This House would produce high quality generic drugs for Africa

While all continents suffer from their own prominent diseases, Africa bears a disproportionate burden. The continents holds 11% of the population, but has 25% of the world’s disease burden[1]. While HIV and malaria are well known, other common deadly diseases such as measles and pneumonia are also prominent on the continent; all of which are exacerbated by high levels of malnutrition. HIV/AIDS alone cost the lives of around 1.2 million Africans in 2012, 75% of the global deaths to the disease[2]. Cheap, generic drugs have been proposed as an answer to this problem

Medical drugs take one of two forms. The first is a patented drug, which has been researched and developed (R&D) by a company and cannot legally be reproduced by another company for a set period of time. This allows the initial company to recuperate financial losses for R&D. Once the patent ends the information on how to create the drug becomes available to all drug companies. They are generally produced at a lower price due to competition between firms and are called generic drugs. Some countries, such India and Brazil, have developed a generic drug industry, with Africa as a primary market[3]. Some legislation in developed countries already provides high quality generic drugs to Africa and there are propositions to increase the quantities. There is, however, a conflict of interests between pharmaceutical companies operating for a profit and humanitarians. This debate examines whether the mass export of high quality generic drugs to Africa is a viable and effective option.   

[1] Coetzee,G. ‘Generic drugs are vital for a healthy Africa’

[2] amfAR ‘Statistics: Worldwide’ 2012

[3] Boseley,S. “Rich countries ‘blocking cheap drugs for developing world’”

 

Title 
Easily affordable drugs will mean greater access
Point 

Generic drugs are much cheaper to produce, which is ideal for Africa’s struggling population. While there has been significant gross domestic product (GDP) growth in Africa, the actual distribution of wealth is relatively unequal. According to Afrobarometer, 53% of Africans still feel that their economic condition is poor[1]. This restricts their ability to purchase high cost drugs. Generic medication would reduce the price of these drugs, making them affordable to the average citizen. The patented drug Glivec, used for cancer treatment, costs £48.62 for 400 mg in South Africa while its generic equivalent (produced in India) costs £4.82[2]. Increased access will result in higher levels of treatment, which in turn will reduce death rates from preventable diseases in Africa.

[1] Hofmeyr, Jan, ‘Africa Rising? Popular Dissatisfaction with Economic Management Despite a Decade of Growth’

[2] Op Cit

Counterpoint 

Greater access of generic drugs can increase the chances of overexposure and misuse. This has a detrimental effect on fighting diseases. Greater access will lead to higher use rates which, in turn increases the chances of the disease developing an immunity to the drug[1], as is already happening to antibiotics resulting in at least 23,000 deaths in the United States.[2] This immunity requires new pharmaceuticals to counteract the disease which can take years to produce. It is therefore, disadvantageous to produce high quality generic drugs for Africa. 

[1] Mercurio,B. ‘Resolving the Public Health Crisis in the Developing World: Problems and Barriers of Access to Essential Medicines’ pg.2

[2] National Center for Immunizations and Respiratory Diseases, ‘Antibiotics Aren’t Always the Answer’, Centers for Disease Control and Prevention, 16 December 2013, http://www.cdc.gov/features/getsmart/

Title 
Savings can be used in other sections of medical care
Point 

The decreased cost of pharmaceuticals allows African states to focus on other aspects of medical schemes. Pharmaceuticals are not the only aspect in treatment, there needs to be sufficient staff, medical equipment and infrastructure[1]. These requirements cost money, which the savings made on pharmaceuticals provide. In Europe, 50% of dispensed medicines are generic yet they cost only 18% of pharmaceutical expenditure, with a similar model predicted for South Africa. This allows the state to focus on other aspects of medical schemes[2]

[1] Ibid

[2] Health24, ‘South Africans embrace generic meds’

Counterpoint 

The use of generic drugs can sometimes fail to bring about a reduced price. For the cost of drugs to decrease, there must be competition within the industry to drive prices down. The switch from patented to generic drugs in Ireland failed to bring about any significant saving for this reason[1]. African countries must therefore ensure competition in order for generic drugs to become truly affordable which could be problematic due to continued protectionism in some states.  

[1] Hogan,L. ‘Switch to generic drugs fails to bring expected savings for HSE’

Title 
Reduce the prominence of bad and fake drugs
Point 

The increased availability of high quality generic drugs will reduce the numbers of bad and fake pharmaceuticals on the markets. The cost of patented drugs has forced many to search for other options. This is exploited by the billion dollar global counterfeit drug trade[1]. Fake drugs are the cause of around 100,000 deaths in Africa every year. Bad drugs, which are substandard, have also found their way in to Africa; one in six tuberculosis pills have been found to be of a poor quality[2]. The widespread introduction of low cost, high quality drugs will hopefully ensure that consumers do not turn to sellers in market places.

[1] Sambira,J. ‘Counterfeit drugs raise Africa’s temperature’

[2] Ibid

Counterpoint 

It is nearly impossible to remove black markets; medication is no exception. Attempts thus far to remove the African counterfeit pharmaceuticals have been unsuccessful. Corruption and a lack of manpower have ensured that counterfeits continue to reach Africa, especially from India[1]. As long as there is a profit to be made, fakes and bad drugs will be sold at a lower price than even generic drugs on the African continent which have the addition of importation and tax in their cost[2].

[1] Sambira,J. ‘Counterfeit drugs raise Africa’s temperature’

[2] Ibid

Title 
Unfair to apply same patent laws universally
Point 

It is unrealistic to expect poorer countries, such as those in Africa, to pay the same price as the developed world’s markets. Current patent laws for many countries dictate that prices for buying patented drugs should be universally the same. This makes it extremely difficult for African countries to purchase pharmaceuticals set at the market price of developed countries. In the US there are nine patented drugs which cost in excess of $200,000[1]. To expect developing African states to afford this price is unfair and reinforces the exploitative relationship between the developed and developing world. Generic drugs escape this problem due to their universally low prices.

[1] Herper,M. ‘The World’s Most Expensive Drugs’

Counterpoint 

Pharmaceutical companies investing in R&D deserve to make a return on their investments. Research and development can take a long time and will cost significant sums of money. The cost of creating many new drugs was estimated to be as high as $5 billion in 2013[1]. There is also a risk that the drug may fail during the various phases of production, which makes the $5 billion price-tag even more daunting. It is therefore necessary for these companies to continue to make a profit, which they do through patenting. If they allow drugs to immediately become generic or subsidise them to some of the biggest markets for some diseases then they shall make a significant financial loss.

[1] Herper,M. ‘The Cost of Creating a New Drug Now $5 Billion, Pushing Big Pharma to Change’

Title 
Dominance of generic drugs will reduce reinvestment and innovation in donating countries
Point 

The production of high quality generic drugs endangers pharmaceutical progress. In order to export high quality generic drugs, some countries have suggested allowing generic drug manufacturers access to patented drugs. In Canada, amendments to Canada’s Access to Medicine Regime (CAMR) would have forced pharmaceutical research companies to give up their patents[1]. This is problematic however as research based companies invest a large proportion of their profits back in to the industry. The requirements proposed for some Western countries for obligatory quantities of generic drugs to be given to Africa have been accused to removing any incentive to invest in research to combat disease[2].

[1] Taylor,D. ‘Generic-drug “solution” for Africa not needed’

[2] ibid

Counterpoint 

Some countries, such as India and Thailand, have specialised in producing generic drugs. These states provide the majority of generic drugs to Africa. This removes the burden of other countries to supply Africa with their own drugs whilst potentially damaging their own research companies.  India has managed to create a very profitable industry based around cheap generic drugs which it mainly exports to the African continent[1], decreasing the necessity of other states to contribute vast resources.

Providing generics to Africa will not damage development by the big pharmaceutical companies as at the moment these countries cannot afford the drugs so are not a market. The drugs are researched on the assumption that they will be sold in the developed world. What matters therefore is to ensure that generics for Africa don’t get sold back to the developed world undercutting patented drugs.

[1] Kumar,S. ‘India, Africa’s Pharma’

Title 
Cheaper drugs aren’t trusted by consumers
Point 

The differences in price between generic and patented drugs can be disconcerting to those wishing to buy pharmaceuticals. As with other product, logic generally follows the rule that the more expensive option is the most effective. There are reports from the USA of generic drugs causing suicidal tendencies[1]. These factors, combined with the lower levels of screening for drugs in Africa, mean that cheaper drugs are generally distrusted[2].

[1] Childs,D. ‘Generic Drugs: Dangerous Differences?’

[2] Mercurio,B. ‘Resolving the Public Health Crisis in the Developing World: Problems and Barriers of Access to Essential Medicines’

Counterpoint 

Medically there is no difference between generic and patented drugs. They are both identical, with the exception of aesthetic differences in some US drugs to avoid copyright infringement. Generic drugs cost less because they do not have to invest in R&D[1]. They focus on efficient methods of production and ensure that their product can be sold at a competitively low price. The lack of a need for R&D is therefore more prominent than quality in the pricing of generic drugs.

[1] Stoppler,M. ‘Generic Drugs, Are They as Good as Brand Names?’

Title 
Most vital drugs are already generic
Point 

Many drugs which are used in the treatment of HIV, malaria and cancer are already generic drugs which are produced in their millions[1]. This removes the necessity to provide further high quality generic drugs as there is already an easily accessible source of pharmaceuticals. Effective treatments for Malaria, in conjunction with prevention methods, have resulted in a 33% decrease in African deaths from the disease since 2000[2]. The drugs responsible for this have been readily available to Africa, demonstrating a lack of any further need to produce pharmaceuticals for the continent.

[1] Taylor,D. ‘Generic-drug “solution” for Africa not needed’

[2] World Health Organisation ’10 facts on malaria’, March 2013

Counterpoint 

These vital drugs will become outdated. Diseases often have the ability to build a resistance to treatment, making many of these currently generic drugs impotent. In Tanzania, 75% of health workers were providing lower than recommended levels of anti-malaria drugs which resulted in a drug resistant form of the disease becoming prominent[1]. Giving recently developed drugs to Africa will have a greater impact against diseases such as HIV than giving them twenty year old drugs to which a disease is already immune.

[1] Mercurio,B. ‘Resolving the Public Health Crisis in the Developing World: Problems and Barriers of Access to Essential Medicines’

Bibliography 

amfAR ‘Statistics: Worldwide’ 2012 http://www.amfar.org/about-hiv-and-aids/facts-and-stats/statistics--worldwide/

Boseley,S. “Rich countries ‘blocking cheap drugs for developing world’”, The Guardian, 14 November 2006

Childs,D. ‘Generic Drugs: Dangerous Differences?’, ABC, 15 October 2007 http://abcnews.go.com/Health/Depression/story?id=3731555&page=1

Coetzee,G. ‘Generic drugs are vital for a healthy Africa’, Mail and Guardian, 06/10/12 http://mg.co.za/article/2012-10-06-generic-drugs-are-vital-for-a-healthy-africa

Health24, ‘South Africans embrace generic meds’, 18 September 2013 http://www.health24.com/Medical/Meds-and-you/News/South-Africans-warm-to-the-use-of-generic-medicines-20130903

Herper,M. ‘The Cost of Creating a New Drug Now $5 Billion, Pushing Big Pharma to Change’, Forbes, 11 August 2013 http://www.forbes.com/sites/matthewherper/2013/08/11/how-the-staggering-cost-of-inventing-new-drugs-is-shaping-the-future-of-medicine/

Herper,M. ‘The World’s Most Expensive Drugs’, Forbes, 22 February 2010 http://www.forbes.com/2010/02/19/expensive-drugs-cost-business-healthcare-rare-diseases.html

Hofmeyr, Jan, ‘Africa Rising? Popular Dissatisfaction with Economic Management Despite a Decade of Growth’,AfroBarometer, Policy Brief No.2, October 2013 http://www.afrobarometer.org/files/documents/policy_brief/ab_r5_policybriefno2.pdf

Hogan,L. ‘Switch to generic drugs fails to bring expected savings for HSE’, Independent.ie, 27 June 2013 http://www.independent.ie/irish-news/switch-to-generic-drugs-fails-to-bring-expected-savings-for-hse-29376148.html

Kumar,S. ‘India, Africa’s Pharma’, The Yale Globalist, data accessed 13 January 2014 http://tyglobalist.org/onlinecontent/blogs/india-africas-pharma/

Mercurio,B. ‘Resolving the Public Health Crisis in the Developing World: Problems and Barriers of Access to Essential Medicines’,  Northwestern Journal of International Human Rights, 5:1, 2007 pgs. 1-40 http://scholarlycommons.law.northwestern.edu/cgi/viewcontent.cgi?article=1046&context=njihr

National Center for Immunizations and Respiratory Diseases, ‘Antibiotics Aren’t Always the Answer’, Centers for Disease Control and Prevention, 16 December 2013, http://www.cdc.gov/features/getsmart/

Sambira,J. ‘Counterfeit drugs raise Africa’s temperature’, Africa Renewal, May 2013, pg.5 http://www.un.org/africarenewal/magazine/may-2013/counterfeit-drugs-raise-africa%E2%80%99s-temperature

Stoppler,M. ‘Generic Drugs, Are They as Good as Brand Names?’, Medicinenet, 28 September 2009  http://www.medicinenet.com/script/main/art.asp?articlekey=46204

Taylor,D. ‘Generic-drug “solution” for Africa not needed’, The Spec, 3 February 2011 http://www.thespec.com/opinion-story/2172542-generic-drug-solution-for-africa-not-needed/

World Health Organisation ’10 facts on malaria’, March 2013 http://www.who.int/features/factfiles/malaria/en/

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