What is the most precious thing in the world which unfortunately we take for granted and realise its true value when it is impaired? Good health, of course.
In the last Global Trends, I wrote about the importance of water on World Water Day.
On April 7 we celebrated World Health Day. Water and health are the most critical things in our daily life.
In the 1980s, the World Health Organisation’s director-general Halfdan Mahler steered through a declaration with the popular slogan “Health for all by the year 2000”.
We crossed into the 21st century without realising that noble goal. Although health has improved in most countries, due mainly to cleaner water and sanitation and also better treatment, much remains to be done.
In recent years, the slogan “Health for All” has been strengthened by the recognition in the United Nations of health as a human right. It has been further boosted by the adoption of the principle of universal healthcare.
This means that no one should be deprived of healthcare, even if he is too poor to afford it.
Unfortunately, while the prices of old medicines whose patents have expired have gone down, there are many newer medicines which are too expensive for the ordinary person to afford.
That’s because a company that owns the patent has a monopoly over the production and sale of the medicine.
Since there are no competitors, the price can skyrocket to high or even astronomical levels. The patent normally lasts 20 years.
For example, the prices of medicines for HIV AIDS were at the level of US$15,000 per person per year in the United States.
For most AIDS patients in Africa and other developing countries this meant they just could not afford them.
Since those medicines were not yet patented in India, because India had until 2005 to implement the TRIPS Agreement of the World Trade Organisation, Indian drug company CIPLA was able to sell and distribute a three-in-one combination drug for about US$300 per person per year.
Later, the price levels of the generic producers fell further to about US$60.
Millions of lives around the world were saved by competitor generic companies which could sell the medicines at a more affordable price.
Health agencies like the Global Fund to fight AIDS, Tuberculosis and Malaria were set up and took advantage of the falling prices to make AIDS medicines available to poor countries.
In recent years a similar storm has been brewing over the prices of new drugs for Hepatitis C, a life-threatening disease which millions around the world suffer from.
One of the drugs, Sofosbuvir, has an efficacy rate of 95% and with fewer side effects, but is being sold in the United States for about US$85,000.
Some generic companies in India are allowed to sell it at their own price level, which is currently around US$200-300 per patient for a course of treatment.
They are also allowed to sell these drugs in India and in lower-income countries at these much cheaper prices.
But they are not allowed to sell in most middle-income countries, including Malaysia, which has around 300,000 people with Hepatitis C.
What can be done?
While the TRIPS Agreement patents for genuine inventions, countries are also allowed to issue a compulsory licence or a government use licence to import or manufacture the patented drug, if the original medicine is found to be too expensive.
The patent owner will receive remuneration from the generic company or the Government for making use of or selling the generic product.
Countries can also carefully examine a company’s application for patents and reject those that are not genuine inventions, for example if a new patent is applied for with just a different dosage or use for another disease.
There are many new medicines already in existence or coming on stream that are patented and therefore out of reach of most patients.
This tension between monopoly for patent holders (usually the big drug companies) and access to medicines for all has become very strong and there are social movements around the world that are fighting for patient’s rights and against excessive monopolies by companies.
Another interesting recent development is the recognition that consumption of too much sugar can lead to and has led to an epidemic of many ailments, such as obesity, heart problems and diabetes.
The authorities in more and more countries are taking action to limit the sugar content, for example, of soft drinks.
The WHO has guidelines on sugar consumption and on how to avoid excessive sugar in many foods, especially those taken by children.
For World Health Day, consumers should resolve to cut down on sugar in their drinks and food.
An emerging threat that endangers human life is the resistance of bacteria and other pathogens to antibiotics and other antimicrobials.
Many antibiotics can no longer work on an increasing number of patients in a wide range of ailments, including TB, malaria, gonorrhoea and stomach ailments.
Diseases that were once easily cured are now developing resistance, meaning the drugs don’t work anymore.
We have stark warnings from top public health offices like WHO director-general Margaret Chan and the Britain’s Chief Medical Officer Dame Sally Davies, that we are approaching a post-antibiotic era.
In the future, even a simple scratch on a child’s knee or infection during surgery could lead to death, according to these officials.
Last September, political leaders meeting at the UN General Assembly pledged to take serious action to deal with antibiotic resistance.
A coordinating group from UN agencies and selected individuals has been formed to review the situation and to recommend further action.
Finally, the World Health Assembly next month will be electing a new director-general for WHO.
There are three candidates from Pakistan, Ethiopia and Britain.
May the successful candidate do a superb job in addressing all the ailments, diseases and problems in world health.
Originally published in The Star.
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