Bitter Pills:Medicines & The Third World Poor | Page 172

A number of West German manufacturers made the first approach to WHO as
early as 1977. At the time the pharmaceutical newsletter SCRIP quoted a leading
German industrialist as saying: "But they f poor countries"] must understand
that they can't get everything free, and must not attempt to undermine our patent
and trade-mark positions which are essential for the industry's profitability and
existence." (19) The clear implication was that as quid pro quo for special prices
for their health services, Third World governments would have to respect patents
and brand names (against the recommendations of UN agencies). To date this
assumption has not been publicly ruled out by the industry. When Dr. Vischer,
President of the International Federation of Pharmaceutical Manufacturers
Associations (IFPMA), addressed the 1982 World Health Assembly to clarify
industry's position, he left delegates still uncertain about whether the industry's
offer really held out any tangible benefits for the majority of developing countries.
Dr. Vischer explained that "the words 'favourable conditions' " meant "quite
simply... a preparedness to supply drugs to the countries taking part in the Drug
Action Programme at non-commercial prices".(20) (our emphasis) Readers who
have seen the striking differences in drug prices (documented in Chapter 4 of this
book) will share the bemusement of delegates to the World Health Assembly as
to what is so "favourable" about a "preparedness" to negotiate on "noncommercial" prices.
Dr. Vischer went on to say that until countries were clearer about their drug
requirements (quantities, pack sizes, labelling, time-scale for orders) he suggested
"that it would not be helpful to speculate on how the term' favourable conditions'
should be interpreted in terms of actual prices".(2I) So three years on from when
the offer was originally made discussions with industry had yet to yield concrete
results in the form of drugs for the world's poor.
The deadlock was a classic chicken-and-egg situation. Industry (understandably)
could not quote prices until it had a concrete order to go on. WHO, for its part,
rightly had no intention of endorsing a deal for the world's poorest countries
without being sure that it would be to their advantage. However, we understand
that in 1981, when industry was asked to quote its prices for the specific needs
of one African country, Rwanda, the prices they came up with averaged out at
more or less the same as those Rwanda was already paying without having to agree
to any special terms. (22)
Consequently, if lower prices were to be made conditional on their agreeing to
recognise patents and brand names, most developing countries would probably
do better bargaining for themselves by buying on competitive tender. That was
certainly the conclusion of a number of delegates at the 1982 World Health
Assembly. Brazil, for example, pointed out that by buying drugs on competitive
tender for health service requirements, the Government never paid more than
50% of local commercial prices. (23)
A number of the poorest countries expressed their uneasiness at the prospect of
any long term agreements they might have to strike with powerful drug producers.
These would reinforce their dependence and leave them highly vulnerable to future
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