetime for human, 30 years (negotable) per corporation and only one corporation per lifetime of the idea/copyright.

  26. PROBLEM: A PATIENT CURED IS A CUSTOMER LOST!! Modern pharmaceutical companies know this, it isn't in their economic interest to cure you!
    SOLUTION: A health care system in which Doctors are paid only when you are healthy!! Additional, the last thing a convalescing patient needs when faced with a debilitating disease is the financial burden of the health care costs!!
    A HEALTHY PATIENT A CUSTOMER FOR LIFE!!… Every body wins

  27. The will jump in only when they judge the risks they are going to face otherwise will be intolerable, right now they have many politicians in their pockets, they won't jump anywhere just yet. Milk that cow while it still makes milk is their policy.

  28. End Capitalism. It is utterly ridiculous that we have the technology to end many illnesses, hunger, poverty, and the rest of it and we have these silly assholes playing the money game. Are you sick of playing the game of Monopoly in real life? many of us are. No one "invents" anything..it is simply discovered and usually through teams and collective research. Stop believing the lies and these privileged turds making you believe they OWN this shit. It's a lie. End patents altogether.

  29. That is 100% true. Same with the American Medical Association. Surgeons..the whole bunch of them. They are greedy monsters, not physicians.

  30. true capitalism is a good thing. the reason LASIK eye surgery is so cheap compared to what it was is because it isn't covered by insurance and so the surgeon has to offer the surgery at a competitive price. if patents on medicine were outlawed you wouldn't have this problem because then pharmaceutical companies would have to compete, which drives down prices. so don't blame capitalism, blame crony capitalism

  31. To be cheap doesnt mean quality…in Capitalism decay in quality is inherent. Even if Capitalism worked, would not be for everyone, Adam Smith said that it was a game were the better would get to the top, others are to be poor for all their lives. We need to forgett all this dilusional problems caused by the same source, Money! Any Monetary ecnomic model will fail, no Capitalism, Comunism, nothing! RBE Revolution yeah!!

  32. Whatever attempt towards social justice in the current socio-economic system is destined to have limited, insufficient results. Until the #1 incentive is profit, funds, interests and resources will always go where the money is.
    In order to make any relevant change, the only way is to move towards the direction outlined by Jacque Fresco and The Venus Project. PLEASE invite Jacque Fresco (or a Venus Project representative) at TED. All other speeches are secondary compared to what he has to say.

  33. The sad fact is that the AIDS hoax is ALL about money and the manipulation of humanity on the basis of sexuality and race.

    Big Pharma and Big Media control the public perception on the statistical condition called AIDS.

    Please do not reply to this comment until you open your mind and research for yourself the statistics of why the same "disease" discriminates different victims on different continents.

  34. There are many engineering patents that do. Like what if I invent a new artificial heart? I only get 15-20 years on the patent.

  35. Hey buddy, would you please explain what 'true' capitalism is and how it differs from 'false' capitalism? Also, I hope you are not trying to sell 'no-true-Scotsman' fallacy here.

  36. There is an actual HIV virus and its been even photographed. Its so well understood now thats its been re-engineered to fight cancer. Different countries have different amounts of wealth to use condoms and have the money for AIDs fighting drugs.

  37. Thanks for your comment.

    Yes I know there is an HIV virus.

    It is not new as they will have you think.

    According to it's discoverer it has been around for over 700 years that he knew of.

    It is AIDS and the medication for it that is the hoax.

  38. "It is AIDS and the medication for it that is the hoax."

    Human immunodeficiency virus can cause acquired immunodeficiency syndrome and medicines developed against the HIV virus works.

  39. Are you saying you want the companies who make patient life-saving drugs not to have patents on their drugs so that they will eventually stop making them and medicine cease to improve?
    They make the drugs, this will discourage them and then we will have no new drugs, they take a massive gamble on any compound when exploring whether it will be useful for humanity.
    (I'm not saying this situation is ideal, just that they should be paid for undertaking this service)

  40. "medicines developed against the HIV virus works"

    Yes they might and that is not what is in question here.

    Why do you think they call AIDS a syndrome.

    Because it is a statistical syndrome.

    As I said, do your own research rather than parroting what the big pharma led doctors say.

  41. What are you objecting to? False postives? False negatives?

    There are several tests for AIDS. There are tests that look for specific sequences of genes found in the HIV virus in your blood.

  42. I hear this "true capitalism" argument all the time, but you dont know the fundamentalism of the system. Read Das Kapital by Marx, he invented the term and the system. it was not Adam Smith. Or Milton Friedman or any other free market quack that defines anything "true" about it. You are another Youtube economist taking the que of anarcho-captialists like Von Misses and Ron Paul. The vicious shitheads that own all the money are destroying the planet. There never was a "free market"..EVER. DOUG.

  43. HIV is the only credible part.

    With confirmation that a patient has HIV then there's a process of ticking off the boxes on a list of a wide variety of ailments.

    More than a certain percentage gives the doctor a diagnosis of AIDS.

    In different countries the list is different.

    The majority of the ailments on the list are the result of mal nutrition (Africa) and drug use (USA).

    Thus AIDS is a syndrome created by statistics.

    HIV is benign and it is the meds and ailments that kill.

  44. It's a little bit disturbing how even these TED talks tend to chronically keep underrepresenting minority/colored women. Basic progressive policy is to prioritize the underprivileged. Yet, the very women in society who suffer the most from the pressures of the religious right and who lack social mobility most often are, time and again, being sidelined in favor of upper class Western white females.

    We're in the year 2012, very nearly 2013. Something about this mentality is really worrying.

  45. If they have something scientifically interesting to say by all means invite them. The fact is, though, that northern europeans are still mostly white. Demographically it is just highly unlikely you'll find a candidate you're describing. They are, as you say, a minority.

  46. You are referring to a resource based economy? I have a question for you then. Let's say, I want a new hammer. My neighbour also wants a new hammer. The producer of hammers can only manufacture one at this time. Who gets it first? Substitute hammer for an apple. Say, a man needs one apple to survive. Another man needs three quarters of it. One available -> conflict.
    The RBE requires a change in human nature -> causes difficulties in implementation -> the RBE is essentially doomed from the start.

  47. It's easy to willfully ignore asymmetric situations when they are in your favour. To us Westerners, everything looks neutral, because we are blind to our own privileges.

    When you become romantically involved with someone who has very much come from an underprivileged position, however, your views on these issues will change dramatically as well.

  48. I realise very well that I have just been born in the right place. What you say does not however suddenly make the minority presenters at TED. Precisely because the situation is in our favor the underprivileged do not have the extra time to create a TED-worthy presentation. It is because they are underprivileged that they are underrepresented. No matter how hard you, as a westerner, fight for it, you will not achieve better representation without letting the underprivileged become privileged.

  49. Precisely. That is why I am dedicated to raising awareness of this issue in this manner. Consider it a form of social activism.

  50. Hi Benno, good questions, thanks for asking.
    I'm sure you know that today we have the technology and resources to fulfill ALL basic needs (and many secondary needs) for the entire human population. Problem is that, in a monetary system, societal and environmental needs are only secondary to profit. Incentives to using technology the way it could be used are little; scarcity is a bioproduct of our culture as our artificial values of materialism and consumerism are.

  51. As 4 the human nature comment, I agree with u, all change is usually from hard… to very hard to get (all the more if we r talking about a cultural shift). Thing is that our current socio-economic model is completely unsustainable – what other chances do you think we have? The change will be forced on us and, at that point, if we will be smart enough we will move towards The Venus Project direction; anything else will be a waste of time. Dig TVP deep Benno, education is crucial at this time!

  52. I don't think The Venus Project is by any means 'the only way'. Yes it has a lot of good ideas, but keep an open mind to smaller changes that can put people in the right mind-set to then make bigger, more radical changes later on….
    I would like to see Jacque Fresco on TED as well 🙂

  53. Thanks for your reply! I do believe that people who have an achievable goal perform better. The free market is imperfect in that it satisfies (some of) our wants and not necessarily our needs. My biggest problem with designs like TVP, however, is that it is very difficult to pinpoint what our needs are exactly, and that it varies from person to person and from time to time what we need. This is difficult matter but I try to help the world by calculating the efficiency of medical treatments.

  54. Mind super-opened Sabby, but whatever change (small or big) made to the current system, just won't do.
    You can either row upstream (on a stream just too strong to beat) or change the whole flow. Take your pick.
    Going green and such is all good, especially for a shift in mind-set – I agree. But we must accept the idea that the WHOLE system must change and move towards a resource-based economy.
    TVP has national teams all over the world; get in touch, and dig TVP deep!!
    Love_

  55. My pleasure Benno!
    The Venus Project offers an holistic solution to the (age old) problems our civilization is facing. It's not just about futuristic designs and cool words. For example, a huge part of TVP is education, through which people can learn to move away from materialistic and suicidal life styles and move towards more healthy and balanced ones. Benno, please dig TVP deep (read The Best That Money Can't Buy) and get in touch with your national TVP team. We are all in this together!

  56. No matter who you are…it is difficult to practice being selfless…
    Whether you wish to or not, if you even attempt to be selfless…in spite of your intentions will come off as selfish because the ppl of higher power (economically and with some sort of status) will take advantage of this kind of opportunity for their own personal gain

    this is a start ^-^ great talk!

  57. We are in danger of destroying ourselves by our greed and stupidity. information and knowledge is power. I like that she points out that we have the tools necessary to end this epidemic. Greed is the mechanism that prevents us from using these tools.

  58. Ellen Hoen brings up an idea, patent pools, that is applicable in most areas of medicine and not just HIV. In all, I think it is a great and ethically supported idea. One of the biggest inequalities in medicine is access to them across the world. Periphery countries simply do not have the resources available to do the research core countries can. In addition, these medical discoveries are being hoarded through patents. In a perfect world, all would benefit from every medical advantage. Medical patent pools help bring this ideal closer to a reality and helps bring more good to more people. One aspect of medical pools that to be in a negative light is the fact that it is optional to put one's patent into the medical pool. However, this aspect increases its ethical soundness. One concept brought up in virtue ethics is that for an act and thus one to be moral the act must be done by choice. If a scientist is forced to share their discoveries the act may seem moral but in reality, it could not be what they would have chosen given the option pool medicines have now. Still not convinced that patent pools are ethically sound. Looking from an egalitarian view patent pools would be accepted under the veil of ignorance. Under the veil of ignorance, there are no biases present and no one knows where they stand in society. Under these conditions wouldn’t you want to have access to advanced medicines if you ended up at the bottom of the totem poll?

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