Thomas Pogge – TRANSCRIPT
Well I hope you’re all healthy and I hope you all will remain healthy for the indefinite future. But that hope is a little bit unrealistic and so I’ve got a second back-up hope. This second back-up hope is that insofar as we have health problems, we will have good medicines to take care of them. Medicines are very cheap to produce and they’re very effective. Much more pleasant actually than the alternatives: hospitalization, operations, emergency rooms, the morgue… None of these are good things.
So we should be very grateful that we have pharmacologists around, people who research these things and develop new medicines, and we should be grateful that we have a pharmaceutical industry that supports their activities. But there is a problem and you can tell from the fact that the pharmaceutical industry isn’t well-loved. In fact, in terms of popularity, they rank just about with the tobacco companies and the arms manufacturers. So that’s the problem that I want to talk about with you today.
How would you organize the pharmaceutical industry? If we did it all over again, how would you do it? I think we would think of three main principles. The first one is: we want patients to have access to all the important medicines. Remember, these things are very cheap to produce. So everybody in the world should have access to all the important medicines.
Secondly, we want innovative activities, the research and development that pharmaceutical companies do, to track the diseases that are the most important, the most damaging. We want them to aim for the greatest health impact.
And thirdly, we want the whole system to be efficient. We want as little of the money that goes into the system to go to waste. To go for overhead, for red tape, and so on.
Very simple three points. Now, what about the existing system? I think it does poorly on all these three counts. First: Universal access. Forget about it. The vast majority of human beings do not have access to medicines, at least not while they’re still under patent. There are extremely high mark-ups and that’s the problem. The problem is that even though these medicines are very cheap to produce, they cost a great amount of money during the time that they’re under patent, and the reason for that is that rich people can pay a lot of money, pharmaceutical companies have a temporary monopoly, they price for the rich, they forget about the poor.
The second problem is innovation. Again, we don’t focus on the diseases that do the most damage, and that’s often put into the phrase of the 10/90 gap. Ten percent of all the money spent on pharmaceutical research is focusing on diseases that account for ninety percent of the global burden of disease. And vice versa: Ninety percent of the money is spent on diseases that account for only ten percent of the global burden of disease. So there’s a huge mismatch between where we spend the research money and where the greatest problems are.
Now, both these problems, the problem with innovation and the problem with access have to do with this: The distribution of money in the world. It’s extremely unequal. The blue area here is the top quarter of the human population. They have more than ninety percent of the global household income. The bottom half of humanity on the other hand has not even three percent of global household income.
So if you’re a pharmaceutical company and you look for profit opportunities, you look at this sort of chart and you say: “Well, where’s the money? What am I gonna research? Who am I going to provide with medicine?” And again, that is in the context of there being only one way in which pharmaceutical companies make money under the present system, that is through patent-protected mark-ups. That’s how they make their money. Through mark-ups. And if you make money through mark-ups, then obviously you will go to where the people have the most income.