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Medicines for the Many

In the UK and across the world Big Pharma is ripping off public health systems and denying patients vital medicines. This week, Labour showed there is an alternative.

In the UK and across the world, patients are being denied medicines because of a system that prioritises profits before lives. Labour announced bold policies this week to tackle the immediate crisis in medicines prices as well as transform a fundamentally broken system and re-orientate it to serve public health.

For decades, ‘Big Pharma’ has decided what medicines get produced and who gets them. They can get away with charging the highest prices because new drugs are awarded 20-year patents which mean that no other company can make or sell that drug during that period. With no competition, they can charge whatever price they like. 

High prices have long been a problem for low and middle income countries but in recent years, prices are so high that rich countries like the UK are also struggling to afford these extortionate rates. Our National Health Service increasingly has to ration or reject effective treatments because they are just too expensive. 

Luis Walker featured in Jeremy Corbyn’s speech at the party conference this week. This nine year old boy with cystic fibrosis has been campaigning to access a drug called Orkambi which could slow down the progression of the disease and add years to his life. But the drug isn’t available on the NHS in England because it is too expensive. And even after three years of negotiations, the drug maker Vertex is refusing to lower the eye-watering £105,000 price tag. 

Sadly, Luis’ case isn’t unique but it does tell a powerful story about the failings of an innovation system whose products are supposed to support health and well-being. Instead, driven by profit and shareholder value, medicines are produced based on their projected financial returns rather than the priorities of public health. And so, even though we are facing an impending global antibiotics crisis, there has been barely any investment in developing new antibiotics. It is simply an unprofitable venture. 

There is also insufficient investment into conditions that affect people living in the Global South, again because these markets are considered not lucrative enough. Pharmaceutical companies spend more on marketing and buying back their own shares than they do in research and development. All of this points to system that does not recognise health as a human right.

In the UK, people treasure the principle of public healthcare for all, free at the point of use, but privatised medicine undermines the values of universality. We desperately need greater public control over medicines to ensure that we have a health innovation system that delivers for public health. And this is exactly what Jeremy Corbyn has announced this week.

The package of measures contained in ‘Medicines for the Many’ couldn’t have come sooner. The proposals include the willingness to use compulsory licensing, a legal mechanism that allows a government to override a patent and permits other companies to produce a medicine at lower prices for the benefit of public health. The World Trade Organisation and the World Health Organisation recognise that intellectual property rights are not absolute and actively supports governments to use this right to address public health needs. A compulsory license on Orkambi could break the current deadlock and allow Luis and other patients to access this crucial treatment.

And that’s just for starters. The public sector plays a significant role in funding research and development. Some estimates say that between ⅓ to ⅔ of upfront health research globally is funded by the public purse. But there are no safeguards in the system to ensure that medicines developed with public money will benefit the public.

Instead, too often public research is bought up by private companies who go on to develop and market the drugs at high prices. Leaving the public to pay twice, first for the research and then in high prices. It’s a classic example of socialising risks while privatising rewards. As part of the reform package, Labour will include conditions on public funding to ensure that drugs developed with public research are affordable for the NHS.

Finally, Labour is supporting democratic public ownership of drug development and manufacturing capabilities. Manufacturing generic drugs especially those that are in shortage or in areas that are deemed unprofitable will enable future governments to determine and deliver on public health priorities. 

This transformative agenda recognises that access to medicines is crucial to achieving the right to health for all. It’s about taking the bold steps to re-orientate the system so that it delivers for public health.

Over many years, the power of Big Pharma has gone largely unchallenged as they have stitched up global rules and constructed for themselves a legal architecture of intellectual property rights and market exclusivities to protect their profits at the expense of patients. Now it’s time for the pendulum to swing the other way – and it looks like Labour will lead the way to start building a pharmaceutical system where saving lives is the priority.