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Patent nonsense about bird 'flu continues to fly far and wide. The wildest is the claim that millions can be saved by breaking the patent on the only known cure: this really would be killing the goose that lays the golden eggs.

This procedure is, in fact, permitted "in good faith" under a World Trade Organisation treaty in cases of emergency. Using it just because you can would set a very dangerous precedent.

We know that one strain of bird 'flu, the H5N1 virus, has already killed at least 80 people worldwide in two years and has infected well over 100. Right now, the only cure for this particular strain is Tamiflu, owned by Roche, a Swiss company. The question, according to public health experts, is not if a human outbreak will happen, but when. The only debate, it seems, is to how much damage this virus, or new mutations, will cause (bearing in mind that in the normal course of events tens of thousands of people die of normal 'flu every year-30,000 in the USA alone).

Based on these fears alone, there has been a worldwide clamour to mass-produce Tamiflu. But flaws in this plan are already beginning to show - there is already evidence that the drug failed to prevent a Vietnamese girl from dying earlier this year and other signs of ineffectiveness are showing in Turkey. The H5N1 virus has already spread to birds on at least three continents, as far West as the Aegean sea and South to Indonesia, leaving everyone in between understandably terrified. This widens the scope for several different mutations, which would almost surely render Tamiflu ineffective for any significant percentage of the world's population.

Despite this, calls are still being heard to "compulsory license" Roche's rights to Tamiflu in order for it to be produced by Indian generic manufacturers, producing medicines that are no longer protected by patents. Without patent-protection in the way, it is argued, these firms will be able to supply anti-virals quickly and cheaply to the people who need them.

But this thinking is flawed in at least three different ways, and Indian policymakers should know better than to advocate breaking the property rights protecting Tamiflu in the event of a serious epidemic.

Firstly, access to the most essential medicines in India still remains inadequate. It is estimated that over 60% of Indians still lack access to what the World Health Organisation calls "essential medicines."

But to blame patents is patent nonsense: 98% of those essential medicines are no longer patent-protected. Anyone in India who has observed the parlous state of healthcare infrastructure realises that the problem remains getting the drugs to the people who need them.

India prides itself on being the world's biggest source of generic AIDS medicines but this still only gives 50,000 Indians--out of a total HIV+ population of five million--reliable access to anti-retrovirals. Again, the issue is not cost but distribution.

Secondly, there are more serious questions about whether generic manufacturers are capable of the complicated manufacturing process that Tamiflu entails. India only recently introduced patent protection, so firms have not in the past invested in the high technology for producing high-tech, patented, drugs.

As a recent outbreak of encephalitis in Eastern Uttar Pradesh showed, the government was incapable of containing a small epidemic that eventually killed 1,000 people, because Indian companies did not have the capacity or the expertise to manufacture the necessary vaccines even though they are not patented.

Even polio vaccines, long since free of patent protection and representing one of the government's biggest health projects every year, cannot be produced here because Indian firms, again, do not have the capacity to produce enough vaccines. Indeed, polio treatments, which are relatively easy to produce, represent our single biggest medicine import.

Thirdly, with new patent legislation, Indian firms now have an incentive to invest in the expensive high technology that would allow them to take on the licensed production of patented products and sell them here and in other markets. Such capacity would allow them in the future to meet an emergency like bird 'flu and routine demands like polio vaccines.

But it is important to remember that this shift will take time and depends entirely on the government upholding the patent laws which makes these crucial investments possible. Without these strong signals that intellectual property rights will be respected, Indian firms will not grow out of their position as cheap copycat producers and international firms will be reluctant to invest in research.

If our government were truly concerned with improving public health, it would stop flirting with compulsory licenses and would give clear incentives to Indian firms to improve their capacity and to international firms to continue spending huge amounts of money on finding miracle cures.

Dogmatic attacks against these intellectual property rights, a major driver of investment, will damage research, damage production and hit the poor hardest. The doomsday projections that we have all heard will then really come true.

Barun Mitra is the director of Liberty Institute, an independent think-tank in New Delhi.

January 25, 2006

Free trade is a powerful force for improving the health of the world's poor.
The rise of the multilateral trading regime under the auspices of the GATT and later the WTO has contributed to a massive liberalisation in global trade that has seen new health knowledge and technologies, and wealth, spread to nearly all corners of the globe. As a result, life expectancies have risen worldwide.

This new paper from the CFD shows how 50 years of trade liberalisation has significantly improved the health of the world's.

Foreign aid funds corruption, new study revealsIn a new study, Professor Wolfgang Kasper examines the correlation between foreign aid and corruption in poor countries.

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Bird 'flu in India: Poliies that kill

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