India: denied the right to produce affordable medicines
Premavati is a 60-year-old widow living in the suburbs of Delhi, India. She suffers from a type of cancer called Non-Hodgkins Lymphoma and has spent all her savings "more than 40, 000 Rupees (c.$900)" on medicines. "My husband died two years ago," says Premavati. "We have absolutely no savings. Of my two sons, one is a casual labourer, the other has no job. My daughter is 30, has two children and is also a widow."
Because of her desperate situation, Premavati has almost resigned herself to the idea that she will die without medicines. “How will I raise the money for my treatment?” she says. “Already, I've spent what we had. If nobody helps, I'll just have to die without medicines."
Everyone who needs it should have access to medicines and health services, regardless of their sex, age, or income level. Yet, in developing countries such as India, roughly 1.42 billion people cannot get the life-saving essential medicines they need. A major reason for this is that they can't afford them.
Gopa Kumar, senior researcher at The Centre for Trade and Development, an advocacy group in New Delhi, says: "In India, where the majority of people don't have health insurance or support programmes, estimates say that in some cases, about 80 per cent of personal income goes on buying medicines alone."
"I wonder if the people in power are listening," says Dr Gopal Dabade, of the Drug Action Forum in the southern state of Karnataka. "If we don't put pressure on the government and make medicines available, poor people will continue to suffer and die," he says.
India is the world's leading supplier of inexpensive generic medicines, with approximately 67 per cent of them being exported to developing countries. A few years ago, they made a groundbreaking contribution to the availability of affordable HIV medicines by producing and marketing the 'first-line, triple-combination drug'. This was possible because patenting of medicines was not allowed in India until the Indian Patent Act was amended in 2005 to comply with requirements set out by the World Trade Organization's TRIPS Agreement (Trade Related Aspects of Intellectual Property Rights). This new amendment paves the way for a 20-year minimum period of product patent protection, including medicines. Put simply, this raises the price of a wide range of medicines, making them increasingly unaffordable to poor people.
I know how tough it was to pay for my first-line treatment," says 35-year-old Umashanker Pandey. "I have lost six kilos in weight in the last three months. My body's response to first-line ARVs is failing and I simply can't afford the second-line treatment." His only wish is to stay alive to see his elder daughter, now aged 15, get married.
"I am worried, because voices like mine are not counted by anyone, not even my government. I do not have any idea how many like me have started counting down the days," he says. Umashanker's wife, and the youngest of his five children, who is eight, are also HIV-positive.
He says he knows of 18 other people in his home town who are in the same position that he is in, urgently needing to begin the 'second-line treatment', but unable to afford it. Umashanker knew a man, only 35 years old, who died last month. "He would have lived if he had been able to have medicines on time," he says.
Hundreds of thousands of people like Umashanker can be saved if only developing countries can ensure that their TRIPS-compliant patent laws provide a balance of rights and obligations ensuring that people's lives are put before drug companies' profits.